Social determinants and mental health

Bell, Ruth; Marmot, Michael

doi:10.1093/med/9780198861478.003.0020

Cited by 4 publications

(5 citation statements)

References 2 publications

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“…Over the past few decades, a substantial range of epidemiological studies have established that there are social determinants of health, that is, a positive correlation between higher social status and better health, the so-called social gradient in health, which underpins health inequalities (Marmot, 2006). This applies to both physical health and mental health (Bell & Marmot, 2022).…”

Section: Bpsm Core Theorymentioning

confidence: 99%

A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications

Bolton

2023

Psychol. Med.

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The biopsychosocial model (BPSM) was proposed by George Engel in 1977 as an improvement to the biomedical model (BMM), to take account of psychological and social as well as biological factors relevant to health and disease. Since then the BPSM has had a mixed reputation, as the overarching framework for psychiatry, perhaps for medicine generally, while also being criticized for being theoretically and empirically vacuous. Over the past few decades, substantial evidence has accumulated supporting the BPSM but its theory remains less clear. The first part of this paper reviews recent well-known, general theories in the relevant sciences that can provide a theoretical framework of the model, constituting a revitalized BPSM capable of theorizing causal interactions within and between biological, psychological, and social domains. Fundamental concepts in this new framework include causation as regulation and dysfunction as dysregulation. Associated research paradigms are outlined in Part 2. Research in psychological therapies and social epidemiology are major examples of programs that have produced results anomalous for the BMM and consistent with the BPSM. Theorized models of causal mechanisms enrich empirical data and two biopsychosocial examples are models of chronic stress and pain perception. Clinical implications are reviewed in Part 3. The BPSM accommodates psychological and social as well as biological treatment effects evident in the clinical trials literature. Personal, interpersonal, and institutional aspects of clinical care are out of the scope of the BMM, assigned to the art of healthcare rather than the science, but can be accommodated and theorized in the BPSM.

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Section: Bpsm Core Theorymentioning

confidence: 99%

A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications

Bolton

2023

Psychol. Med.

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“…Social disadvantage strongly affects health outcomes for the general population [ 37 ]. For people living with mental illness, this effect is amplified [ 39 ]. While people living with mental illness have 2.4 times increased risk of early death, for those with low SES, this increases to three times, and for those not in full-time employment, it is five times the risk (see Figure 2 ).…”

Section: Social Health Physical Health and Mental Healthmentioning

confidence: 99%

The Potential Impact of a Public Health Approach to Improving the Physical Health of People Living with Mental Illness

Roberts

Johnson

Hopwood

et al. 2022

IJERPH

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With already wide disparities in physical health and life expectancy, COVID-19 presents people with mental illness with additional threats to their health: decreased access to health services, increased social isolation, and increased socio-economic disadvantage. Each of these factors has exacerbated the risk of poor health and early death for people with mental illness post-COVID-19. Unless effective primary care and preventative health responses are implemented, the physical illness epidemic for this group will increase post the COVID-19 pandemic. This perspective paper briefly reviews the literature on the impact of COVID-19 on service access, social isolation, and social disadvantage and their combined impact on physical health, particularly cancer, respiratory diseases, heart disease, smoking, and infectious diseases. The much-overlooked role of poor physical health on suicidality is also discussed. The potential impact of public health interventions is modelled based on Australian incidence data and current research on the percentage of early deaths of people living with mental illnesses that are preventable. Building on the lessons arising from services’ response to COVID-19, such as the importance of ensuring access to preventive, screening, and primary care services, priority recommendations for consideration by public health practitioners and policymakers are presented.

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“…There is consensus that our mental health depends on the conditions we live in and the events that happen to us ( 1 ). It has been argued that those Social Determinants of Mental Health (SDMentH) are the main drivers of our health outcomes ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Development and content validation of a questionnaire to assess the social determinants of mental health in clinical practice

Handerer,

Kinderman,

Nevard

et al. 2024

Front. Psychiatry

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IntroductionThere is growing consensus that consideration of the Social Determinants of Mental Health should be at the centre of mental health care provision. To facilitate this, a validated means to assess mental health service users' social contextual information is arguably needed. We therefore developed a questionnaire to assess the Social Determinants of Mental Health in clinical practice.MethodsOur guideline-informed development consisted of three steps; i) construct and purpose definition, ii) initial item generation based on the literature, similar questionnaires, and a selection of the ICD-10, iii) evaluation, revision, and content validation of the questionnaire. Initially we developed 249 items that were reduced, revised, and validated in several stages to 73 items. Content validation of the questionnaire was achieved through surveys and focus groups including mental health care service users and professionals.ResultsThe surveys and focus groups indicated the need for a standardised assessment of adverse social factors and highlighted that the benefits of such an assessment would be a more holistic approach to identifying and addressing fundamental factors involved in the development of mental health difficulties. Importantly, this study also revealed how any assessment of the Social Determinants of Mental Health must prioritise the assessed person having a central role in the process and control over their own data. The focus groups identified contradicting recommendations regarding the most suitable context to administer the questionnaire.DiscussionThe resulting questionnaire can be considered to be theoretically robust and partially validated. Future research is discussed.

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Social determinants and mental health

Cited by 4 publications

References 2 publications

A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications

A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications

The Potential Impact of a Public Health Approach to Improving the Physical Health of People Living with Mental Illness

Development and content validation of a questionnaire to assess the social determinants of mental health in clinical practice

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