Family Counselors Addressing Social Determinants of Mental Health in Underserved Communities

Abstract

Couple and family counselors (CFCs) practicing in underserved communities must be aware of and properly address social determinants of mental health (SDOMH). This conceptual manuscript offers an explanation of how the SDOMH domains impact families in underserved communities and provide evidence-based recommendations for infusing SDOMH into family counseling through the ecological social justice counseling theory, adapted for couple and family counselors. This article concludes with the next steps for practice and research.

Addressing social determinants of mental health in therapy: A thematic synthesis

“…Research suggests that people who are less privileged tend to behave in more community‐ and socially–oriented ways, because they rely more heavily on community than on more affluent people; thus community relationships have a stronger impact on their mental health, in both positive and negative directions (Fonagy et al, 2019). Whilst the therapeutic relationship can provide a space in which clients can develop their communication and interpersonal skills (Fonagy et al, 2019; Lee et al, 2021; Robins et al, 2022; Wampold, 2015), this review highlights the importance of involving family and community when working with people who are experiencing adverse social determinants (Fonagy et al, 2019; Hynie, 2018; Lee et al, 2021; Robins et al, 2022). It suggests that therapists should aim to develop collaborative therapeutic relationships with the families and communities they work with (Hynie, 2018; Lee et al, 2021; Tucker et al, 2019).…”

School counseling prevention programming to address social determinants of mental health

“…An important concept in ASE is seeing all individuals in their school community as contributory governors or assets to their own success as well as the success of others (Lemberger‐Truelove et al., 2023). To support this, a growing number of studies have documented the importance of building partnerships with school personnel, family members, health professionals, and communities to promote desirable and sustainable change for students (Bryan & Henry, 2012; Henry et al., 2017; Robins et al., 2022). Although school counselors cannot control social determinants such as poverty or housing insecurity, they can initiate collaborative partnerships to maximize assets that promote students’ resilience (Lemberger‐Truelove & Hutchison, 2014; Williams & Bryan, 2013).…”

Assessing the social determinants of mental health in counseling practice

“…We identified at least one social justice‐informed counseling framework that integrates aspects of the socioecological model of health promotion and includes deliberate steps for assessing the SDMH—the Ecological Social Justice School Counseling framework (ESJSC; Johnson & Brookover, 2021). ESJSC theory and its family counseling counterpart—Ecological Social Justice Counseling theory (ESJC; Robins et al., 2022)—both emphasize identifying systemic factors influencing mental health and well‐being. Thus, ESJSC encourages universal assessment of the SDMH for all students (Johnson & Brookover, 2021; Johnson et al., 2022).…”

“…Professional counselors seek to positively influence mental health and well‐being in society through work with individuals, groups, families, and communities. Not only do we believe that mental health is fundamental to a healthy lifestyle, but we also envision a future in which all people have equal opportunity to achieve and sustain optimal functioning across the lifespan (Robins et al., 2022). Though counselors have certainly made progress toward this goal, certain challenges still lie ahead.…”