Social Determinants of Mental Health

On the 10th October, we celebrated World Mental Health Day

There has been a growing movement to recognise that our mental health is just as important as our physical health, and both should be treated and recognised with parity of esteem. 


How can we take care of our mental health? 

Our solution may be found within a few branches of the same tree: as individuals, we can look at how we take care of our own needs, and as global and local communities we need to change systems in order to set our future selves and future generations up for success. There seem to be an abundance of self-help articles and posts making their way around and so today, we’ll focus on that second branch. What systems and factors impact our mental health and wellbeing? 

According to the World Health Organization (WHO), mental health is “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. 

The social determinants of mental health, or those outside factors which influence it, include social, economic, and physical factors. This may seem like a no brainer, but “certain population subgroups are at higher risk of mental disorders because of greater exposure and vulnerability to unfavourable social, economic, and environmental circumstances, interrelated with gender. Disadvantage starts before birth and accumulates throughout life.” Let’s stop and think about that last statement. The disadvantage starts before the individual is even born. This is something that individuals have no control over and is something that progressively builds up as they spend more years on this earth. 

At each point in the span of an individual’s life these factors may present differently. As a young child the factors may include things such as who you learn from and spend time with (social), how much your parents make (economic), and what kind of nutrition or exercise you get (physical). As an older individual, the factors may look more like how often you get to see family, who your support system is (social), whether you are working or are able to retire (economic), and your level of  physical health based on your lifestyle and access to healthy and affordable food sources (physical). All of these factors impact your daily living routines. 

Let’s look at a few examples of the factors that support mental health across age span and then reflect on how these factors may have impacted you or a loved one:

  • Social connectedness through family, friends, community, sports, and religious groups
  • Access to safe outdoor spaces for exercise and play
  • Fresh/healthy foods which are readily accessible (both physically and monetarily) within your community
  • Stable relationships that provide companionship and support
  • Safety within a neighborhood, as related to violence, perceived threats, as well as physical aspects such as lead in water or unclean air or shelter availability
  • Fitting in with the social definition of “normal”
  • Connecting with our common humanity

Now think about how these factors could be influenced by social forces such as as racism, colonialism, disableism, classism, heteronormativity, and the traditional gender binary, to name a few. Think about how these factors can be influenced by the dominant culture.

What are some factors that have influenced your life or the life of a loved one?

  • As an infant?
  • Small child? 
  • Teenager?  
  • As an adult?

To come back to our tree analogy, a tree cannot grow without the rain and the sun, good soil, and protection from being chopped down, burned, or blown down by natural disaster. The things that are out of our control, both good and bad, influence the health of the tree. Acknowledging the myriad of supportive and risk factors at these various levels can be a good step to understanding this branch of our mental health. 

Next time you take stock of your mental health, I highly recommend thinking about the outside factors that may be influencing your ability to cope and to thrive. And if you are lucky enough to have a tree in full bloom right now, take a look around your community and see where you can contribute. Together we can make a difference for our future selves and for those around us!

Table 1: As listed from the WHO’s Social determinants of mental health (2014, p.17) and adapted from Unicef (2013, p.35)

Important areas for Research and Action:Details of each:
Life-coursePrenatal, pregnancy and perinatal periods, early childhood, adolescence, working and family building years, older ages all related also to gender
Parents, families, and householdsParenting behaviours/attitudes; material conditions (income, ac- cess to resources, food/nutrition, water, sanitation, housing, employment), employment conditions and unemployment, parental physical and mental health, pregnancy and maternal care, social support; 
CommunityNeighbourhood trust and safety, community based participation, violence/crime, attributes of the natural and built environment, neighbourhood deprivation;
Local servicesEarly years care and education provision, schools, youth/adolescent services, health care, social services, clean water and sanitation;
Country level factorsPoverty reduction, inequality, discrimination, governance, human rights, armed conflict, national policies to promote access to education, employment, health care, housing and ser- vices proportionate to need, social protection policies that are universal and proportionate to need. 

Sources:

World Health Organization and Calouste Gulbenkian Foundation. Social determinants of mental health. Geneva, World Health Organization, 2014. https://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf;jsessionid=0D16A605776C30F73B3816889EC5CCA8?sequence=1 

Bell R, Donkin A, Marmot M. Tackling structural and social issues to reduce inequalities in children’s outcome in low and middle income countries [paper submitted to Unicef]. 2013. https://www.unicef-irc.org/publications/708-tackling-structural-and-social-issues-to-reduce-inequities-in-childrens-outcomes.html 

Author: Emily Polovick-Moulds 
Bio: Emily is an American Occupational Therapist who is passionate about mental health, community participation, and prevention and wellness.

leave a comment

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.