New Caucus on Social Determinants of Mental Health to Meet During Annual Meeting

The APA Caucus on Social Determinants of Mental Health (SDoMH) is seeking new members who are interested in the ways that social, economic, and environmental factors—such as food, housing, access to health care, education, and proximity to green space—influence the health of patients.

The caucus, APA’s newest, held its first meetings in February and March and will be meeting in May at this year’s Annual Meeting in San Francisco. The date and time will be announced in the PN Update enewsletter.

Eric Rafla-Yuan, M.D., was appointed chair of the caucus by APA President Rebecca Brendel, M.D., J.D.; his term expires in September. During the Annual Meeting, elections will be held for a chair-elect and other caucus positions.

Members interested in joining the caucus are urged to visit the Join a Caucus page on the APA website.

Rafla-Yuan noted that one of the first official actions of the caucus has been to cosponsor the proposed APA position statement on Housing, Homelessness, and Mental Health with the Council on Advocacy and Government Relations, the Council on Minority Health and Health Disparities, and the Council on Health Systems and Financing. The statement is expected to be submitted to the Joint Reference Committee later this year.

The proposed position statement asserts: “Studies have shown that the majority of homelessness triggers are not related to mental health disorders but are economic, such as the loss of a job and debt. Additionally, although individuals with mental illness are at increased risk for homelessness, multiple studies have also shown that the majority of individuals who are unhoused have neither mental illness nor substance use disorders.

“Conflation of mental health disorders with poverty and homelessness worsens stigma toward people with mental illness and toward people who are unhoused. … Large-scale trials demonstrate improved health outcomes and cost savings from scalable interventions such as permanent supportive housing. This includes the Housing First approach, which combines permanent housing with rehabilitation, support, and recovery services for people with disabilities. Housing First emphasizes choice and the belief that housing is a basic human right.”

Said Rafla-Yuan, “There is a general consensus that social determinants are extremely important and affect the health of our patients. It’s an active area of research, but the question for us as clinicians is how to translate that research into interventions that can impact the health of our patients. We must also recognize that social determinants of heath do not occur in a vacuum, but arise from policy decisions that we as psychiatrists can have a say in.”

He noted as well that while social determinants disproportionately negatively affect poor and disadvantaged communities, they can also be leveraged to influence health and mental health in positive ways that affect everyone.

“We need to think in a holistic way about SDoMH and have a diversity of voices that reflect how these factors affect our patients, ourselves, and the communities we live and practice in,” he said. “We are looking for psychiatrists who will take the research on social determinants and help APA apply it to policy, clinical care, and education. We want to train the next generation so that psychiatrists have an awareness of these issues and the tools to act and advocate on them.” ■