The relationship between good governance, social support, and perceived discrimination with mental health through the mediation role of quality of life: a cross-sectional path analysis in Iran.

BACKGROUND

Recognizing the established link between social determinants of health, such as social support, good governance, and perceived discrimination, and individual mental health, this study aims to delve deeper into the specific relationships within the Iranian adult population. It seeks to elucidate the potential mediating role of quality of life in the association between mental health disorders (MHDs) and these social factors.

METHODS

This cross-sectional study employed path analysis to investigate the relationships between social determinants of health and MHDs among 725 Iranian adults in Tabriz, Northwest Iran. Data collection occurred between March and September 2022, utilizing a multi-stage and cluster sampling approach. Good governance, social support, perceived discrimination, MHDs, and quality of life were assessed using valid questionnaires. Statistical analysis was conducted using SPSS-24 and Lisrel-8 software, with a significance level set at p < 0.05.

RESULTS

This study found that nearly 70.0% of the participants reported experiencing mental health problems. The path analysis showed that good governance had a significant indirect and negative effect on MHDs via quality of life (β = -0.05; P < 0.05). Major racial discrimination had a positive relationship in the direct and indirect paths (β = 0.24; P < 0.01). While, social support was a directly and indirectly significant predictor of decreased MHDs (β = -0.17, p < 0.01). Furthermore, quality of life had a negative relationship on the indirect path with MHDs (β = -0.24, P < 0.01).

CONCLUSIONS

This study reveals a significant burden of mental health issues among Iranian adults. It highlights the crucial role of social factors like good governance, social support, and perceived discrimination in shaping mental health through their impact on quality of life. Consequently, addressing these factors through improved governance, strengthened social support systems, and active efforts to reduce discrimination is essential for promoting mental well-being.