Symposium to Address Social Determinants of Mental Health

For at least two decades, social determinants of health—such as income status, education, food security, and other factors in the social environment—have been recognized by the World Health Organization and Centers for Disease Control and Prevention as playing a role in individuals’ health and well-being.

Not receiving as much attention have been the negative social determinants of mental health—stigma, loneliness and isolation, and substance use, among others At this year’s Annual Meeting, past APA President Dilip Jeste, M.D., chair of the APA Presidential Task Force on Social Determinants of Health and Mental Health, will lead a symposium that will introduce members to the work of the task force.

“More people with mental illnesses and substance use disorders are in prisons and jails than in hospitals,” Jeste said. “Our patients are less likely to receive needed treatments and more likely to die prematurely. The primary reasons for this state of affairs are social, not biological. During the last 25 years, there has been a behavioral pandemic of loneliness, social isolation, opioid abuse, and suicides. The increase in deaths of despair due to socioeconomic dislocation and ongoing mental health inequities caused by systemic racism reflect policies riddled with inequity. Recently, the COVID-19 pandemic and structural racism have worsened health inequities.”

The task force is charged with developing sustainable policies and programs to improve psychiatric care of affected populations consistent with APA’s Position Statement on Mental Health Equity and the Social and Structural Determinants of Mental Health. It aims to produce tools for action, specifically policies and programs to improve the well-being of patients, the public, and psychiatrists. They may be used by clinicians, teachers, researchers, and administrators of health care systems and community organizations, among others, to assess social determinants of mental health (SDoMH) and improve well-being at the individual and community levels. The task force has established four workgroups focusing on specific areas:

• Clinical Workgroup: Francis Lu, M.D. (chair), Tresha Gibbs, M.D., and Steven Koh, M.D.

• Policy Workgroup: Allan Tasman, M.D. (chair), Gary Belkin, M.D., and Lisa Fortuna, M.D.

• Public Health Workgroup: Kenneth Thompson, M.D. (chair), Michael Compton, M.D., and Sanya Virani, M.D.

• Research & Education Workgroup: Dolores Malaspina, M.D. (chair), Elie Aoun, M.D., and Kimberly Gordon-Achebe, M.D.

• At the Annual Meeting session, the chairs will report on the progress of their respective work groups.

Lu will discuss what clinicians should do to assess patients for SDoMH and provide appropriate treatment. Malaspina will describe the type of research and training needed to spread knowledge of SDoMH, including among the general public. Thompson will focus on the public health significance of SDoMH. He will review the literature on health consequences of SDoMH and make recommendations for addressing them at a systems level. Tasman will summarize what APA and government policymakers should do to promote strategies to change the mental health care system to prioritize SDoMH in their economic and financing considerations.

The session will end with a 20-minute question-and-answer session and general discussion. Look for further updates about dates and times. ■