The physical environment, including air quality, noise levels, and green spaces, influences mental well-being. For example, exposure to environmental toxins, such as lead or high levels of air pollution, is linked to increased risks of depression and other psychiatric disorders.¹

Clinical Relevance

• External conditions such as the quality of the places where a person lives, learns, works, and interacts socially are considered social determinants of health (SDoH).²
• Patients living in areas with high levels of environmental stressors, such as exposure to violence, may experience worsened mental health outcomes.³
• Children raised in less green neighborhoods had a 55% higher risk of psychiatric disorders, even when considering other SDoMH factors.⁴
• Those exposed to environmental toxins or residing near busy highways are at higher risk for anxiety and depression.⁴

Economic Impact

• Environmental degradation contributes to mental health costs through increased healthcare utilization and treatment of environmental-related psychiatric conditions.
• Addressing environmental hazards can reduce both health risks and related economic burdens.⁵

Policy and Programs

• Policies promoting urban green spaces and improved air quality are essential in mitigating the mental health impacts of poor environmental conditions.³
• Neighborhood-level measures of social support should also be validated in people with Schizophrenia-Spectrum Disorders (SSPD) to enrich the understanding of the possibly bidirectional relationship between symptoms of SSPD and social support.²

Avenues of Intervention

• For Psychiatrists: Incorporate environmental assessments into patient evaluations, especially in areas with known environmental stressors.⁶
• For Individuals: Engage in community efforts to advocate for clean air, green spaces, and environmental justice.⁷
• For Organizations: Partner with environmental groups to promote policies that improve the physical environments in underserved communities.⁸

References

1. Helbich, M. (2018). Mental Health and Environmental Exposures: An Editorial. International Journal of Environmental Research and Public Health, 15(10), 2207–2207. https://doi.org/10.3390/ijerph15102207
2. Sturm, E. T., Thomas, M. L., Sares, A. G., Dave, S., Baron, D., Compton, M. T., Palmer, B. W., Jester, D. J., & Jeste, D. V. (2023). Review of Major Social Determinants of Health in Schizophrenia-Spectrum Disorders: II. Assessments. Schizophrenia bulletin, 49(4), 851–866. https://doi.org/10.1093/schbul/sbad024
3. American Psychiatric Association. (2022). Report of the Presidential Task Force on the Social Determinants of Mental Health (.pdf). In American Psychiatric Association.
4. Reuben, A., Manczak, E. M., Cabrera, L. Y., Alegria, M., Bucher, M. L., Freeman, E. C., Miller, G. W., Solomon, G. M., & Perry, M. J. (2022). The Interplay of Environmental Exposures and Mental Health: Setting an Agenda. Environmental Health Perspectives, 130(2). https://doi.org/10.1289/ehp9889
5. Hwong, A. R., Kuhl, E. A., Compton, W. M., Benton, T., Grzenda, A., Doty, B., Thompson, L., Gogtay, N., Clarke, D., & Alpert, J. (2021). Climate Change and Mental Health: Implications for the Psychiatric Workforce. Psychiatric Services, 73(5), 592–595. https://doi.org/10.1176/appi.ps.202100227
6. Compton, M. T. (2023). Food and Nutrition Insecurity: A Social Determinant Hungry for Attention by Mental Health Professionals. Psychiatric Services, 74(12), 1303–1306. https://doi.org/10.1176/appi.ps.20220511
7. Pienkowski, T., Keane, A., Booth, H., Kinyanda, E., Fisher, J. C., Lawrance, E., Oh, R., & Milner-Gulland, E. J. (2024). Nature’s contributions to social determinants of mental health and the role of conservation. One Earth, 7(7), 1213–1227. https://doi.org/10.1016/j.oneear.2024.05.004
8. Wang, M. L., Narcisse, M.-R., Togher, K., & McElfish, P. A. (2024). Job Flexibility, Job Security, and Mental Health Among US Working Adults. JAMA Network Open, 7(3), e243439–e243439. https://doi.org/10.1001/jamanetworkopen.2024.3439