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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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