The social determinants of mental health and disorder: evidence, prevention and recommendations

People exposed to more unfavourable social circumstances are more vulnerable to poor mental health across the life course, reflecting structural factors that generate and perpetuate intergenerational cycles of disadvantage and ill health. This paper provides a roadmap to address social determinants that cause mental ill health, focusing on pervasive determinants across the life course and common to major disorders, drawing primarily on evidence from the Global North and highlighting marginalized groups (refugees/asylum seekers, ethnoracially minoritized groups, LGBTQ+ communities, and people in poverty). The paper maps literature supporting causal links between social determinants and mental health, introduces a preventive framework (universal, selected, indicated; with secondary and tertiary strategies), reviews evidence for candidate preventive strategies that intervene on social determinants, and offers seven recommendations framed around social justice to guide research, policy and public health. Adoption of these recommendations could advance efforts to intervene on modifiable social determinants and improve population mental health while reducing inequalities.

James B. Kirkbride, Deidre M. Anglin, Ian Colman, Jennifer Dykxhoorn, Peter B. Jones, Praveetha Patalay, Alexandra Pitman, Emma Soneson, Thomas Steare, Talen Wright, Siân Lowri Griffiths