A social determination framework for mental health

Area of Science:

• Global Mental Health
• Social Medicine
• Decolonial Approaches

Background:

• Current global mental health practices overemphasize individual risk factors and biomedical treatments.
• Structural forces like globalization, colonialism, and neoliberal reforms are often overlooked as drivers of mental health inequities.
• There is a need for more socially embedded and decolonial perspectives in mental health research and policy.

Purpose of the Study:

• To critique reductionist frameworks in mental health that fragment structural causation.
• To articulate a social determination approach for mental health research and practice.
• To demonstrate how participatory and mixed-method research can support transformative, community-led responses.

Main Methods:

• Drawing on Latin American traditions of social medicine, particularly Jaime Breilh's paradigm of social determination of health.
• Critiquing reductionist frameworks that depoliticize structural causation into lists of risk factors.
• Emphasizing multi-level embodiment of power relations, historical-political organization of social life, and structural drivers in institutions and policies.

Main Results:

• Illustrative vignettes from Latin America demonstrate how historically structured processes become embodied as mental distress.
• These processes link global political economy, institutional arrangements, and everyday social relations.
• Participatory and mixed-method research can document these dynamics and support community-led responses.

Conclusions:

• Adopting a social determination lens can reorient global mental health policy and scholarship toward structural justice.
• This approach aligns with international calls to decolonize and politicize mental health research.
• It emphasizes collective agency and praxis in addressing mental distress.