The Social Determinants of Mental Health: Psychiatrists’ Roles in Addressing Discrimination and Food Insecurity
Abstract
Conceptualizing the Social Determinants of Mental Health
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Two Examples of the Social Determinants of Mental Health
Type of discrimination | Definition | Example |
---|---|---|
Interpersonal (individual) | Face-to-face or covert acts of discrimination toward a person | Physician’s implicit bias that leads to poorer treatment of a patient |
Institutional (organizational) | Policies and practices within and across institutions that disadvantage certain groups | Denial of mortgage applications to black and Latinx populations compared with white populations with similar credit histories |
Structural (systemic) | A system in which public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing, ways to perpetuate group inequities | Mass incarceration and its disproportionate effects on people of color |
Legal (de jure) | Discrimination that is mandated by law | Jim Crow laws; racial housing covenants |
Illegal (de facto) | Discrimination that is without legal basis but sanctioned by custom or practice | Underrepresentation of women and minorities in leadership roles in medicine |
Overt | Blatant forms of discrimination | Racist or sexist epithets |
Covert | Subtle forms of discrimination | Microaggressions |
BOX 1. Two-item screening for food insecurity and examples of questions that clinicians can ask to follow up on a positive screening
Psychiatrists’ and Mental Health Professionals’ Roles
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