The social determinants of mental health and disorder: evidence, prevention and recommendations

World Psychiatry, Год журнала: 2024, Номер 23(1), С. 58 - 90

Опубликована: Янв. 12, 2024

People exposed to more unfavourable social circumstances are vulnerable poor mental health over their life course, in ways that often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage health. Addressing these challenges is an imperative matter justice. In this paper we provide a roadmap address the determinants cause ill Relying as far possible on high-quality evidence, first map out literature supports causal link between later outcomes. Given breadth topic, focus most pervasive across those common major disorders. We draw primarily available evidence from Global North, acknowledging other global contexts will face both similar unique sets require equitable attention. Much our focuses groups who marginalized, thus multitude intersecting risk factors. These include refugees, asylum seekers displaced persons, well ethnoracial minoritized groups; lesbian, gay, bisexual, transgender queer (LGBTQ+) living poverty. then introduce preventive framework for conceptualizing disorder, can guide much needed primary prevention strategies capable reducing inequalities improving population Following this, review concerning candidate intervene interventions fall broadly within scope universal, selected indicated strategies, but also briefly important secondary tertiary promote recovery with existing Finally, seven key recommendations, framed around justice, constitute action research, policy public Adoption recommendations would opportunity advance efforts modifiable affect

Язык: Английский

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Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: I. Clinical Outcomes

Schizophrenia Bulletin, Год журнала: 2023, Номер 49(4), С. 837 - 850

Опубликована: Апрель 6, 2023

Social determinants of health (SDoHs) are receiving growing attention and particularly relevant to persons with schizophrenia-spectrum psychotic disorders (SSPDs), considering their heightened risk comorbidities, cognitive functional decline, early mortality. Yet, we did not find any comprehensive review multiple SDoHs in SSPD.

Язык: Английский

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Recent Advances on Social Determinants of Mental Health: Looking Fast Forward

American Journal of Psychiatry, Год журнала: 2023, Номер 180(7), С. 473 - 482

Опубликована: Июль 1, 2023

The fields of psychiatry and mental health are increasingly recognizing the importance social determinants (SDOH) their impact on outcomes. In this overview, authors discuss recent research, from past 5 years, advances made in SDOH work. frameworks theories have expanded to include more conditions, traumas associated with immigration psychosocial community strengths, that well-being. Research has consistently shown pervasive deleterious impacts inequitable conditions (e.g., food insecurity, housing instability) minoritized populations’ physical health. Social systems oppression racism, minoritization) also been confer higher risk for psychiatric disorders. COVID-19 pandemic illuminated More efforts years intervene through interventions at individual, community, policy levels, which promise improving outcomes marginalized populations. However, major gaps remain. Attention should be paid developing guiding incorporate equity antiracism when designing methodological approaches evaluating these interventions. addition, structural-level policy-level critical making long-lasting impactful toward equity.

Язык: Английский

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The weaponization of medicine: Early psychosis in the Black community and the need for racially informed mental healthcare

Frontiers in Psychiatry, Год журнала: 2023, Номер 14

Опубликована: Фев. 9, 2023

There is a notable disparity between the observed prevalence of schizophrenia-spectrum disorders in racialized persons United States and Canada White individuals these same countries, with Black people being diagnosed at higher rates than other groups. The consequences thereof bring progression lifelong punitive societal implications, including reduced opportunities, substandard care, increased contact legal system, criminalization. Other psychological conditions do not show such wide racial gap as disorder diagnosis. New data that differences are likely to be genetic, but rather origin. Using real-life examples, we discuss how overdiagnoses largely rooted biases clinicians compounded by traumatizing stressors among due racism. forgotten history psychosis psychology highlighted help explain disparities light relevant historical context. We demonstrate misunderstanding race confounds attempts diagnose treat individuals. A lack culturally informed exacerbates problems, implicit prevent patients from receiving proper treatment mainly mental healthcare professionals, which can empathy. Finally, consider role law enforcement stereotypes combined psychotic symptoms may put danger police violence premature mortality. Improving outcomes requires an understanding perpetuating racism pathological stereotypes. Increased awareness training improve plight severe health disorders. Essential steps necessary multiple levels address issues discussed.

Язык: Английский

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Making cities mental health friendly for adolescents and young adults

Nature, Год журнала: 2024, Номер 627(8002), С. 137 - 148

Опубликована: Фев. 21, 2024

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education economic gain, urban environments are often detrimental

Язык: Английский

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Post‐traumatic stress disorder: evolving conceptualization and evidence, and future research directions

