Social Determinants of Mental Health

Social determinants of mental health are environmental, societal, and social factors that influence the way we live. While social determinants of health were originally intended to address physical health, there is growing awareness of how these factors affect our behavioral health and ability to access mental healthcare.

Why Are They Important In Mental Healthcare?

Addressing social determinants of health allows for mental health service delivery that recognizes the context that a person lives in. On a broader level, it helps deliver better care by breaking down societal barriers that create inequalities in our healthcare system -- such as poverty, stigma, and lack of access to education or healthcare.

According to the World Health Organization, addressing social determinants is crucial to achieving “health equity” around the world. WHO defines health equity as: “when everyone has the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance.” 

5 Categories of Social Determinants

There are many different factors that can influence our behavioral health. To break this down, the National Council of Behavioral Health splits social determinants of health into 5 main categories. 


Economic influences include our employment status, income level, expenses, debt, medical bills, and access to familial financial support. Economic determinants can change over time and are driven by our personal lives, our communities, and the economy.

Neighborhood and Physical Environment

This includes everything in our surrounding physical environment that could influence our health. This includes safety, access to transportation, and availability of housing. Public spaces such as parks, playgrounds, and walkways can contribute to our mental health.



Education plays a huge role throughout our lives. Access to affordable early childhood education, vocational education, and higher education fall within this category.

Community and Social Context

We benefit from healthy social groups and social support systems. Discrimination, racism, and systemic inequality have a huge impact on our physical and mental health.

Healthcare System

The quality of our healthcare system influences our behavioral health. This includes provider availability, health insurance coverage, translation services, and more. The affordability of healthcare and disparities in access to health insurance are crucial parts of this category.

How Mental Health Agencies Are Addressing Them

There are a variety of ways that agencies are already working to address and track social determinants of health through their work.

  • Evaluating resources within the community: such as affordable education, free preschool, food banks, meal deliveries, and job search/interviewing assistance.
  • Developing and maintaining community resource lists and databases.
  • Creating and implementing Social Determinants of Health assessment tools.
  • Tracking food security, housing security, access to transportation, and employment through their EHR and analytics tools.
  • Developing partnerships with organizations in their area who have similar goals.

How Does COVID-19 Affect Social Determinants of Mental Health?

COVID-19 has affected almost every aspect of our lives. Within a few weeks, our educational, economic, healthcare, and social support structures have been uprooted. 

Foothold Technology founder and Chief Product Officer, Marlowe Greenberg, writes about the effects of the COVID-19 pandemic on social determinants of health in the US and human services agencies. 

“This is a once-in-a-lifetime opportunity to create bonds with these individuals that will outlast the pandemic; to create a new class of supporters and donors and political allies that can be with us after things return to normal”
Marlowe Greenberg
Founder & Chief Product Officer,
Foothold Technology

Care Coordination

Since behavioral health is influenced by a wide variety of factors, it’s more important than ever for agencies to be able to send and receive data from other providers. Connections between human services agencies and other providers in their community can greatly enhance treatment and provide a holistic view of a client. In this interview, Marlowe Greenberg, Foothold’s Founder and Chief Product Officer, discusses with David Guth, Jr., Co-Founder and CEO of Centerstone:

  • The intersection of mental health and whole health.
  • Coordination among providers and payers.
  • Trends and predictions related to data.
  • Consumerism and technology.
  • Capacity-building and the search for systemic solutions through social determinants.

We have decades of expertise in the impact of social determinants of health on communities and providers.