Awareness of the impact of environmental factors on health is not a new concept. What is new is the increased awareness of the relationship of our environment on mental health. While it may be clear to many people reading this article, we should clarify that in this context, the word environment really means environmental factors – and that phrase refers to more than the weather or geography. It means the impact that everything around you – everything we see when we look around – has an impact on our psychological and emotional lives, meaning everything we see when we look within.
In the language of psychology and sociology, experts discuss the intersection of environmental factors and health outcomes with the general phrase the social determinants of health. The American Medical Association (AMA) define the social determinants of health (SDOH) as follows:
“The underlying community-wide social, economic, and physical conditions in which people are born, grow, live, work and age.”
The Centers for Disease Control (CDC) the World Health Organization (WHO), and the U.S. Department of Health and Human Service (HHS) provide valuable resources on the SDOH. However, the definition provided by Kaiser Family Foundation (KFF) in their article “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity” is concise, informative, and comprehensive.
What Are the Social Determinants of Health?
The KFF publication identifies and defines the following social determinants of health and the practical components related to each. Their contribution to overall mental health cannot be understated.
The Social Determinants of Health (SDOH)
- Economic Stability
- Employment
- Income
- Expenses
- Medical bills
- Support
- Neighborhood and Physical Environment
- Housing
- Transportation
- Safety
- Parks
- Playgrounds
- Walkability
- Location
- Education
- Literacy
- Language
- Early childhood education
- Vocational training
- Higher education
- Food
- Hunger
- Access to healthy options
- Community and Social Context
- Support systems
- Community engagement
- Discrimination
- Stress
- Health Care
- Insurance coverage
- Provider availability
- Access to care
- Provider competency: linguistic and cultural
- Quality of care
That list combines factors from all the various resources on the SDOH we list above and integrates them into a single group, which helps us understand the following statement from the World Health Organization (WHO):
“Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health. For example, numerous studies suggest that SDOH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.”
This analysis relates to the overall health impact of the SDOH. Organizers at Mental Health America extracted and condensed the components of the SDOH that have the most powerful impact on mental health, and placed them at the top of the awareness and advocacy list:
- Safe, stable housing
- Healthy home environments
- Neighborhoods and towns
- Nature and the outdoors
We’ll explain how to join the advocacy movement this month below. First, we’ll offer the latest facts on figures on mental health in the U.S.
The MHA Report: Mental Health in the United States in 2023
Mental Health America collects and publishes helpful resources from trustworthy sources to produce their yearly report, “The State of Mental Health in America.” They collect important data on key metrics by analyzing available data to answer the following question:
- How many adults and youth have mental health conditions/diagnoses?
- How many adults and youth have access to insurance?
- How many adults and youth have access to adequate insurance?
- How many adults and youth have access to mental health care?
- Which states have higher barriers to accessing mental health care?
The State of Mental Health: Key Findings for 2023
Presence of Mental Health Condition/Diagnosis
- 21% of adults 18+ reported a mental health condition
- That’s over 50 million people
- 10% of adolescents age 12-17 reported depression that impairs their ability to engage in school or homes, school, family, work, or social life
- 16% of adolescents age 12-17 reported suffering at least one major depressive episode (MDE) in the past year.
- 11.5% of adolescents age 12-17 report depression with severe impairment
Suicidal Ideation
- 4.9% of adults 18+ reported having serious thought of suicide
- That’s 12.1 million people
- 11% of adults 18+ who identify as “more than one race” reported having serious thought of suicide
- That’s over twice the national average
- 22% of high school students reported having serious thoughts of suicide
Received Treatment
- 55% of adults 18+ with a clinical mental health diagnosis did not receive mental health treatment
- That’s 28 million people
- 29% of adults 18+ with a mental health diagnosis reported that they could not access the treatment they needed
- 60% of adolescents 12-17 with depression did not receive treatment
- 28% of adolescents 12-17 engaged in some form of consistent treatment
Insurance Coverage and Treatment Access
- 42% of adults 18+ with a mental health diagnosis didn’t receive care for financial reasons
- 23% of adults who missed two weeks or more of work for mental health reasons could not afford mental health treatment
- 11% of adults 18+ with a mental health diagnosis do not have insurance
- That’s 5.5 million people
- 10% of adolescents age 12-17 with private insurance are not covered for mental health or psychological services
Those are the latest, big-picture facts and figures on mental health in the U.S. They tell us at least three important things: first, millions of people need mental health support, second, millions of people do not get the treatment they need, and third: there’s a real need for Mental Health Awareness.
