Social factors like poverty, discrimination, and education access have a major impact on your mental health.
This approach to psychiatry tries to understand how your social environment shapes your well-being.
Discussing social factors with your psychiatric provider can lead to more affirming, effective care.
Humans are social. Every one of us is highly impacted by our family, society, and neighborhood, whether we realize it or not. Psychiatric providers understand that society impacts every person's mental health, and vice versa.
By working with a psychiatrist discussing your social factors, you can understand how your environment shapes your mental health and find strategies that address both psychological and social factors.
Disclaimer: Many people think "social psychiatry" is a special type of psychiatry. That’s not necessarily true. However, all psychiatric care involves consideration of social factors because they can have an impact on your mental health. A psychiatric provider will consider all these aspects as you collaborate on a treatment plan that meets your needs.
What role do social factors play in psychiatry?
Psychiatric providers understand that mental health doesn’t happen in a vacuum. They look at mental health and psychiatric issues through the lens of the social environment. They see how societal issues affect each person’s mental health.
Psychiatric providers might treat depression as an individual condition. They understand depression as a partially genetic psychiatric disorder. They might look at differences in brain structure and activity. At the same time, they’ll take into consideration how sociocultural factors play into depression. This includes economic level, educational status, family relationships, discrimination, community violence, and more.
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How psychiatrists use social psychiatry
Psychiatrists today incorporate social factors/history to some degree. Here are some ways you might see the principles of social factors in psychiatry showing up in your treatment:
Social history evaluation: Most psychiatric providers will ask at least some questions about your family background, educational or work history, and friendships. This is to get a sense of how your mental health symptoms fit into the social and cultural context of your life.
Identity-affirming care: Unfortunately, not all psychiatric providers are identity-affirming, but it’s important to find a provider who is. Identity-affirming care means your psychiatrist respects and validates your gender, sexuality, culture, and other aspects of identity. This can reduce distress and build trust in treatment.
Attention to structural barriers: Psychiatric providers may ask questions about your insurance coverage, housing, and income level.
Collaboration with other services: Psychiatric providers may work with schools, workplaces, or community organizations to address the broader context of your care.
Social factors affecting mental health
One of the key principles behind social factors in psychiatry is the social determinants of health. These are all nonmedical factors that significantly impact health, including your mental health.
Some of these factors are:
Racial discrimination
Studies have repeatedly shown that racial discrimination is significantly linked with mental health. Being the victim of racism can even affect your brain physically. Racial discrimination is linked to depression, anxiety, and post-traumatic stress disorder (PTSD).
Poverty
Poverty is another factor that’s highly linked with mental health problems. People without access to housing are much more likely to have mental health concerns. Substance use disorder, especially, is common. Over half of people with high levels of debt also live with mental health conditions. Poverty can also directly impact access to mental health treatment.
Education access
Low education is related to a higher chance of mental health concerns. This is primarily because of the fact that access to education is directly linked with poverty levels. But some research also suggests there’s an independent link between low education access and mental health problems.
Neighborhood
Living in a neighborhood with lots of poverty is linked with increased rates of depression. People who live in public housing are more likely to be anxious and depressed. On the other hand, living in neighborhoods with more green space is linked with better mental health.
Community and social networks
The togetherness of community, on the other hand, can help protect against mental health concerns. Even between neighborhoods of similarly low socioeconomic status, those with a strong sense of community are linked with better mental health.
Government policies
Governments play important roles in the sociocultural context of our lives. The policies created can have a direct impact on the mental health and well-being of many people. For example, a policy change could reduce or eliminate healthcare access for certain groups, which could mean that some people can’t get the mental health treatment that they need.
Eight ways considering social factors can benefit your care
The world in which we live impacts our mental health regardless of who and where we are. Working with a social psychiatrist can help you understand this on a deeper level.
Seeing a psychiatric provider can offer many other benefits, including:
Recognizing how racism and discrimination directly affect your mental health and address these issues in treatment
Providing identity-affirming care that validates your cultural background, gender, and sexuality
Strengthening the therapeutic relationship by respecting your lived experiences
Encouraging culturally sensitive approaches that reduce the risk of misdiagnosis and mistreatment
Creating opportunities for systemic change by advocating for fairer policies
Building resilience by helping you strengthen social and community networks that provide safety and support
Helping prevent relapse by addressing ongoing stressors like racial trauma or financial strain
Discussing medication options that may benefit your mental health symptoms
A major social factor that can impact someone’s mental health is social status, which can impact where a person lives. We have seen that people with lower economic status experience an increase in depressive symptoms due to housing difficulties.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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Social factors play a major role in shaping your mental health and recovery. Social psychiatry shows that your well-being isn’t only about biology or brain chemistry. Your environment, identity, and community matter too. By working with a provider who understands this, you can receive care that feels more personal, affirming, and effective.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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