Social Vulnerability and Mental Health Inequalities in the “Syndemic”: Call for Action

Abstract

Covid-19 is referred to as a “syndemic,” i.e., the consequences of the disease are exacerbated by social and economic disparity. Poor housing, unstable work conditions, caste, class, race and gender based inequities and low incomes have a profound effect on mental health and wellbeing. Such disparities are increasing between, among and within countries and are exacerbated by human rights violations, in institution and in society, stigma and discrimination. Social capital can mediate health outcomes, through trust and reciprocity, political participation, and by mental health service systems, which can be coercive or more open to demand of emancipation and freedom. Societal inequalities affect especially vulnerable groups, and Covid itself had a wider impact on the most socially vulnerable and marginalized populations, suffering for structural discrimination and violence. There are complex relations among these social processes and domains, and mental health inequalities and disparity. Participation and engagement of citizens and community organizations is now required in order to achieve a radical transformation in mental health. A Local and Global Action Plan has been launched recently, by a coalition of organizations representing people with lived experience of mental health care; who use services; family members, mental health professionals, policy makers and researchers, such as the International Mental Health Collaborating Network, the World Federation for Mental Health, the World Association for Psychosocial Rehabilitation, the Global Alliance of Mental Illness Advocacy Networks (GAMIAN), The Mental Health Resource Hub in Chennai, India, The Movement for Global Mental Health (MGMH) and others. The Action Plan addresses the need for fundamental change by focusing on social determinants and achieving equity in mental health care. Equally the need for the politics of wellbeing has to be embedded in a system that places mental health within development and social justice paradigm, enhancing core human capabilities and contrasting discriminatory practices. These targets are for people and organizations to adopt locally within their communities and services, and also to indicate possible innovative solutions to Politics. This global endeavor may represent an alternative to the global mental discourse inspired by the traditional biomedical model.

Vulnerability through the Eyes of People Attended by a Portuguese Community-Based Association: A Thematic Analysis

“…Poor physical and mental health, harmful risk-taking behaviours (e.g., drug misuse, HIV, and sexually transmitted infection) [ 41 ] and public health consequences [ 3 , 43 ] are frequently identified, in the literature, as barriers to and negative consequences of vulnerability. Our findings demonstrate that lack of literacy and individual frailty increased vulnerability to stressors and limited social reintegration [ 37 ].…”

“…Although there is no precise definition of vulnerability or vulnerable persons, the literature suggests common indicators of vulnerability and/or vulnerable groups [ 2 ]. Typically, it refers to a lack of physical, psychological, and social well-being, and hence the risk of lagging behind or becoming socially isolated from society [ 3 , 4 ]. Other indicators commonly stressed in the literature include: “(a) accumulation of problems or limitations (multi-complex problems); (b) feelings of powerlessness and distrust; (c) disrupted communication; (d) limited or no access to resources; (e) marginality; (f) imbalance in burden and capacity; (g) dependency situation; and (h) low self-esteem” [ 2 ] (p. 2).…”

“…The ongoing COVID-19 pandemic has raised the vulnerability of many people, with several health implications. The disease and its repercussions—including dietary deficits, physical and mental health issues (potentially decreasing awareness of distinct hazards), and more limited access to healthcare services—were factors exacerbated by the pandemic [ 3 , 5 ].…”

Involuntary psychiatric hospitalizations in Greece: Contemporary research and policy implications

“…Apart from the scientific originality of the study, which in many respects is a unique undertaking for Greece, and thus its expected impact in terms of understanding the phenomenon of involuntary hospitalizations, this research project aims to raise awareness of this problem at the level of national health policy and to formulate strategic goals to address the problem of violation of human rights and to promote mental health democracy in Greece. [34][35][36] Actions in this direction may include using the definitions of human rights and fundamental freedoms in the United Nations Convention on the Rights of Persons with Disabilities as a tool to change the legal status of the procedure of involuntary hospitalization, engaging with and empowering mental health service users, family and carers, changing mental health practice culture through training mental health professionals, justice officers, police officers, organizations and communities, creating a national observatory to monitor involuntary hospitalization. 37 Encouraging family involvement and psychoeducation as part of routine mental health care may change carers' attitudes and practices regarding recourse to coercive psychiatric treatment.…”

The five C-S of positive youth development and life purpose among Roma and Egyptian minority adolescents in Albania

“…Referring to the two minorities, they are often excluded from participating in studies, based also on the social-cultural dynamics where a part of young people leave school too early, especially girls, even though the number of school drop-out from both sexes is high (Miconi et al, 2021;Wiium, & Uka, 2021). This makes their inclusion and participation in studies more difficult (Dervishi et al, 2021;Maguire et al, 2016;Miconi et al, 2021;Mezzina et al, 2022). Based on the existing data, members of the minority, mainly Egyptians, do not identify as such, as a way to escape discrimination and exclusion (Dervishi et al, 2021;Miconi et al, 2021).…”