Mental health as a social problem
Increasingly, physical and mental health are understood not only in terms of individual and interpersonal factors, but in terms of social, political, cultural and economic drivers of health and illness.
In 2014 the World Health Organization (WHO) released a report detailing its conclusion that “mental health and many common mental disorders are shaped to a great extent by the social, economic, and physical environments in which people live.” The WHO has accordingly urged healthcare sectors, among others, to address “social, economic, environmental, and political determinants of the distribution of mental disorders across the lifespan” (WHO, & Calouste Gulbenkian Foundation, 2014, p.12).
The social determinants of health include education, employment and working conditions, built environment, physical environment, housing, gender, culture, ethnicity, safety, social connectedness, income, early childhood development, health and social services.
They are the circumstances in which people are born, grow up, live, work, and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies and politics.
The APS endorsed the WHO’s social determinants of health approach in 2012, acknowledging the social gradient in health and recognising the contribution of social determinants to unequal health outcomes. The APS has also been a member of the Social Determinants of Health Alliance since 2013.
In this issue A social determinants approach and Moving beyond diagnosis further our understanding on the importance of attending to the broader social, political and economic context within which our clients and indeed the profession of psychology are situated, and offer further support for psychologists to better pursue best-practice in socially and culturally sensitive psychological care.
The first article provides a robust discussion about the role of diagnosis within psychology and provides some alternatives to our largely medical understanding of mental health within this context. The second article builds on these concepts to discuss ways in which psychologists can apply a social determinants approach in clinical settings, specifically in case conceptualisation and treatment.
As health professionals working at the coalface, often seeing the outcome of preventable issues, psychologists are uniquely placed to adopt a social determinants of health approach.
- May, Carey, T. A., & Curry, R (2013). Social determinants of health: Whose responsibility? Australian Journal of Rural Health, 21(3), 139-140. doi: 10.1111/ajr.12050
- World Health Organization & Calouste Gulbenkian Foundation (2014). Social determinants of mental health. Geneva, Switzerland: World Health Organization.