Friedli

Mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual solutions. A focus on collective efficacy, as well as personal efficacy is required. A preoccupation with individual symptoms may lead to a ‘disembodied psychology’ which separates what goes on inside people’s heads from social structure and context. How things are done (values and culture) and how things are distributed (economic and fiscal policy) are the key domains that influence and are influenced by how people think, feel and relate. Mental health promotion has made and continues to make a significant contribution to our understanding of the wider determinants of health and the crucial relationship between social position and emotion, cognition and social function or relatedness. What difference does it make if discomfort and difficulties are shared by everyone? These questions lie at the heart of current debates about the social determinants of health, the relative contribution of material, psycho-social and biological factors and the effects of inequalities.5

Dr Lynne Friedli