Do mental health problems exist within ourselves or within our societies?


A perspective for Mental Health Awareness Week.

Mental Health Awareness Week has been accompanied by a cascade of newspaper reports and social media posts encouraging people to talk more openly about their mental health. Nurturing a society with positive attitudes towards their emotional wellbeing and a tendency to accept and support those around them who are struggling is invaluable. However, framing mental health issues in this way places the responsibility of finding solutions on the individual. This approach has the potential to undermine the social determinants of mental health.

Mental health and many common mental disorders are shaped to a great extent by the social, economic, and physical environments in which people live. – WHO

Mental health disorders can be attributed in large part to the life circumstances in which they arise. Across a lifetime distress can find its roots in exposures as babies, trauma in childhood and stressful employment in adulthood.

Financial problems, poor housing and breakdown of relationships all cause emotional stress. Poverty increases the likelihood of someone encountering adversity and eradicates the financial and social safety net to catch them.

This is what leads people to despair.

But – governments can provide a safety net in the form of welfare provision and adequate funding for support within the community.

There are almost certainly biological and psychological mechanisms that translate adversity and stress into severe distress and disorder. But rather than thinking of the consequences as ‘brain disorders’, which suggests that ‘the brain’ is primary, these conditions could equally be called ‘social adversity disorders’ – Nikolas Rose

To find solutions to mental health problems we need policies directed at the social conditions which produce them and comprehensive support which meets the emotional, social, health, nutritional and psychological needs of our population. Below is a summary of national strategies which could have a significant impact on mental health inequalities.

Evidence suggests that these country level policies have the potential to improve the mental health of a population.

The emotional impact of COVID-19 is undeniable – in a recent survey by the National Board of Italian Psychologists 80% of people said they needed psychological support to overcome the effects of the pandemic. As society rebuilds it is critical that governments implement policy which considers the social determinants of mental health.


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