Social determinants of mental health: the missing dimensions of mental health nursing?

In this paper we explore how aspects of the social world may be linked to mental health and psychiatric morbidity and propose that conditions should be created which allow individuals and communities greater opportunities for self-care and self-management. Specifically the focus is on social connections, disability and homelessness and work stress. There is a clear policy direction pursued by many national governments and international organizations such as the World Bank to build healthy communities. The environment as it relates to health and well-being can be thought of in terms of physical and social dimensions. We will argue that self-care and self-management at both the individual and the community level, in partnership with economic and health policies, are necessary to effectively address social determinants. It will also be suggested that although many in the profession will make the usual refrain that this has little relevance to mental health nurses, the opposite may be the case as mental health nurses have an important, albeit ill-defined, role to play in tackling social determinants.