scholarly journals National or population level interventions addressing the social determinants of mental health – an umbrella review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Neha Shah ◽  
Ian F. Walker ◽  
Yannish Naik ◽  
Selina Rajan ◽  
Kate O’Hagan ◽  
...  

Abstract Background Social circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198). Results We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk. Conclusion This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health.

2019 ◽  
Vol 83 (3) ◽  
pp. 162-171
Author(s):  
Tom Swinson ◽  
Jennifer Wenborn ◽  
Paul Sugarhood

Introduction Evidence suggests group walking in natural environments is more beneficial to the general population’s mental health than walking indoors, in urban environments, and alone. Such ‘green walking groups’ have been suggested as an occupational therapy intervention that could be suitable for adults with mental health problems. However, there have been no reviews of the mental health outcomes of participating in green walking groups for this population. Method A mixed-methods literature review was conducted. A range of databases was systematically searched electronically. Papers that met pre-defined inclusion criteria were selected, critically appraised, and qualitative and quantitative data were extracted. Thematic analysis was used to identify key qualitative outcomes. Findings Six papers were included and eight mental health outcomes identified. The evidence suggests participants can experience connections with other people, connections with nature, and a sense of freedom. There is some limited evidence to support improvements to mood, self-esteem, reflection on life tasks, and symptoms of depression, with mixed evidence for experiencing a sense of achievement. Conclusion This review can be used to build the evidence base for the link between occupation and mental health, and inform the clinical decision-making of occupational therapists, who are well-placed to design and implement green walking groups.


2020 ◽  
Vol 7 (2) ◽  
pp. 162-172 ◽  
Author(s):  
Corrado Barbui ◽  
Marianna Purgato ◽  
Jibril Abdulmalik ◽  
Ceren Acarturk ◽  
Julian Eaton ◽  
...  

Author(s):  
Susan Wingert

This article examines how the social structure distributes risk and protective factors and mental health outcomes within the off reserve Aboriginal population in Canada. It uses the stress process model, a prominent model in the sociology of mental health, to explore pathways between social status, stress, coping resources, and mental health outcomes. Path analyses are used to decompose total effects on distress and well-being into direct and indirect or mediating pathways. The results suggest that stress, mastery, and social support are important mediators between social status and mental health outcomes. Stress appears to be a stronger contributor to distress while mastery and social support are of higher relative importance to well-being.


2020 ◽  
Author(s):  
Md Mahbub Hossain ◽  
Abida Sultana ◽  
Neetu Purohit

Background: Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent novel coronavirus disease (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases.Materials and methods: We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population.Results: Among 1364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes.Conclusion: This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.


2021 ◽  
Vol 218 ◽  
pp. 108385
Author(s):  
Xiao Li ◽  
Jacob T. Borodovsky ◽  
Erin M. Kasson ◽  
Andrea Fentem ◽  
Patricia A. Cavazos-Rehg

2015 ◽  
Vol 24 (2) ◽  
pp. 107-113 ◽  
Author(s):  
J. K. Burns

The relationship between poverty and mental health is indisputable. However, to have an influence on the next set of sustainable global development goals, we need to understand the causal relationships between social determinants such as poverty, inequality, lack of education and unemployment; thereby clarifying which aspects of poverty are the key drivers of mental illness. Some of the major challenges identified by Lund (2014) in understanding the poverty–mental health relationship are discussed including: the need for appropriate poverty indicators; extending this research agenda to a broader range of mental health outcomes; the need to engage with theoretical concepts such as Amartya Sen's capability framework; and the need to integrate the concept of income/economic inequality into studies of poverty and mental health. Although income inequality is a powerful driver of poor physical and mental health outcomes, it features rarely in research and discourse on social determinants of mental health. This paper interrogates in detail the relationships between poverty, income inequality and mental health, specifically: the role of income inequality as a mediator of the poverty–mental health relationship; the relative utility of commonly used income inequality metrics; and the likely mechanisms underlying the impact of inequality on mental health, including direct stress due to the setting up of social comparisons as well as the erosion of social capital leading to social fragmentation. Finally, we need to interrogate the upstream political, social and economic causes of inequality itself, since these should also become potential targets in efforts to promote sustainable development goals and improve population (mental) health. In particular, neoliberal (market-oriented) political doctrines lead to both increased income inequality and reduced social cohesion. In conclusion, understanding the relationships between politics, poverty, inequality and mental health outcomes requires us to develop a robust, evidence-based ‘political economy of mental health.’


Author(s):  
Joao H. Bettencourt-Silva ◽  
Natasha Mulligan ◽  
Charles Jochim ◽  
Nagesh Yadav ◽  
Walter Sedlazek ◽  
...  

Social determinants of health (SDoH) are the factors which lie outside of the traditional health system, such as employment or access to nutritious foods, that influence health outcomes. Some efforts have focused on identifying vulnerable populations during the COVID-19 pandemic, however, both the short- and long-term social impacts of the pandemic on individuals and populations are not well understood. This paper presents a pipeline to discover health outcomes and related social factors based on trending SDoH at population-level using Google Trends. A knowledge graph was built from a corpus of research literature (PubMed) and the social determinants that trended high at the start of the pandemic were examined. This paper reports on related social and health concepts which may be impacted by the COVID-19 outbreak and may be important to monitor as the pandemic evolves. The proposed pipeline should have wider applicability in surfacing related social or clinical characteristics of interest, outbreak surveillance, or to mine relations between social and health concepts that can, in turn, help inform and support citizen-centred services.


2022 ◽  
Author(s):  
Marlee Bower ◽  
Scarlett Smout ◽  
Amarina Donohoe-Bales ◽  
Lily Teesson ◽  
Eleisha Lauria ◽  
...  

Introduction: Vast available international evidence has investigated the mental health impacts of the COVID-19 pandemic. This review aims to synthesise evidence, identifying populations and characteristics associated with poor mental health.Methods: A meta-review of pooled prevalence of anxiety and depression, with subgroup analyses for the general population, healthcare workers (HCW) and COVID-19 patients; and a meta-synthesis of systematic reviews to collate evidence on associated factors and further mental disorders. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to May 2021. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the pandemic.Results: Eighty-one systematic reviews were included, 51 of which incorporated meta-analysis. Meta-review overall anxiety prevalence was 29% (95%CI: 27–31%, I2: 99.83%), with subgroup prevalence as 35% (95%CI: 23–47%, I2: 97.4%) in COVID-19 patients, 29% in HCW (95%CI: 25– 32, I2: 99.8%) and 28% in the general population (95%CI: 25–31%, I2: 99.9%). Meta-review overall depression prevalence was 28% (95%CI: 26–30%, I2: 99.7), with subgroup prevalence as 30% (95%CI: 7–60%, I2: 99.8%) in COVID-19 patients, 28% (95%CI: 25–31%, I2: 99.7%) in HCW and 27% (95%CI: 25–30, I2: 99.8%) in the general population. Meta-synthesis found many experienced psychological distress and PTSD/PTSS during COVID-19, but pooled prevalence ranged substantially. Fear of, proximity to, or confirmed COVID-19 infection; undergoing quarantine; and COVID-19-related news exposure were associated with adverse mental health outcomes. Amongst other factors, people who are younger, female, LGBTIQ, pregnant, parents or experiencing low social support, financial issues or socio-economic disadvantage, tended to have poorer mental health during the pandemic period.Conclusions: Despite high volumes of reviews, the diversity of findings and dearth of longitudinal studies within reviews means clear links between COVID-19 and mental health are not available, although existing evidence indicates probable associations.


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