Addressing Social Needs and Social Determinants of Health for People Experiencing SMI-View Presentation Slides

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This American Psychiatric Association webinar (Oct 27, 2023), presented by Somava Saha, MD, MS, focuses on addressing social needs and social determinants of health (SDOH) for people experiencing serious mental illness (SMI). It aims to help clinicians understand how mental health and social circumstances interact to worsen or improve outcomes, apply the “Pathways to Population Health Equity” framework to individual clients, and adopt population-based approaches.

The presentation distinguishes <strong>individual social needs</strong> (e.g., inability to pay rent, unemployment) from <strong>social determinants/drivers</strong> (e.g., lack of affordable housing stock, job markets and workplace structures that exclude neurodivergent or disabled people). It highlights how SMI can contribute to social instability—school dropout, reduced lifetime earnings, loss of social supports, limited access to affordable care, and housing insecurity—while also emphasizing how upstream forces (racism, discrimination, adverse childhood experiences, community violence, poverty, and inequitable access to care) shape mental health risk and recovery.

Using place-based data examples (e.g., Los Angeles well-being patterns) and a “tree” metaphor, the talk frames <strong>health outcomes</strong> as the visible “leaves,” <strong>social needs</strong> as “branches,” <strong>community conditions</strong> as the “trunk,” and <strong>root causes</strong> (racism, classism, sexism, colonialism and related policies/narratives) as the underlying “roots.” Chronic inequities are presented as system-produced rather than accidental, requiring life-course and contextual perspectives.

Action strategies include integrating social needs supports into stepped, team-based care (e.g., Cambridge Health Alliance’s model and mental health homes for severe persistent mental illness), measuring well-being with brief validated items for risk stratification, cross-sector data systems, and community hub models. Case examples (Delaware outcomes; Indigenous and community-led healing programs such as Nuka) illustrate potential reductions in overdose, incarceration, homelessness, and acute care utilization when care, resilience-building, and structural change efforts are aligned.

Keywords

social determinants of health

serious mental illness

individual social needs

population health equity

Pathways to Population Health Equity framework

structural racism and discrimination

housing insecurity and affordable housing

team-based stepped care

cross-sector data systems

community hub models