Feldman JM, et al. Social determinants of mental health: report of the working group. Presented at the American Psychiatric Association Annual Meeting; May 21-25, 2022; New Orleans.

Disclosures: The speakers did not report any relevant financial information.

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NEW ORLEANS – Mental health services are only a small part of public health psychiatry, according to presenters here at the American Psychiatry Association’s annual meeting.

Kenneth StewartThompson

“Public health psychiatry is what we collectively do as a society to ensure the conditions for people to be mentally healthy,” said Kenneth Stewart Thompson, MD.

Source: Adobe Stock.
Source: Adobe Stock.

He spoke on a panel presenting a report from the APA’s Social Determinants of Mental Health Task Force.

Panelist Sanya Virani, MD, MPHexplained that the social determinants of mental health are societal issues that impede the achievement of optimal mental health.

“It’s not clinical care,” Thompson said. “I don’t think you can solve a collective problem one patient at a time. »

He said this aspect of psychiatry involves people and the health conditions they experience, promoting health, operating at the level of “place”, considering the impact of policies on people and reaching large numbers of people through program development, mental health services being just one part.

He shared examples of public health psychiatry: the elimination of lead from the environment, screening and early intervention for psychosis and other psychiatric problems, grassroots initiatives to promote emotional literacy and life skills. adaptation, reserved housing and the child tax credit.

This tax credit, Thompson said, “was probably the most important mental health intervention we’ve ever done, and we lost it. We lifted 50% of children in the United States out of poverty, and they’re back. It is shameful.

The working group came up with a list of recommendations for ABS, he said.

“There’s no better time than now to do something different in American psychiatry,” Thompson said. “We are a society in crisis. We cannot simply do more of what we have already done. We are among the most privileged people who have ever lived, sitting at the top of a society that daily generates the losses that make us rich. If we do nothing, we are complicit.

Member of the working group Gary Belkin, MD, PhD, MPH, former New York City deputy health commissioner, said, “We need to embrace the social. There are currently 28 antidepressants on the market. Our clinical model failed to reduce morbidity in our population.

“We believe that social determinants are about people who are disadvantaged and facing adversity,” he continued. “But it’s a call to favored people.” In New York, nurseries and places of worship immediately understood this.

Belkin said psychiatrists have to be out of their offices a day or two a week, making it the new norm for getting involved in child care centers and senior centers.

“We are proposing to create a center within the APA that will recruit national experts on this and start a long game to reach out to the rest of the world and show them all we can offer, he said. “A work plan must be included in the bylaws that push our allies and friends, the organizations that advocate for housing, equity and well-being.”

Virani noted that the task force will release a white paper detailing its findings and recommendations.