So now, we move on to Interventions to Promote Community Mental Health. A lot of the information for this section is generated from the World Health Organization report on Promoting Mental Health. This is available online, and the link for that is in your resource list. So, one of the things that this report talks about is really addressing the social determinants of health as a way of promoting mental health. And it takes you through how different components of that can have an impact on mental health. So we're starting with nutrition here. From nutri-, from the perspective of nutrition. Chronic hunger and energy deprivation affects the mood and affects responsiveness. We know that it affects things like your ability to learn. Your ability to tolerate stress. All of these sort of things. And then, in ways that we've already described in the earlier segment. It also is going to affect early childhood development. So nutrition is seen as a mental health promoting tool because it promotes healthy cognitive development. And it's seen as being most effective when it's also combined with psychosocial care. So it's not enough to make sure people are fed, they also have to be taken care of them in other ways. Housing. You'll remember that housing is one of the social determinants of mental health and physical health. And certainly, improved housing has been demonstrated to improve mental and physical health. The reason that is, is certainly that poor housing is an indication of poverty, it's one of the indicators of poverty. And we know that poverty is associated with poor mental health. As I've already said it improves physical and mental health. But also, when you improve housing, you usually improve the safety of the situations that people are in. Improved housing is usually associated with being in better situations in terms of crime. And also, improved housing is usually associated with being in settings where there is more of a sense of social and community citizenship. So there's improved social and community participation. Education, we've already talked about. We know that education is a social determinant of mental health. Education is a protective factor for mental health. It increases the opportunities that people have. It decreases the barriers that they are going to experience in trying to live fuller lives. Staying in school is very important. And as we discussed in the previous sections, schools are uniquely positioned to promote resilience and also identify early problems. For those of you that may not be familiar with the term resilience, resilience refers to the ability to withstand stressors. So, we're always interested in promoting resilience as a potential mental health promoting mental health promoting intervention. Because it means that people can deal with what are considered normal stressors. But it also means that they're much more able to handle extrordinary stressors as well. So as I said, education is a determinant of mental health. Improving literacy has been demonstrated to be associated with mental health partly because it increases the opportunities pe, people have. Education is also associated with increased confidence. And I've already spoken about the barriers. Economic security. Now, when people talk about economic security and mental health I have to admit I, I often kind of feel a little hesitant about it. Because it gets into a discussion about productivity and, sort of has these capitalist overtones I'm not so sure about. But there's no question that when whether you're talking about individuals, families, communities or countries. There's definitely better mental health if there's more economic security. And as you, we've talked about many times in the course. There's this consistent link between poverty and depression. So economic security translates into things like increased employment and support for unemployment. In terms of when people lose jobs, that there are services available for them. Economic security is also attached to things like being able to train people for jobs. And to train them to search for jobs. And hopefully, they're, that it means those jobs are there for them to have. And also in times of economic security there's more likely to be a social safety net. Which means for those people who aren't able to be part of the mainstream or paid workforce, there are things that are in place to ensure that they are still able to have a decent quality of living. And a quality of living that will contribute to good, positive mental health and physical health. Domestic and public safety. Well, we've talked about violence many times. Violence in terms of violence in families. And violence in neighborhoods. And even violence at the scale of war and civic, civil conflict. So, preventing violence is very important to promoting mental health. And effective timely responses to family violence are very important. So you all know I am a social worker. And social workers are involved in the child welfare system. And child welfare is really about trying to intervene and prevent child abuse and neglect. Because we recognize that this has long term consequences in, in addition to the immediate consequences of course. So when we talk about domestic and public safety, we are interested in preventing violence at all of these levels. But also decreasing an environment, decreasing the possibility of people living in environments where they are living in an overall state of fear and anxiety. Because that also has an impact. And in fact, there's research that talks about how being in long-term consequences of fear affects the way that your brain functions. And, and that's sort of the basis in some ways for the development of post-traumatic responses. The other thing about domestic and public safety is that when you're increasing public safety. It usually means that the community is involved in a collaborative effort to increase the safety of the environment. And that has a positive impact on individual and community mental health. This is closely connected to the idea of community networks. So, I've already said that when communities are more involved, and when people in communities are more involved with