Commercial determinants of mental health

Conceptualising the commercial determinants of suicide: broadening the lens on suicide and self-harm prevention

“…The importance of commercial drivers to other health issues has garnered increasing attention, with clear recognition that understanding and countering these drivers is important for the prevention of harm, and for protecting the production of knowledge and policymaking. 11 The most obvious and comprehensive example is the recognition by the WHO and its member states that the tobacco industry is a leading driver of tobacco-related harms, and a formidable obstacle to policies directed at reducing those harms globally. Another important example is the International Code of Marketing of Breast-milk Substitutes, adopted by the 34th session of the World Health Assembly (WHA) in 1981, which "aims to stop the aggressive and inappropriate marketing of breast-milk substitutes", including restricting the activities of infant formula manufactures and distributors in their interactions with the public, mothers, and health workers.…”

“…Powerful corporations or entire industries adopt sophisticated corporate political strategies to secure and maintain permissive regulatory environments that allow them to maximise product affordability, availability and accessibility and thus profits, with some pursuing such an agenda despite the harms this poses to public health and environmental sustainability. 11 Commercial actors can shape the production of knowledge and ignorance (or doubt) by influencing the entire 'pipeline' of science, from research agendas and conduct, through to research dissemination, use and understanding of evidence in policymaking and the media, the setting of standards of proof, what is defined as evidence and who is seen as a legitimate 'expert'. 13,14 Commercial actors seek to shape social norms about the role of government and regulation, and the balance of individual versus collective responsibility for problems that societies are challenged with addressing.…”

“…13,14 Commercial actors seek to shape social norms about the role of government and regulation, and the balance of individual versus collective responsibility for problems that societies are challenged with addressing. 11,15,16 Such actors can influence public health by promoting a particular problem definition over alternative definitions that may threaten business interests, thereby setting the terrain on which responsibility for an issue is assigned and restricting the solutions that come to be seen as necessary and legitimate. 17,18 Corporations whose products and practices are health harming or environmentally destructive often seek to emphasise the benefits they provide through job creation, taxation or through corporate philanthropy, while deflecting from the negative impacts of their practices and products.…”

“…Indeed, the activities of specific industries and their allies to cast doubt, shift blame and resist regulation, from lead, silica, and asbestos to tobacco, sugar, opioids, highly hazardous pesticides, and fossil fuels, for example, have led to (and indeed are often designed to create) delays in taking action to prevent harm with devasting outcomes for people and the planet. 11,16,[19][20][21][22]…”

“…These activities can help an industry or corporation to portray themselves as part of the solution and to gain legitimacy. 11,16,41 Industry promotion of education and awarenessbased measures has the potential to serve as a form of policy substitution with the aim of preempting more restrictive and evidence-informed policy approaches. 6,9,42 The implications of these types of corporate strategies for suicide prevention warrant further scrutiny and future analysis.…”