Environmental Factors of Mental Health

*The language in this section was developed based on a review of similar research studies that utilize different terminology to describe the same concept.

The assumption that environmental factors (e.g., social, non-medical, and physical environments) influence health and well-being is not a new development. Non-medical Drivers of Health (NMDoH) is a concept that details how the conditions “where people are born, live, learn, work, play, worship, and age” affect a wide array of health risks, outcomes, and overall quality of life.1 More recently, discussions and research surrounding NMDoH has expanded to include how environmental factors also influence a person’s mental health.2

The inclusion of mental health in the NMDoH conversation is not far-fetched, as many of these environmental conditions can impact both physical and psychological well-being. As defined in research, the Social Determinants of Mental Health involve economic, social, and political systems that individuals interact with each day.3,4 Examples include socioeconomic status, exposure to childhood adversity, access to healthcare, as well as the physical environment in which people live.5 Understanding the intersection of a person’s life with these environmental factors can provide insight for developing effective, large-scale interventions that promote mental health care and well-being.

The following list of Social Determinants of Mental Health provides specific environmental conditions or experiences a person could face that can influence their mental health:

  • Social and environmental contexts;
  • Racial discrimination;
  • Adverse early life experiences;
  • Social Isolation;
  • Unemployment and underemployment, job insecurity;
  • Poor access to health care;
  • Poor education;
  • Economic inequality, poverty, and neighborhood deprivation;
  • Food insecurity;
  • Transportation barriers;
  • Poor housing quality and housing instability; and
  • Neighborhood and built environment.6,7,8,9,10

Certain populations are at higher risk of experiencing mental health challenges due to the aforementioned structural and environmental disadvantages.11 For instance, individuals with low socioeconomic status are systematically associated with increased rates of depression.12 This relationship is often reciprocal: poor mental health can create difficulties in finding and maintaining employment, which in turn reduces income, contributes to poverty, and increases the risk of mental disorders.13 Additionally, experiencing food insecurity is linked to an increase in a person’s anxiety, agitation, and poor mental health.14 The risks are amplified if an individual, family, or community is experiencing more than one of these determinants simultaneously.

Currently, there are Texas policies that aim to address some environmental factors of mental health for citizens with mental illness and behavioral and developmental disabilities. One example includes Texas’s COVID-19 supplemental public health emergency funding that is allocated toward housing initiatives at $45.6 million.15 This funding helps prevent individuals from experiencing housing instability and homelessness, entering the criminal justice system, or returning to a psychiatric hospital.16

Learn more about Texas policy recommendations from the Texas Consortium for the Non-Medical Drivers of Mental Health. Check out their report: Enhancing Texas’ Health Care Investments by Addressing Patients’ Non-Medical Needs

Moreover, Texas utilizes waivers obtained in the 1990s through Section 1915 of the Social Security Act to cover non-medical services, helping people with behavioral and intellectual disabilities access home meal delivery, transportation services, and employment assistance.17 Other recent legislative and policy actions, such as HHSC’s Medicaid & CHIP Services Non-Medical Drivers of Health Action Plan, Directed Payment Programs, and the Value-Based Payment and Quality Improvement Advisory Committee are assisting Texans in addressing needs that lie outside the bounds of traditional medical or psychiatric care.18

References

  1. Texas Health and Human Services. Non-medical drivers of health. (n.d.). https://www.hhs.texas.gov/about/process-improvement/improving-services-texans/medicaid-chip-quality-efficiency-improvement/non-medical-drivers-health ↩︎
  2. Jeste, D. V., & Pender, V. B. (2022). Social Determinants of Mental Health: Recommendations for Research, Training, Practice, and Policy. JAMA Psychiatry (Chicago, Ill.), 79(4), 283–284. https://doi.org/10.1001/jamapsychiatry.2021.4385 ↩︎
  3. Cuff, P. A., & Forstag, E. H. (2020). Educating health professionals to address the social determinants of mental health: proceedings of a workshop. Global Forum on Innovation in Health Professional Education; Board on Global Health; Health and Medicine Division; the National Academies of Sciences, Engineering, Medicine ↩︎
  4. Kirkbride, J.B. et al., (2024). The social determinants of mental health and disorder: evidence, prevention and recommendations. World psychiatry: official journal of the World Psychiatric Association (WPA), 23(1), 58–90. https://doi.org/10.1002/wps.21160 ↩︎
  5. Ibid. ↩︎
  6. Compton, M. T., & Shim, R. S. (2015). The Social Determinants of Mental Health. American Psychiatric Publishing, a division of American Psychiatric Association. ↩︎
  7. Kirkbride, J.B. et al., (2024). The social determinants of mental health and disorder: evidence, prevention and recommendations. World psychiatry: official journal of the World Psychiatric Association (WPA), 23(1), 58–90. https://doi.org/10.1002/wps.21160 ↩︎
  8. Alegría, M., NeMoyer, A., Falgàs Bagué, I., Wang, Y., & Alvarez, K. (2018). Social Determinants of Mental Health: Where We Are and Where We Need to Go. Current psychiatry reports, 20(11), 95. https://doi.org/10.1007/s11920-018-0969-9 ↩︎
  9. Allen, J., & Marmot, M. (2014). Social Determinants of Mental Health. Fundação Calouste Gulbenkian: World Health Organization. Retrieved from https://iris.who.int/bitstream/handle/10665/112828/9789241506809_eng.pdf?sequence=1 ↩︎
  10. Centers for Disease Control and Prevention. (2024, August 29). Current release notes. PLACES: Local Data for Better Health. https://www.cdc.gov/places/help/data-notes/index.html ↩︎
  11. Allen, J., & Marmot, M. (2014). Social Determinants of Mental Health. Fundação Calouste Gulbenkian: World Health Organization. Retrieved from https://iris.who.int/bitstream/handle/10665/112828/9789241506809_eng.pdf?sequence=1 ↩︎
  12. Ibid. ↩︎
  13. Ibid. ↩︎
  14. Compton, M. T., & Shim, R. S. (2015). The Social Determinants of Mental Health. American Psychiatric Publishing, a division of American Psychiatric Association. ↩︎
  15. Marks, E. M., & Mathias, C. W. (2024). (rep.). Enhancing Texasʼ Health Care Investments by Addressing Patientsʼ Non-Medical Needs. Rice University’s Baker Institute for Public Policy. ↩︎
  16. Ibid. ↩︎
  17. Ibid. ↩︎
  18. Ibid. ↩︎

Updated on December 13th, 2024



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