Social determinants of mental health

Question 1

What is the social gradient in health?

Answer 1

People who are less advantaged have worse health than those who are advantaged.

Question 2

What is socioeconomic inequalities in mental health?

Answer 2

Those who live in the poorest households are more likely to experience mental health problems. Poverty is a modifiable risk factor for mental health

Question 3

What is the impact of socioeconomic factors on the mental health services?

Answer 3

In local areas, increased service demand which is already underfunded. This is due to patient’s circumstances like poor housing, stress related to debt or poverty
Less staff can afford transport

Question 4

What is the experience of low income?

Answer 4

Acute pressures about providing food, heating
Chronic pressures
Anxiety
Greater risk of Adverse Childhood Experiences

Question 5

What are the socioeconomic factors which link to mental health?

Answer 5

-> Social causation: experiences of poverty lead to poorer mental health
-> Health selection: Health determines socioeconomic position. Experiencing poor mental health problem leads to labour market disadvantage when job seeking
-> Adverse childhood experiences due to stressful childhood events which impact on adult health and financial circumstances

Question 6

How can social factors link to health?

Answer 6

Poverty can lead to stress and mental health magnified include:
-> debt and food insecurity
-> precarious employment
-> greater risk of experiencing adverse childhood experiences. This can be reduced through supportive relationships.
Greater availability of financial resources will mitigate this.

Question 7

What are the Adverse Childhood Experiences?

Answer 7

Stressful life experience including:
-> domestic violence
-> Separation
-> Parent with mental health condition
-> Victim of abuse or neglect
-> Member of household being in prison
-> Parental alcohol and drug problems
-> Living in care

Question 8

What should healthcare providers do about the social determinants of mental health?

Answer 8

-> Consider financial strain as a cause of symptoms
-> Social prescribers can identify financial strain and signpost to relevant services such as money and debt advice and support
-> Create social support networks, resources, community resilience

Question 9

How can preventative measures be implemented?

Answer 9

-> Addressing the costs of childhood
-> Adequacy in social security system
-> Improve the relationship between benefit claimants and Department for Work and Pensions