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PSYCHIATRY AT LARGE The social factors that drive mental health

PSYCHIATRY AT LARGE The social factors that drive mental health. Apu Chakraborty BA MB BS MA MRCPsych MSc PhD FRCPC Medical Manager, Community Mental Health HOpe Centre. Disclosures. Relationships with commercial interests: Unrestricted educational grants from Lundbeck & Lilly.

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PSYCHIATRY AT LARGE The social factors that drive mental health

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  1. PSYCHIATRY AT LARGEThe social factors that drive mental health Apu Chakraborty BA MB BS MA MRCPsych MSc PhD FRCPC Medical Manager, Community Mental Health HOpe Centre

  2. Disclosures • Relationships with commercial interests: • Unrestricted educational grants from Lundbeck & Lilly • Managing potential bias: • The industry companies listed above were not involved nor did they influence the content of this presentation • The following content complies with the UBC CPD standards

  3. A Model of the Determinants of Health

  4. Social Determinants of Health Aboriginal status gender disability housing early life income and income distribution education race employment and working conditions social exclusion food insecurity social safety net health services unemployment and job security Source: Raphael, D. (2009). Social Determinants of Health: Canadian Perspectives, 2nd edition. Toronto: Canadian Scholars’ Press.

  5. Social Determinants of Health and the Pathways to Health and Illness Figure shows how the organization of society influences the living and working conditions we experience that then go on to shape health. These processes operate through material, psychosocial, and behavioural pathways. At all stages of life, genetics, early life, and cultural factors are also strong influences upon health. Source: Brunner, E., & Marmot, M. G. (2006). ‘Social Organization, Stress, and Health.’ In M. G. Marmot & R. G. Wilkinson (Eds.), Social Determinants of Health. Oxford: Oxford University Press, Figure 2.2, p. 9.

  6. The “total drug effect” patient doctor intervention the room the world

  7. Working with ethno-cultural identity and values • story of our connections to heritage, ancestors; evolution of group identities as we migrate, organise, reorganise • cultural/religious tradition shapes myths, beliefs, organises perception of experience, determines limits of behaviour • cultural identity is basic to self respect, core values • important for therapeutic work to acknowledge, and use as source of resilience and strength

  8. Services perceived to be discriminatory Distrust is fuelled Avoidance Poorer service-related outcome: Police involvement, Compulsory admissions Poor medication adherence, missed appointments, disengagement from services

  9. Thank you apu.chakraborty@vch.ca

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