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The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: * Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level.* Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level.* All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward.* In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.
Social justice entails equal access to liberties, rights, and opportunities, as well as care for the least advantaged members of society. The paradigm-shifting new book Social (In)Justice and Mental Health addresses the ways in which society's failure to deliver on that humane ideal harms people with mental illness. The editors, at the forefront of the effort to make psychiatry responsive to critiques of institutional racism, argue that in the United States, a perfect storm of unfair and unjust policies and practices, bolstered by deep-seated beliefs about the inferiority of some groups, has led to a small number of people having tremendous advantages, freedoms, and opportunities, while a growing number are denied those liberties and rights. Mental health clinicians bear a special responsibility to be aware of these structural inequities, to question their own biases, to intervene on behalf of patients and their families, and to advocate for mental health equity. To that end, the book provides a framework for thinking about why these inequities exist and persist and provides clinicians with a road map to address these inequalities as they relate to racism, the criminal justice system, and other systems and diagnoses. The book is hands-on, with topics mental health clinicians will find timely and relevant: * The role of social injustice and specific diagnoses and conditions, including substance use disorders, schizophrenia, personality disorders, and child trauma, is covered. For example, research has shown that white psychiatrists are more likely to over diagnose schizophrenia in Black patients, and this diagnostic bias may partly account for Black men being involuntarily committed to mental institutions in higher numbers.* The authors advocate for research that prioritizes the needs of participants and communities, rather than the needs of institutions, and focuses on structural, not individual-level, differences.* Accompaniment, an important strategy for infusing social justice into clinical practice, is described and modeled. This process of radical empathy-of trying to minimize power dynamics in clinical relationships by listening, witnessing, and advocating with patients-is critically important in confronting mental health inequities. * The inadequacy of current medical and mental health education and training in countering the powerful forces of social injustice in mental health is discussed in detail. The authors emphasize that change requires adopting an active practice of self-study and self-reflection, and accordingly, a list of self-study resources, consisting of books, documentaries, podcasts, and TED talks, is provided to further the reader's knowledge and awareness. * Of further assistance are the chapter-ending "Questions for Self-Reflection," which challenge mental health clinicians to examine their own attitudes and preconceived ideas about race, poverty, disabilities, and privilege. Social (In)Justice and Mental Health addresses the context in which mental health care is delivered, strategies for raising consciousness in the mental health profession, and ways to improve treatment while redressing injustice. Clinicians owe it to themselves, their patients, and their profession to read-and heed-this important work.
This issue of Psychiatric Clinics, guest edited by Drs. Altha J. Stewart and Ruth Shim is entitled Achieving Mental Health Equity. This issue is one of four each year selected by our series consulting editor, Dr. Harsh Trivedi of Sheppard Pratt Health System. Topics in this issue include: The Business Case for Mental Health Equity; Shifting the Policy Paradigm to Achieve Equity; Clinical Considerations in an Equitable Mental Health Care System; Training Psychiatrists to Achieve Mental Health Equity; The Role of Organized Psychiatry; A Consumer and Family Perspective on mental health equity; as well as mental health equity for: Criminal Justice, Child and Adolescents, Addictions, Collaborative Care, and Community Psychiatry.
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