What You Can Do: Mental Health Awareness
In our introduction to the social determinants of health (SDOH) above, we identify four key ways we can all raise awareness, based on four SDOH components the advocates at MHA focus on: safe/stable housing, healthy home environments, community (neighborhoods and towns), and nature/the outdoors. When these components of life work in positive ways to support each individual, they increase the likelihood of overall mental wellness and emotional wellbeing.
That means that if you can find ways to make these components of life work for you, you increase your chance at achieving mental wellness and emotional wellbeing. And if you can find a way to improve these elements in the lives of your friends and family, then you can help improve their mental wellness and emotional wellbeing, too.
Safe and Stable Housing
This can be challenging for many people for many reasons. The main barriers to safe and stable housing are finances, age, and the presence of a mental health diagnosis. If you or someone you love has a mental health condition and experiences housing instability or disruptions in their home environment, please navigate to this page maintained by NAMI: Finding Stable Housing. Safe, consistent, and stable housing is a cornerstone of positive recovery, and barriers to safe stable housing can severely limit treatment, recovery, and the path toward mental health and wellness.
Healthy Home Environments
If you or someone you love has a mental health condition or has received a mental health diagnosis, a reliable and consistent home environment – think of it as a home base – is a critical factor for a successful recovery. Once you or your loved finds appropriate safe and stable housing, the next step is making it a peaceful, relaxing, comfortable home, conducive to healing and recovery. The absence of a home base can create stress and sense of isolation, whereas the presence of a real home base decreases stress and increases feelings of connectedness, self-esteem, and self-worth.
Things in your home that you may not think affect your mental health, but actually do, include:
- Maintaining basic cleanliness and tidiness
- Keeping the home well-lit and well-ventilated
- Creating sleep-friendly rooms for rest and quiet personal time
- Small touches that increase feelings of positivity and calmness, including art, houseplants, or flowers
When the home feels peaceful and nurturing, the chance of health and healing increases.
Community
Whether you live in a big city, a small town, or a suburban neighborhood, your community exists. To help you or a loved one improve your overall mental health and sense of wellbeing, the advocates at MHA recommend creating bonds with people in your environment, meaning your neighbors and community. You can do this by:
- Talk to your neighbors. You don’t have to become a busybody and suddenly get all up in everyone’s business. Say hello, find out who they are, and keep an eye on them. Help when they need help, and accept help when offered.
- Be visible. Get outside. Go for walks, sit on the stoop, get out in the yard. Being seen is the first step to being known and being heard.
- Join the groups. Join any neighborhood associations you can. Show up for the volunteer days, the block parties, the zoning meetings, the school events, everything: if and when people see you helping, they may help you when you’re in need
- Offering help. If you see a neighbor who needs help, then help them in whatever way you can and in whatever way they’ll accept. This will help you feel a sense of purpose, and increase the likelihood your neighbors will support you when you need it
Nature and the Outdoors
With regards to mental health, your environment, and overall emotional wellbeing for you or a loved one, this is crucial. You need to spend time outside. Time outside in greenspace is even better. Research shows that spending time in a small urban park or greenspace can improve mood and wellbeing in the same way that spending time in a state or national park can: it reduces stress, improves mood, and increases overall wellness. You don’t have to go overboard or become a hardcore hiker: what matters is that you get outside – preferably near trees or water – and spend time enjoying the simplicity of the sights and sound of nature. It’s one of the best ways known to rest, reset, and recharge – and it also support another “R” word: recovery.
Join the Movement: Look Around, Look Within
We encourage everyone who reads this article to consider the four bullet points above, and find ways to implement those suggestions in daily life. This is especially true if you have a mental health condition, or you know someone with a mental health condition or diagnosis and factors in their environment make things more difficult. Look around to see who you can help – and suggest they take the steps we list above. Look within to see if you need help – if you do, take the steps we list above. Finally, if you think you or a loved one has a mental health condition that has not been diagnosed, we recommend arranging a full mental health evaluation performed by a mental health professional. The sooner you or your loved one gets the treatment they need, the better the outcome.
About Relief Mental Health
Relief Mental Health is an outpatient provider of transcranial magnetic stimulation (TMS), SPRAVATO® (esketamine), psychiatry/medication management services, and talk therapy for the treatment of depression, obsessive compulsive disorder, anxiety and other mental health diagnoses. A member of the Rockford Area Chamber of Commerce, Relief Mental Health has 10 clinics in three states, including one right here in Rockford. For more information, visit reliefmh.com, call 855.205.4764 or email info@reliefmh.com.
