New research reveals that trauma, poverty, discrimination, and housing instability have a more profound impact on mental health than clinical models acknowledge. Yet, mental health providers remain ill-equipped to respond.
A recent scoping review published in Translational Psychiatry offers a sobering analysis of how the social determinants of mental health (SDoMH) continue to be sidelined in clinical practice. Authored by a group of prominent psychiatrists and psychologists, the paper reviews the literature on how these social forces shape mental health outcomes and proposes new guidelines for integrating that knowledge into care.
Despite decades of evidence linking social and structural factors—such as poverty, trauma, and racism—to mental distress, the authors find a lack of institutional training, guidance, or infrastructure to support interventions that address these root causes.
“A healthcare system should start by identifying the SDoMH that apply widely in the community/ies it serves. Next, a community task force should determine which interventions to address the SDoMH are feasible locally or regionally. Finally, when assessing an individual patient, the clinician should determine which specific SDoMH are potentially modifiable and are of particular concern to a patient based on their and their family’s input,” the authors write.
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I am thinking it should be for all humans. We all every one of us in a sense is a survivor of something. Trouble is many don’t want to admit it or use it as in victomology.
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As true as this may be, I don’t think it is correct for the mental health system to get into social justice work.
What the mental health system must be able to do is determine when the social justice aspect of a person’s life (which I call Ethics) is more important than their actual mental experiences. Then there should be a separate system that addresses those issues.
Human psychology is a real subject. And it will not be solved by creating some sort of social justice utopia on Earth. The psychologists need to keep working on their part until they begin to get it right. And the social justice people can keep working on their part.
The purpose of Psychology should be to figure out how to achieve real mental health.
The purpose of the Social Justice Movement should be to figure out how to achieve real social justice.
Of course the two are connected. But they are not the same.
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If, as the author concludes (rightly, in my opinion), mental health providers are “slow to respond” to the economic and social factors that are responsible for a great deal of emotional distress among the impoverished, unemployed, homeless, and otherwise victimized, this can hardly be an accident.
I venture to say that the overwhelming majority of those engaged in this field are from the more privileged strata of society and therefore possess the considerable financial resources needed to pursue higher education. I really wouldn’t expect them to feel genuine empathy with the suffering of unfortunate individuals whose life experience is totally different, or to seriously challenge–at the risk of their careers and professional standing–the neoliberal system that embodies this competitive, mercenary culture.
The predictable result: exorbitant rehab centers and psychotherapy for the rich and well-connected; holding pens for members of the underclass unable to afford high-priced lawyers to bail them out of trouble; squalid, understaffed nursing homes administering potent drug cocktails and ECT to keep their infirm patients passive and compliant.
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“Slow to respond” is putting it mildly. “Largely impervious” is closer to the mark!
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