each other, it promotes mental health. Fostering connection and social responsibility has a proven positive effect on mental health. And it also has an effect on these other factors that we know can be risks to people's mental health. Reducing substance misuse actually can have a huge impact on mental health. So, some of these things we've already talked about. Early childhood development and the neuro-developmental consequences of alcohol use during pregnancy. Family environments, alcohol use is often associated with family violence. With all kinds of violence, frankly. And so if you're reducing substance misuse, you're reducing violence as well that can have an effect on, on peoples mental health. And then the intergenerational effects. We certainly see that there are families where substance use is through the generations. And I mean you can do a whole other course on the social context of substance use. Some people think of that as reflecting genetic predispositions, physical vulnerabilities to substance use. Others think it has to do with the environments that people grow up in. But any way you look at it, it can be harmful to people's mental health. And certainly in many ways can put people at risk for mental disorder, as well as other types of problems. It's, it's important to talk about suicide prevention as well. So I have mentioned that suicide is often associated with mental health problems and illness. And so whatever we're doing to prevent mental health and prevent the development of mental disorders is also going to be helpful in terms of preventing suicide. I've mentioned psychological distress because there are people who will be thinking about suicide who don't necessarily meet criteria for a mental disorder but they are highly distressed. So we also have to think about how to intervene with those people, who may not be recognized as somebody who is dealing with any kind of mental health problem. Another consideration is that we know that there are elevated suicide rates among specific groups. Sometimes you see a specific regions where there'll be higher rates of suicides, specific countries, specific age groups. So when I talk about targeting hot spots, in the green box there. What I'm talking about is that we know that there are places where they're are elevated, like extremely elevated rates for suicide attempts. So if we're aware of such a place, then we have to be very specifically getting in place support that will promote mental health. That will identify people who are dealing with mental disorder and will specifically be dealing with the possibility, possibility of suicidal IDs, ideas, and suicide attempts. Another thing that we have here, I have here, is the mention of crisis lines and crisis centers that many, many places have. So that when people are in situations of extreme psychological distress and, and contrib-, contemplating something like suicide they can call such places. And I mentioned the Warmlines, that's something that we have here in Toronto. Which is for people who are not necessarily in that, at that, at that level of crisis. But still, somebody who is trained at the other end is able to talk to them. And maybe help them deal with whatever it is that is causing them stress in, as a way of, of preventing them getting to a point where they would be in crisis. So there's a great deal of international attention to the question of how to prevent suicide and also how to education the public about it so that. If they encounter somebody that they're concerned about, they know what to do and who to call. And then, another thing that people talk about is Cross-sector collaboration. Because although we are focused on the mental health care system, because this is a course about the social context of mental health. People who are dealing with mental health problems don't only come into contact with the healthcare sector. Mental health concerns cut across sectors. So it's very important that healthcare systems are also working with other systems, like the school system, like the immigration systems, like the justice system. To ensure that people with mental health problems get the help they need wherever they are. And then also, so that people who are working in those other sectors feel like they have what they need to be able to support people. Who may be coming to them with mental illness, or mental disorders, or at risk of mental illness and mental disorder. I've mentioned workplace interventions there as well. Because, as I said in the other segment. This seems to be an area in which people are very concerned. And that there are growing problems. So we need to think about how we think about work. And what we're doing in our workplaces. And then, use of technology. Technology is actually introducing a lot of interesting possibilities for mental health services. And one of the things that technology is enabling us to do that wasn't in place before, is that we can reach people who are hard to reach. So if you're not somebody who can come to a mental health center or doesn't want to come to a mental health center. Technology is providing other ways for us to provide support to people who need it. So Telehealth and online mental support these are actually things that we have here in Ontario. Telehealth is, is a line that you can call for any kind of health concern. But there are other Telehealth lines that are for people who are dealing specifically with mental illness. And there's also online mental health support in the form mostly of mutual support groups that meet online through things like Facebook or other networks. And, and that has proven to be a quite helpful source of support for people who wouldn't necessarily come in for a face to face. Kind of encounter, or can't come in for a face to face kind of encounter. Social media is also becoming very important for just doing general public edu-, public education and support. Especially when we're thinking about reaching out to adolescents and young adults who tend to be on social media a lot. This is proving to be a very effective way of doing outreach. So next, we're going to talk about, more generally, how communities can support mental health.
