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The rhetoric/reality gap in social determinants of mental health

The rhetoric/reality gap in social determinants of mental health Purpose – The purpose of this paper is to establish that social determinants are vital contributing factors to mental health difficulties and that, similar to physical health, mental health follows a social gradient. Despite this acknowledgement, there is a rhetoric/reality gap found in social determinants of mental health (SDMH). It will be argued in this paper that this rhetoric/reality gap is located on a number of levels, including theoretical, methodological, practical, political and policy based, which are proposed here to be interrelated. Design/methodology/approach – The approach is a conceptual analysis of the rhetoric/reality gap found in SDMH using a critical perspective. It draws on a wide variety of theories in order to provide an analysis of the issues outlined. Findings – The paper's central finding is that there is a dissonance between the dominant ontological, epistemological and methodological, or axiomatic, focus in contemporary mental health theory and practice and SDMH. This dissonance has led to a form of “analysis paralysis” on all levels, and the initiatives required to tackle SDMH have been marginalised in favour of a narrow interpretation of evidence‐based research and its accompanying ideology centring on the individual, which has established itself as a primary position on what constitutes valid knowledge to the detriment of other views. Originality/value – The paper offers a critical perspective on an area of SDMH which is often alluded to but never explicitly explored, and questions the underlying assumptions inherent to mental health theory and practice. The paper's value is that it draws attention to this particular dilemma on a wider scale, including on a political and policy‐based level, which is often neglected in mental health theory, and it makes some recommendations on how to move forward. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Mental Health Review Journal Emerald Publishing

The rhetoric/reality gap in social determinants of mental health

Mental Health Review Journal , Volume 18 (4): 12 – Nov 29, 2013

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Publisher
Emerald Publishing
Copyright
Copyright © 2013 Emerald Group Publishing Limited. All rights reserved.
ISSN
1361-9322
DOI
10.1108/MHRJ-04-2013-0013
Publisher site
See Article on Publisher Site

Abstract

Purpose – The purpose of this paper is to establish that social determinants are vital contributing factors to mental health difficulties and that, similar to physical health, mental health follows a social gradient. Despite this acknowledgement, there is a rhetoric/reality gap found in social determinants of mental health (SDMH). It will be argued in this paper that this rhetoric/reality gap is located on a number of levels, including theoretical, methodological, practical, political and policy based, which are proposed here to be interrelated. Design/methodology/approach – The approach is a conceptual analysis of the rhetoric/reality gap found in SDMH using a critical perspective. It draws on a wide variety of theories in order to provide an analysis of the issues outlined. Findings – The paper's central finding is that there is a dissonance between the dominant ontological, epistemological and methodological, or axiomatic, focus in contemporary mental health theory and practice and SDMH. This dissonance has led to a form of “analysis paralysis” on all levels, and the initiatives required to tackle SDMH have been marginalised in favour of a narrow interpretation of evidence‐based research and its accompanying ideology centring on the individual, which has established itself as a primary position on what constitutes valid knowledge to the detriment of other views. Originality/value – The paper offers a critical perspective on an area of SDMH which is often alluded to but never explicitly explored, and questions the underlying assumptions inherent to mental health theory and practice. The paper's value is that it draws attention to this particular dilemma on a wider scale, including on a political and policy‐based level, which is often neglected in mental health theory, and it makes some recommendations on how to move forward.

Journal

Mental Health Review JournalEmerald Publishing

Published: Nov 29, 2013

Keywords: Policy; Politics; Mental health axioms; Rhetoric/reality gap; Social determinants of mental health

References