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For the past 40 years or so, the biopsychosocial model has been an organizing framework for case formulation in clinical psychiatry. The basic sciences and neuroimaging, interventional and effectiveness research, and epidemiology have advanced our understanding of the pathophysiology, treatment, and prevalence and comorbidity of psychiatric disorders; however, societal and environmental factors and their contributions to the development of mental illnesses and substance use disorders continue to warrant research and programmatic attention. Social determinants of mental health are defined as societal, environmental, and economic conditions that influence and affect mental health outcomes at the population level. In considering the current state of psychiatry as well as future directions for the field, the importance of social factors that contribute to mental health should not be underestimated. These factors are primarily responsible for disparities and inequities in mental health services access, treatment quality, and outcomes seen within and between population groups. In this chapter we discuss the importance of social determinants of mental health, present up-to-date evidence on specific social determinants, explain the relevance of these social determinants to clinical psychiatry, and consider action points that could help reduce mental health inequities, prevent mental illnesses and substance use disorders, and promote mental health at the population level.
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