TY - JOUR PY - 2021// TI - National or population level interventions addressing the social determinants of mental health - an umbrella review JO - BMC public health A1 - Shah, Neha A1 - Walker, Ian F. A1 - Naik, Yannish A1 - Rajan, Selina A1 - O'Hagan, Kate A1 - Black, Michelle A1 - Cartwright, Christopher A1 - Tillmann, Taavi A1 - Pearce-Smith, Nicola A1 - Stansfield, Jude SP - e2118 EP - e2118 VL - 21 IS - 1 N2 - BACKGROUND: Social circumstances in which people live and work impact the population's mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198).

RESULTS: We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk.

CONCLUSION: This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health.

Language: en

LA - en SN - 1471-2458 UR - http://dx.doi.org/10.1186/s12889-021-12145-1 ID - ref1 ER -