The Mental Health Link – Home, Hope, and Mental Health: Social Determinants of Family Resilience

By Philipa Owusu-Antwi, M.D., M.P.H., CCTP
Dr. Owusu-Antwi is a dedicated PGY-3 resident and APAF Fellow with a strong commitment to advancing mental health care, advocacy, and health equity. Passionate about community and addiction psychiatry, she aims to make a lasting impact both nationally and globally.
By now, we have all heard of social determinants of health (SDOH). It is a phrase that spells out its own meaning: social, non-medical factors determining one’s health.
Why do some children grow up to live productive lives and become productive contributing members of society, while others don’t? Think about the systemic barriers that hold them hostage. Think of SDOH. Now close your eyes and imagine the kind of person, neighborhood, or image you see.
The cries of babies, crowded apartments, invisible sidewalks, a frustrated mother working multiple hand-to-mouth jobs, food deserts, poorly funded education, and hopelessness and helplessness plaguing neighborhoods — that’s what I hear, see and have come to know through my education and our work.
SDOH have repeatedly been shown to affect quality of life across generations. Yet, the efforts to bridge the gap and bring healing do not match expectations. The conditions in which an individual is born, raised, grows, lives, works, and most often dies have a significant impact on not only their lives but also their children’s lives. Access to quality education, sidewalks, healthy produce, playgrounds, good jobs, after-school programs, and health care play a significant role in the trajectory of their lives.
Over the years, literature has shown that SDOH contribute to health disparities affecting mental and physical well-being — how the absence of a playground, sidewalk, or affordable food; unemployment; low income; and low-quality education can increase the risk of cardiovascular conditions, short- and long-term depression, and anxiety, and lead to lower life expectancy.
Even the most loving families under stress, poverty, housing instability and health challenges can struggle to provide emotional support. The persistent stressors — limited resources, multigenerational trauma and erosion of protective factors — breed hopelessness and break down resilience.
Maslow’s hierarchy of needs postulates biophysiological factors such as water, food, warmth, rest, and safety and security as basic needs for human fulfillment. The theory also touches on a higher need for feelings of belonging and accomplishments, which, unfortunately, specific populations have been systematically excluded from. How can people have a sense of purpose and contribution to society at the pinnacle of this hierarchy when they have not been allowed to care for themselves adequately?
"It takes a village" is not just a proverb but a reality often missing in underserved and marginalized communities. These people do not have the social and economic stability needed to thrive that other more fortunate ones enjoy — and they are the ones who need our voices.
Universal, indicated, and selective preventive measures are needed as protective actions. These actions include advocacy for systemic changes that focus on rebuilding communities and expanding access to quality education, including literacy programs, healthier food options and housing security. But how do we do that in the current climate? SAMHSA and Medicaid are examples of infrastructures that address SDOH. We start by fighting for and preserving our existing frameworks. We cannot sit idly by and watch the villages we have collectively built and continue to build be torn apart. I call on you, everyone, to use your voice. I call on you to continue advocating and collaborating with faith-based programs and organizations focused on addressing SDOH because families thrive physically and mentally when they feel secure in their homes, neighborhoods, jobs, schools and country.
Suggested websites to stay connected:
Suggested webinars:
- Social Determinants of Mental Health Spotlight: Highlights from the Social Determinants of Mental Health Convening
- Social Determinants of Mental Health Convening
- Allan Tasman, M.D.
- Dilip Jeste, M.D.
- Dolores Malaspina, M.D.
- Elie Aoun, M.D.
- Enrico Castillo, M.D., M.S.
- Eric Rafla-Yuan, M.D.
- Paul Rosenfield, M.D.
- Rahn Bailey, M.D.
- Vivian Pender, M.D.
- Elvis Gyan, Ph.D.
- Regina James, M.D.
- Looking Beyond: Nourishing Minds, The Role of Culturally Attuned Nutrition, Food Security, and Social Determinants in Mental Health
- Abiodun Atoloye, Ph.D.
- Adjoa Smalls-Mantey, M.D, D.Phil.
- Gregory Brown, M.D. Nebeyou Abebe, M.A.M.P.
- Elvis Gyan, Ph.D.
- Regina James, M.D.
Suggested books:
- Health and Wellness in People Living with Serious Mental Illness; Edited by Patrick W. Corrigan, Psy.D., and Sonya L. Ballentine
- The Social Determinants of Mental Health; Edited by Michael T. Compton, M.D., M.P.H., and Ruth S. Shim, M.D., M.P.H.