To effectively address parental mental health, we need to move beyond examining only individual psychological factors that place parents at risk. It is essential to evaluate the systemic level, considering how our social context and policies contribute to this crisis.
Social determinants of health capture these overarching factors and are used to describe how broader systems impact an individual’s ability to engage with healthcare and their influence on health outcomes. The Center for Disease Control (CDC, 2022) has placed a special emphasis on healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. Broadly - access to transportation, childcare, education, nutritious food, affordable healthcare, housing, and the ability to live without racism and gender-based violence are social determinants of health that have specific bearings on parents.
Maslow’s Hierarchy of Needs is a great visual demonstration of the fundamental factors that shape the way we interact with the world and can serve as either facilitators or barriers in our pursuit of higher-level wellbeing.
In medical contexts, we often focus on behavioral and psychological factors that lead to the incidence of mood symptoms and, subsequently, offer individual-level interventions to rectify the issue. For example, when we determine that a parent is suffering from anxiety, we start them on medication or refer them to therapy. However, if the root cause of their anxiety stems from housing insecurity, lack of employment, or an abusive partner, these interventions are only tangential. We must work from the bottom up to ensure that a patient’s basic needs are met before we have expectations of higher-level engagement.
Although we, as individual providers, cannot solve these systemic issues for our patients/clients, there are steps we can take to offer support. This ties well into the pursuit of integrated care by taking a holistic, patient-centered approach to care provision and building a collaborative network of specialized providers that can fulfill the needs that we cannot.
Slowing down standard clinical care processes to discuss these factors and offering the involvement of other systems is a necessary first step. This builds trust that will have positive effects on all other domains of care and show your patients that you are invested in their wellbeing. Further, engaging in advocacy efforts on behalf of your patients is a low-demand but impactful way to promote systemic change. As providers in this field, we are situated to bring these points to a higher level and actually be able to influence these systems in a way our patients may not.
Center for Disease Control. (2022). Social Determinants of Health at CDC. Center for Disease Control. https://www.cdc.gov/about/sdoh/index.html#:~:text=Healthy%20People%202030%20sets%20data,and%20neighborhood%20and%20built%20environment.
Healthy People 2030. (n.d.). Social Determinants of Health. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas/social-determinants-health