Many factors influence how likely we are to stay physically healthy or to become ill. Researchers refer to these as the determinants of health (Australian Institute of Health and Welfare, 2016). Some of these factors relate to us as individuals, such as our:
- biology e.g., genetics, sex, age, medical conditions
- psychology e.g., thinking patterns, how we deal with our emotions, and how we relate to others, and
- lifestyle or health behaviors e.g., alcohol or drug use, smoking, diet and physical activity.
However, research going back over two decades shows that between 30 – 55% of health outcomes relate to drivers that occur beyond the level of the individual (Osmick & Wilson, 2020; Wilkinson & Marmot, 1998; World Health Organization, n.d.). These social determinants of health are our everyday living and working conditions, what the World Health Organization calls “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (World Health Organization, n.d.).
The social determinants of health include:
- employment status and working conditions
- access to affordable health services
- social connectedness
- adverse life events (Australian Institute of Health and Welfare, 2016; World Health Organization, 2022a, n.d.).
Mental health and wellbeing is about more than individual factors
In recent years there has been a growing awareness that mental health is similarly influenced by both individual factors and social determinants (Compton & Shim, 2015; Jurkowski, 2012; World Health Organization and Calouste Gulbenkian Foundation, 2014). Mental health conditions, which include anxiety, depression and post-traumatic stress disorder, are now understood to result from a complex interplay between:
- an individual’s vulnerability based on their biology, psychology and lifestyle behaviors, and
- the stress caused by stressors from their environment (the social determinants) (Figure 1).
Figure 1. Mental health status involves an interplay between individuals and their environment (World Health Organization, 2022c).
Although most of us are sufficiently resilient to cope with stress most of the time, the more our environment exposes us to risk factors (stressors), the greater our likelihood of experiencing a mental health condition (World Health Organization, 2012). Governments, communities and workplaces all have a role to play when it comes to addressing the stressors we are exposed to.
Does your mental wellbeing strategy focus only on individuals? Interventions at the individual level are not enough
The previous point drives home the fact that interventions targeting individuals are inadequate to comprehensively address threats to mental health and wellbeing. It is certainly helpful for all of us to build personal resources that reduce our vulnerability and help us to cope. However, interventions that target the environmental stressor side of the equation, that is, the social determinants of mental health are also essential.
Work is a social determinant of health. Australian work health and safety (WHS) laws focusing on psychosocial hazards are therefore a much-needed mechanism for addressing risks to mental health. The changing regulatory landscape signals an understanding by governments that the onus for mental health should not solely be placed on individuals. Attention must be given to work-related stressors.
Safe Work Australia, the national body responsible for the development of model WHS laws, defines psychosocial hazards as hazards that arise from or in relation to:
- the design or management of work,
- the working environment,
- plant at a workplace (machinery, equipment and tools), or
- workplace interactions or behaviors;
and may cause psychological and physical harm (Safe Work Australia, 2022).
Australian businesses have a legal obligation not just to respond to psychological injuries but to prevent workers being exposed to psychosocial hazards in the first place. As can be seen from the list above, preventing exposure requires good work design and safe work systems. Focusing on individuals without considering the systems in which they exist is no longer enough. In the World Health Organization’s recent publication Guidelines on mental health at work, organizational-level interventions and manager training for mental health, alongside training for workers in mental health literacy and awareness, are recommended (World Health Organization, 2022b). Are you ready to apply systems thinking and develop organizational-level interventions?
If your organization has a mental wellbeing strategy, you’ve made a start. But if your programs only emphasize personal responsibility for mental health such as resilience and stress management skills, a paradigm shift is needed. Well Excel’s digital badges on psychological health and safety can be your guide (contact us to learn more).
- Our physical and mental health are determined by both individual factors and social determinants.
- The greater our exposure to stressors, including psychosocial hazards at work, the greater our likelihood of developing a mental health condition.
- Interventions that reduce an individual’s vulnerability, such as stress management and resilience training, are valuable but insufficient to prevent psychological injuries.
- Australian businesses have a legal obligation under WHS laws to prevent workers being exposed to risks to their mental health. It’s time to add organizational-level approaches that focus on work design and safe systems of work.
- Australian Institute of Health and Welfare. (2016). Determinants of Health. Retrieved from https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/chapter-4-determinants-of-health
- Compton, M. T., & Shim, R. S. (2015). The Social Determinants of Mental Health. Focus: The Journal of Lifelong Learning in Psychiatry, 13(4), 419-425. https://focus.psychiatryonline.org/doi/pdf/10.1176/appi.focus.20150017
- Jurkowski, E. T. (2012). Psycho-social determinants of mental health. In Social determinants and mental health. (pp. 19-35). Nova Biomedical Books.
- Osmick, M. J., & Wilson, M. (2020). Social Determinants of Health—Relevant History, A Call to Action, An Organization’s Transformational Story, and What Can Employers Do? American Journal of Health Promotion, 34(2), 219-224. https://doi.org/10.1177/0890117119896122d
- Safe Work Australia. (2022). Model Code of Practice: Managing psychosocial hazards at work. Retrieved from https://www.safeworkaustralia.gov.au/doc/model-code-practice-managing-psychosocial-hazards-work
- Wilkinson, R. G., & Marmot, M. (1998). The solid facts: social determinants of health. https://apps.who.int/iris/handle/10665/108082
- World Health Organization. (2012). Risks to mental health: An overview of vulnerabilities and risk factors. https://www.who.int/publications/m/item/risks-to-mental-health
- World Health Organization. (2022a). Mental health at work. Retrieved from https://www.who.int/news-room/fact-sheets/detail/mental-health-at-work
- World Health Organization. (2022b). WHO guidelines on mental health at work. Retrieved from https://www.who.int/publications/i/item/9789240053052
- World Health Organization. (2022c). World mental health report: transforming mental health for all. L. C. B.-N.-S. IGO. https://www.who.int/teams/mental-health-and-substance-use/world-mental-health-report
- World Health Organization. (n.d.). Social determinants of health. Retrieved from https://www.who.int/health-topics/social-determinants-of-health
- World Health Organization and Calouste Gulbenkian Foundation. (2014). Social determinants of mental health. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf