Addressing the Social Determinants of Mental Health: If Not Now, When? If Not Us, Who?

In public health, recognition of the importance of the social determinants of health has led to significant shifts in practice and research. Psychiatry is making great progress in developing evidence-based, high-fidelity treatments that improve outcomes for patients who have access to high-quality mental health care. But for the less fortunate, acting further upstream, long before these mental health problems occur, is just as important as advancing new treatments. "Treating" the social determinants of mental health involves focusing more on policies than on medication, therapy, and neurobiological innovation. It entails creating public policies that improve these issues and changing social norms to place greater value on giving everyone an equal chance at living a fulfilling and healthy life. Local, state, and federal governments set policies, and the psychiatric field has considerable power in influencing those policies and shaping the social norms that inform them. This new column offers a forum to discuss these issues.