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Drawing on a qualitative synthesis of 18 studies, we show that ecological frameworks are predominantly used as descriptive mapping devices, that power and inequalities enter analyses in partial and fragmented ways, and that intersystemic connections often generate formally inclusive yet experientially exclusionary arrangements. To address these limitations, we propose an Integrated Ecological Model for Mental Disability, which retains Bronfenbrenner\u2019s multilevel architecture but introduces four structural extensions: asymmetry of reciprocity in the microsystem, the defensive mesosystem, capital-modulated exosystemic permeability, and the performative and normalizing exosystem. These concepts integrate Bourdieu\u2019s theory of capital and field, Foucault\u2019s genealogy of\n                    <jats:italic toggle=\"yes\">dispositifs<\/jats:italic>\n                    ,\n                    <jats:sup>1<\/jats:sup>\n                    and group psychoanalysis, and they are grounded in recurrent patterns observed across school transitions, family-service relations, residential services, and autism employment programs. The framework has implications for research designs that move beyond barriers and facilitators for multilevel clinical and educational interventions, and for normative debates on relational justice and psychopolitical validity in mental-disability policy.\n                  <\/jats:p>","DOI":"10.1177\/17456916261474857","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:36:43Z","timestamp":1790617003000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inclusion That Excludes: Rethinking the Ecological Model for Mental Disability Through Defensive Dynamics, Institutional Power, and Capital Asymmetries"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6798-0777","authenticated-orcid":false,"given":"Miriam","family":"Belluzzo","sequence":"first","affiliation":[{"name":"Department of Mental, Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-2146","authenticated-orcid":false,"given":"Giorgia","family":"Tiscini","sequence":"additional","affiliation":[{"name":"Department of Psychology, Research in Psychopathology and Psychoanalysis, Rennes 2 University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Ahmed R. 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