Decoding what causes diseases requires a deeper understanding of the underlying factors or determinants which affect health. These determinants do not operate in silos and interact with other factors, cumulatively driving health outcomes. Mental health is a complex issue and, much like health, is caused by a complex interplay of several factors at an individual, community and population level.
This framework for mental health addresses three key needs in the existing approaches to understanding determinants of mental health. Firstly, it adopts a broader view to break down determinants of overall health and nuances it further for mental health. Secondly, recognising the need for a comprehensive view, this framework brings together social, cultural and economic, political, commercial, biological and environmental determinants of mental health within a four-part framework, drawing from literature by leading organisations. Thirdly, the framework is contextualised to the Indian landscape, acknowledging the unique factors at play in this large and diverse country.
This perspective demonstrates the complex interplay between the determinants and how their interaction can aggravate mental health outcomes, with the help of real-life personas and use cases, relevant to the Indian landscape. Each determinant, which operates as a stressor in an individual’s life, closely interacts with other determinants to create a complex set of mental health needs which require contextualised solutions. Determinants may also act as enablers which can drive positive health outcomes and aid in addressing stressors. Ecosystem stakeholders including funders, non-profit organisations and digital and other solution providers can apply this framework to drive sustainable mental health outcomes.
The framework allows a holistic understanding of all types of determinants and their interplay to view underlying stressors and situational realities of a population. This can inform the design of solutions and interventions which recognise the root causes of mental health issues and the social, cultural and all other nuances in the Indian landscape, including systemic factors in their environment. As a result, this enables solutions which are contextualised to the hyperlocal and diverse needs of populations to effectively drive positive mental health outcomes, and over time, reduce the prevalence of mental illness.
Authors: Yashasvi Murali, Disha Kouli, Karthika Kumar, with inputs from Granthika Chatterjee Advisor: Dr Prabhakaran Dorairaj, Vice President (Research and Policy), Public Health Foundation of India (PHFI) and Executive Director, Centre for Chronic Disease Control (CCDC) Technical Review: Lakshmi Sethuraman