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 52 - 80

Опубликована: Янв. 15, 2025

The understanding of responses to traumatic events has been greatly influenced by the introduction diagnosis post‐traumatic stress disorder (PTSD). In this paper we review initial versions diagnostic criteria for condition and associated epidemiological findings, including sociocultural differences. We consider evidence reactions occurring in multiple contexts not previously defined as traumatic, implications that these observations have diagnosis. More recent developments such DSM‐5 dissociative subtype ICD‐11 complex PTSD are reviewed, adding there several distinct phenotypes. describe psychological foundations PTSD, involving disturbances memory well identity. A broader focus on identity may be able accommodate group communal influences experience trauma impact resource loss. then summarize current concerning biological with a particular genetic neuroimaging studies. Whereas progress prevention disappointing, is now an extensive supporting efficacy variety treatments established trauma‐focused interventions – cognitive behavior therapy (TF‐CBT) eye movement desensitization reprocessing (EMDR) non‐trauma‐focused therapies, which also include some emerging identity‐based approaches present‐centered compassion‐focused therapies. Additionally, promising neither nor pharmacological, or combine pharmacological approach, 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy. advances priority areas adapting resource‐limited settings across cultural contexts, community‐based approaches. conclude identifying future directions work mental health.

Язык: Английский

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AI chatbots cannot replace human interactions in the pursuit of more inclusive mental healthcare

SSM - Mental Health, Год журнала: 2021, Номер 1, С. 100017 - 100017

Опубликована: Авг. 30, 2021

Язык: Английский

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Police Violence and Public Health

Annual Review of Clinical Psychology, Год журнала: 2021, Номер 18(1), С. 527 - 552

Опубликована: Дек. 10, 2021

Despite their enormous potential impact on population health and inequities, police violence use of excessive force have only recently been addressed from a public perspective. Moving to change this state affairs, article considers in the USA within social determinants disparities framework, highlighting recent literature linking exposure mental symptoms, physical conditions, premature mortality. The review demonstrates that is common USA; disproportionately directed toward Black, Latinx, other marginalized communities; exerts significant adverse effect broad range outcomes. state-sponsored nature violence, its embedding historical contemporary context structural racism, unique circumstances itself make it an especially salient impactful form exposure, both overlapping with distinct forms violence. We conclude by noting solutions clinical psychology allied fields may offer toalleviate while simultaneously recognizing true solution issue requires drastic reformation or replacement criminal justice system, as well addressing broader systemic racism USA.

Язык: Английский

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Trauma and US Minority Children and Youth

Current Psychiatry Reports, Год журнала: 2022, Номер 24(4), С. 285 - 295

Опубликована: Март 14, 2022

Язык: Английский

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Association of Social Determinants of Health and Vaccinations With Child Mental Health During the COVID-19 Pandemic in the US

JAMA Psychiatry, Год журнала: 2022, Номер 79(6), С. 610 - 610

Опубликована: Апрель 27, 2022

Importance

The COVID-19 pandemic disproportionately affected mental health in socioeconomically disadvantaged children the US. However, little is known about relationship of preexisting and time-varying social determinants (SDoH) at individual structural levels, vaccination eligibility/rates, racial ethnic differences to trajectories child during pandemic.

Objective

To estimate association multilevel SDoH eligibility/rates.

Design, Setting, Participants

This prospective longitudinal cohort study, conducted from May 16, 2020, March 2, 2021, integrated structural-level, pandemic-related data with Adolescent Brain Cognitive Development (ABCD) (release 4.0). ABCD study recruited 11 878 (baseline) 6 rapid response surveys across 21 US sites (in 17 states) 2021.

Exposures

Preexisting (eg, household income) (area deprivation) food insecurity, unemployment) distancing, eligibility/rates) SDoH.

Main Outcomes Measures

Perceived Stress Scale, National Institutes Health–Toolbox emotion measures, COVID-19–related worry.

Results

sample included 8493 (mean [SD] age, 9.93 [0.63] years; 5011 girls [47.89%]; 245 Asian [2.34%], 1213 Black [11.59%], 2029 Hispanic [19.39%], 5851 White [55.93%], 1124 other/multiracial ethnicity [10.74%]). Trajectories stress, sadness, worry decreased after adult rollout. Compared younger children, boys, or those living married parents, who reported greater perceived stress older aged 12 15 years (β = 0.26; 95% CI, 0.12-0.41;P < .001); 0.75; 0.61-0.89;P 0.24; 0.01-0.47;P .04); separated parents 0.50; 0.03-0.96;P experiencing disrupted medical care access 0.19; 0.01-0.36;P economically deprived neighborhoods 0.28; 0.05-0.51;P .02); areas more full-time working-class adults were unable distance 1.35; 0.13-2.67;P states fewer fully vaccinated 0.59; 0.16-1.02;P .007). pandemic–related was higher among 0.22; 0.08-0.37;P .003), 0.33; 0.22-0.43;P .001), 0.17; 0.09-0.25;P 0.15; 0.09-0.21) treatment 0.11; 0.06-0.16). Inability afford associated increased sadness 1.50; 0.06-2.93;P .04). States later eligibility dates for all 0.16; 0.01-0.31;P .03) positive affect −1.78; −3.39 −0.18;P children.

Conclusions Relevance

Results this suggest a adverse minority groups, which may be improved by addressing modifiable (food unemployment, services, parental supervision) deprivation, job protection, vaccination)

Язык: Английский

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