When I was an adolescent and young adult, I struggled with depression. As I reflect back on that time, so much of what I was experiencing was deeply tied to coming to terms with my sexuality. Growing up in the 1980’s in a relatively conservative town, I was closeted (even to myself) until I was a young adult. The pain and fear of being different, of not belonging, of being judged or rejected for who I was more than my adolescent brain could wrap its conscious head around.

This post argues for the application of the social determinants frameworks to the problems of mental health. What this post misses or underemphasizes are the opportunities to change through social policy some of the social circumstances that help shape the likelihood of mental health challenges.

Much evidence has been published supporting Pender's call for social determinants to be considered as key in understanding and treating mental illness. The Lancet Commission on global mental health and sustainable development stated that research consistently shows a strong association between social disadvantage and poor mental health. The COVID-19 pandemic has further focused attention on the importance of social determinants in causing both mental and physical illness.

One of the largest and, arguably, most successful efforts to “Open Dialogue” differences in community and culture challenges - Peer-supported Open Dialogue (POD) - has resulted in the largest research study yet of Open Dialogue-inspired services. The ODDESSI trial is studying the adoption of Peer-supported Open Dialogue within several of the U.K.’s National Health Service trusts.

“Mental Health Is Political,” a guest essay by Professor Danielle Carr in the New York Times (9.20.2022), asks “What if the cure for our current mental health crisis is not more mental health care?” She argues that what has been called an “’epidemic’ of mental illness” medicalizes what is primarily a social and political problem – that is, it makes it a medical problem to be dealt with through treatment rather than a larger social problem to be addressed through changes in social policy and...