Social Factors and Specific Mental Health Issues

Mental health issues can be treated by designing comprehensive strategies that address these social determinants at the population level can improve the mental health of the population and reduce inequality. Because these strategies are more focused on improving mental health conditions by considering the social factors influenced by the conditions in which people are born, grow up, nurture,  work, married, and lead a life  (Baumeister & Bushman, 2020). According to Parker (2013), the systemic disparities in mental health based on gender, age, race, income, education, or geographic area of residence are both unfair and unjust due to which systemic inequalities between social groups are raised. Weick (2015) claimed that systemic inequalities are perceived to be avoidable are unjust which can be reduced by addressing social factors or social determinants.

Adler, Glymour, and Fielding (2016) identified that major health illnesses such as depression and anxiety are distributed along a gradation of socioeconomic status and the poor and disadvantaged people suffer most and disproportionately from major mental health disorders. A systematic review conducted by Compton and Shim (2015) related to the epidemiological literature investigated the prevalence of mental disorders and poverty in low- and middle-income regions. It was found that more than 70% of the studies reported that there is a positive relationship between measures of poverty and major mental illnesses. However, the strength of the relationship is influenced by the type of poverty measures used. Silva, Loureiro and Cardoso (2016) also confirmed that the link between low income and mental illnesses is rooted in each other and people living in lower SES and poor economic situations are more likely to develop major mental health disorders.  

Depression, schizophrenia and addictions:

Mental illness:	Social factors:
Depression	Social factors that can contribute to the development of depression include stress, low socio-economic status, lack of social support, and traumatic life events such as the loss of a loved one, physical or sexual abuse, or bullying. Studies have also shown that people who are exposed to high levels of chronic stress, such as those living in poverty or working in high-stress jobs, are more vulnerable to depression.
Schizophrenia	Social factors that can increase the risk of developing schizophrenia include poverty, homelessness, and exposure to urban living environments. Other risk factors include growing up in a high-stress family environment, experiencing abuse or neglect, and social isolation. People who experience these risk factors are more likely to develop the condition, although the exact cause of schizophrenia remains unknown.
Addictions	Social factors that can contribute to the development of addiction include peer pressure, availability of drugs, early exposure to drugs, and stressful life events such as trauma, abuse, or neglect. Additionally, people who are exposed to poverty, homelessness, or other forms of social marginalization may be more vulnerable to addiction as they may use drugs or alcohol to cope with stress and emotional pain.

Social Determinants of Mental Illness

A multi-layered framework was presented by Chiu and Hong (2013) to understand the social determinants of mental illnesses. This framework was applied to design strategies, policies, and interventions to prevent and reduce major mental disorders and promote mental health and well-being. The key areas of this framework are listed below which are important for two reasons. First, is that they influence the risk of psychiatric illness and second, they enable interventions to reduce the risk.

Life Course:

The social influences throughout all stages of life including prenatal, perinatal, infancy, adolescence, working and family years, and old age are represented by life path. There is a greater need to take action and measures to address health inequality at different stages of life. This is because, Silva, Loureiro and Cardoso (2016) highlighted that the symptoms of physical and major mental health illnesses are developed later in life, but are triggered by the experiences and events of the initial stages of life. Similarly, Compton and Shim (2015) suggested that stress and childhood trauma that occurs during the sensitive developmental period of early childhood affects the biological stress control system, immune system, and neural mechanisms in the brain that control psychological health. The effects of life-course stressors on these systems can be reduced by social support, responsiveness, love, and stable relationships with others.

Parents, families and households:

The social influences of parental behaviours and attitudes and the associated conditions such as income, parental employment, access to resources, water, food/nutrition, sanitation, housing, the status of employment and unemployment physical and mental health of parents maternal greatly impact the mental health of the families and individuals (Adler, Glymour, & Fielding, 2016).

Community:

The social factors related to the local community include social trust, safety, rate of violence/crime, community participation, built environment, and characteristics of the natural and local relationships (Baumeister & Bushman, 2020). Similarly, Weick (2015) claimed that community services are imperative to maintain the mental health of a community because early childhood facilities, education services and schools, youth services, clean water and sanitation, healthcare facilities, and social services should be addressed by the community service providers to ensure mental health. Community services provide a platform for developing and improving norms, social practices, and values while promoting community empowerment and participation. These types of social factors are driven by community-based efforts to improve key social determinants of mental health by integrating communities so that violence and discrimination can be prevented and access to economic resources could be improved  (Silva, Loureiro & Cardoso, 2016). Compton and Shim (2015) argued that many low- and middle-income countries lack the financial and human resources to design strategies and interventions for mental health care.

Country-level factors:

Social factors that impact mental health at the country level include poverty, inequality, governance, discrimination, armed conflicts, human rights, and national policies. Moreover, Chiu and Hong (2013) highlighted that access to education, employment, health, housing and healthcare services are imperative to be ensured at the country level for appropriate social protection of mental health. Countries with low levels of political freedom unstable political environments and underdeveloped service and monitoring systems lead to vulnerability for the population, which negatively affects mental health. Primary healthcare at the country level plays an important role in addressing mental health needs and promoting mental health. It is the first point of contact between citizens and health services in most countries of the world (Alegría et al., 2018). This allows for early recognition of mental disorders and prevents them from happening again in the future as well as promoting more professional services through the direct provision and referral of mental health (Parker, 2013). However, there are large differences between countries in the provision of primary health care because, in some countries, country-level primary healthcare is the main source of health care for the poor, disadvantaged people, and mental health patients  (Silva, Loureiro & Cardoso, 2016).

References:

(1) Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642.

(2) Alegría, M., NeMoyer, A., Falgàs Bagué, I., Wang, Y., & Alvarez, K. (2018). Social determinants of mental health: where we are and where we need to go. Current psychiatry reports, 20(11), 1-13.

(3) Baumeister, R. F., & Bushman, B. J. (2020). Social psychology and human nature. Cengage Learning.

(4) Chiu, C. Y., & Hong, Y. Y. (2013). Social psychology of culture. Psychology Press.

(5) Compton, M. T., & Shim, R. S. (2015). The social determinants of mental health. Focus, 13(4), 419-425.

(6) Parker, I., 2013. The Crisis in Modern Social Psychology (Psychology Revivals): and how to end it. Routledge.

(7) Silva, M., Loureiro, A., & Cardoso, G. (2016). Social determinants of mental health: a review of the evidence. The European Journal of Psychiatry, 30(4), 259-292. Weick, K. E. (2015). The social psychology of organizing. M@ n@ gement, 18(2), 189

(8) Weick, K. E. (2015). The social psychology of organizing. M@ n@ gement, 18(2), 189.