CS06-03 - Mental health, resilience and inequalities: a social determinants perspective

Abstract

The current discourse on resilience is intuitively appealing - it focuses on strengths or assets (rather than deficits), it is consistent with key themes within the recovery movement and it reassures us that, after all, individuals and communities are capable of adapting to adversity. A focus on resilience also speaks to the resistance of deprived or disadvantaged communities to being pathologised or described in terms of multiple deficits or disorders. In other words, the discourse on resilience is one of hope, transcendance and insistence on the power of the human spirit. The growing interest in resilience could, therefore, be cause for celebration - contributing to a richer, more nuanced understanding of deprivation and a recognition of the the social, emotional and spiritual impact of poverty and inequity and the fact that’wellbeing does not depend solely upon economic assets’ (Sen 1992). Too often, however, concepts of resilience are abstracted from the material circumstances of peoples lives and distract from, rather than deepen understanding of, societal determinants of life outcomes. This paper will critically review the literature on mental health and resilience and to assess whether the concept of resilience is a help or a hindrance in understanding social gradients in the distribution of both mental illness and mental wellbeing. Reflection on competing theoretical approaches to understanding population mental health A focus on resilience cannot adequately explain inequalities in mental health and wellbeing and may serve to disguise or distract from analysis of social structures that result in and maintain inequalities in power, wealth and privilege and the impact of these inequities on population mental health. At the same time, there is a need for greater recognition, in the social determinants literature, of the non material dimensions of poverty and deprivation.