Portal de Periódicos da CAPES

The Social Determinants of Mental Health

2015; Volume: 13; Issue: 4 Linguagem: Inglês

10.1176/appi.focus.20150017

1541-4108

Michael T. Compton, Ruth S. Shim,

Psychological Well-being and Life Satisfaction

It is well known that social factors affect risk for mental illnesses and substance use disorders, as well as health outcomes of persons with these disorders. Social and environmental factors, in addition to their independent and combined effects, can influence genetic determinants of health and illness through gene-by-environment interactions and epigenetic mechanisms. Such social and environmental factors clearly have an effect at the individual level and should encounter intervention in the clinical setting. However, the social determinants of health and the social determinants of mental health exert their effects more broadly at the societal level and thus can be most effectively addressed through changes in public policies and social norms. Specifically, the social determinants of mental health—exemplified here by income inequality and poor education—are understood as being underpinned by unequal distribution of opportunity and, more deeply, by public policies (e.g., legislation that may not specifically pertain to health but ultimately has far-reaching effects on health) and social norms (e.g., cultural opinions and biases that set the stage for poorer health among disadvantaged groups). The greatest population-based impact for improving mental health and reducing risk of mental illnesses and substance use disorders will be achieved by optimizing public policies to make them more health promoting, and by altering social norms so that the health of all members of society is a priority.