When we talk about mental health, we tend to take a very individualistic approach. This is often entirely appropriate – everyone’s different, and our mental health is unique and personal to each one of us. But the world is an unequal place – and our mental health is also affected by the social and economic situations we find ourselves in. So it’s important to think about social inequalities and mental health too.
World Mental Health Day is on 10th October each year – and this year’s theme is ‘mental health in an unequal world’. So we’re thinking about the social factors that have an impact on our mental health and wellbeing – and trying to do our bit to make a difference too.
Social determinants of mental health
We can all experience mental health problems, whatever our background or financial circumstances. But the risk factors for mental health problems aren’t evenly distributed. Those who face the greatest disadvantages in life are also at greater risk of developing mental health problems.
According to the World Health Organization, mental health is shaped to a great extent by the social, economic and physical environments in which people live. The Canadian Mental Health Association also identifies the three main socioeconomic factors that have an impact on our mental health as: freedom from discrimination and violence; social inclusion; and access to economic resources.
Social inequalities are, sadly, all around us. Poverty, food insecurity, income inequality, job insecurity, poor housing, homelessness, racism, sexism, homophobia and disability discrimination, to name just a few. These social factors impact on our health – including our mental health.
How do social inequalities lead to mental health problems?
Our socioeconomic circumstances, combined with our individual risk of developing mental health problems, can make poor mental health more prevalent in certain communities. The Health Survey for England consistently finds that people in the lowest socioeconomic class have the greatest risk of mental health problems. And disadvantaged young people are two to three times more likely to develop mental health problems.
Some of the social inequalities that can negatively affect our mental health include:
- Discrimination. Whether it’s racism, misogyny, homophobia, transphobia, or prejudice related to immigrant or occupational status, discrimination has repeatedly been linked with negative mental health outcomes. Research shows that the emotional and psychological effects of racism are consistent with traumatic stress. For people with disabilities, an environment with poor accessibility also contributes to social exclusion.
- Bullying and violence. Being a member of a minority group can not only result in discrimination, it can lead to greater vulnerability to experiences such as bullying, hate crime, domestic violence or abuse. Studies show that experiences of bullying and violence put LGBTQ+ people at substantial risk of poor mental health outcomes, for example – especially through their link to suicide attempts, substance use and difficulties attending school.
- Poverty. It’s hard to enjoy good mental health if you don’t have enough money or are constantly financially stressed. Economic influences on mental health include income inequality, living in poverty or debt, employment status and educational level. Not only can the stress of poverty and debt lead to mental health problems, but they can also make existing mental health problems worse. Research shows that socioeconomic disadvantage is a cause of depression. One of the reasons for this may be due to people comparing themselves to others in unequal societies.
- Unemployment. Employment is important not just as a source of income, but as a factor in individual autonomy, fulfilment and confidence – plus the benefits of having the social support of colleagues. Unemployment has been found to increase mental distress, including higher risk of depression and anxiety.
- Homelessness. Homeless people are much more likely to have mental health problems compared to the general population. In 2015, 32% of single homeless people reported a mental health problem – and depression rates are over 10 times higher in the homeless population. Complex trauma, substance misuse and social exclusion are also common.
These negative effects can build up over time – which may also lead to mental health problems as a result of a lifetime of stress.
Ways to tackle social inequalities
If we can reduce social inequalities in society, and support communities and individuals to mitigate their effects, we can also reduce the prevalence of mental health problems. Three key areas are:
- Public policy – such as policies that seek to reduce discrimination, income inequality, poverty, food poverty, unemployment, homelessness or domestic violence.
- Community interventions – including activities that build community cohesion and connectedness, and increase awareness of community resources to support mental health.
- Individual resilience – such as education about how to look after your own mental health. This is an area where we can help, with our Self-care courses, including ‘Manage Anxiety’ and ‘Deal with Depression’.
What we’re doing at My Online Therapy
In recognition of this year’s World Mental Health Day theme of ‘mental health in an unequal world’, we’d like to do something to redress some of the inequality surrounding access to expert mental health care.
We’re giving away annual subscriptions to Self-care to some charities who are working to tackle inequalities in society – to their staff, volunteers and beneficiaries. We hope our Self-care courses will help people learn how to deal with mental health difficulties. Charities we’re currently working with include:
- Bags of Taste works to tackle food poverty by helping people achieve healthy eating on a low budget, through mentoring and courses.
- KORI helps young BAME people overcome disadvantaged and/or low-income backgrounds with mentoring, to nurture personal and professional growth.
- LandAid is the property industry charity, working to end youth homelessness in the UK. They bring the property industry together to support charities delivering life-changing services for young people who are or have been homeless, or who are at risk of homelessness in the future.
We’re hoping to roll out this offer to more charities in future. So if you’re interested in learning more, please get in touch.
Social inequalities can influence – and directly cause – mental health problems. But we can all take action, either individually or as part of a community or charity, to reduce social and economic inequalities – and reduce the impact they have on mental health and wellbeing. Together, we can all help to make mental health outcomes a little less unequal.