Social policies andmental health

CRISP policy forumGlasgow 12.12.2017

Kristian Wahlbeck

This project has received funding from the European Union’s Horizon 2020 research and innovationprogramme under the Marie Skłodowska-Curie grant agreement No 690954

Mental health is shaped early in life

Half of all mental disorders start before age 0f 15

4.10.2017

NIH/NIDA: A child’s first eight years are critical for substance abuse prevention

4.10.2017

“There is strong evidence that a stable home environment, adequate nutrition, physical and cognitive stimulation, and supportive parenting can lead to good developmental outcomes.”

• Going upstream: Structuraldeterminants of mental health

PovertyIncome inequalityGender inequalityWar and conflictsSocial exclusion

4.10.2017

22.11.2017

Most of the mental health determinantsare outside the health sector

-families at struggle-economic hardship-low education-social exclusion-vulnerabilities

Launch of School of Public Health / Wahlbeck

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25.11.2016 Policies in economic crises

Social determinantsof mental health

Policyaction

Mental Health in AllPolicies

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Mental Health in All Policies (MHiAP)

Health in All Policies is an approach to public policies

across sectors that systematically takes into account the

health implications of decisions, seeks synergies, and

avoids harmful health impacts in order to improve

population health and health equity.

It provides a framework for regulation and practical

tools that combine health, social and equity goals with

economic development, and manage conflicts of

interest transparently.

25.11.2016 Policies in economic crises9

www.mentalhealthandwellbeing.eu

25.11.2016 Policies in economic crises10

Policy level interventions

Parenting supportAccess to child day careYouth guaranteeActive employment policiesPoverty alleviationDebt policies

WHO:The mentalhealth effectsof economiccrises can beoffsetby the rightpolicy measures

Social welfare mitigates the effectsof macro-economic crises

• Economic downturns result in smaller deteriorations in the mental health

of the population in countries with strong safety nets

• In the Nordic countries, health inequalities remained stable and suicide

rates diminished during financial and economic crises in (Finland and

Sweden 1990-93) and Iceland (2008-11)

Uutela 2010, Wahlbeck 2012, Asgeirsdottir 2014

• EU data indicate that unemployment does not increase suicide if per

capita spending on welfare programmes is above approx 200 €/year

Stuckler 2009

25.11.2016 Policies in economic crises12

Intergenerationaltransmission ofmental healthproblems isprevented byparenting support

Risk of mental disorders in the offspring of parents with mental disorders is reduced by 40% by preventive interventions

Siegenthaler et al. JAACAP 2012

Universal access to good quality childday care

Child day care centers were set up in Nordic countries to enable mothers to

access labour market. Purpose has since shifted toward supporting child

development and reducing social inequalities.

In times of economic and financial stress of families is reflected in parenting

style and mental health of children. Retaining right to child day care in spite of

parental unemployment is an important protective factor to reduce

transgenerational transmission.

Solantaus 2004

25.11.2016 Policies in economic crises14

Income-to-needs ratio = poverty line = 1Internalizingproblems

Norwegian Mother and Child Cohort Study (MoBa), N=75296 (Zachrisson & Dearing, 2014)

Successful mental health actions buildon intersectoral collaboration