Salud mental 2024;
ISSN: 0185-3325
DOI: 10.17711/SM.0185-3325.2024.007
The relevance of social analysis in mental health research
Ingrid Vargas-Huicochea1
1 Coordinación de Investigación. Departamento de Psiquiatría y Salud Mental. Facultad de Medicina de la Universidad Nacional Autónoma de México, UNAM. Ciudad de México, México.
Correspondence:
Ingrid Vargas-Huicochea Coordinación de Investigación del Departamento de Psiquiatría y Salud Mental, Facultad de Medicina de la Universidad Nacional Autónoma de México, UNAM. Circuito Interior y Cerro del Agua, sin número. Ciudad Universitaria. Copilco Universidad, Alcaldía de Coyoacán, C.P. 04510, Ciudad de México. Phone: 55 5623 - 2300 ext 43135 Email: ivargas@facmed.unam.mx
The mind has always been an object of wonder and study. Over the years there have been great scientific advances to bring us closer to its understanding, but there is still much to investigate. It would be necessary to recognize that, in addition to the intricacies of the neuroanatomy and physiology of the brain, the mind manifests itself in the light of what each individual is, so that these expressions have particular tints derived from who each person is and the sociocultural scenario that underlies them.
It is said that we are our brain (Hachinski, 2022), but we can also say that the brain, particularly the mind, is a reflection of our biology and society.
The social determinants of health are a example of the aforementioned relationship. They are those circumstances in which people live and work and which influence their state of health (Marmot, 2005). Talking about mental health, they have even been extended to include elements such as traumas associated with migration and social systems of oppression (Alegría et al., 2023).
Today more than ever, after the global impact of the COVID-19 pandemic, it is recognized the relevance of identifying these determinants in decision making and implementation of interventions at the individual, community and geopolitical levels.
The articles included in this journal issue highlight some of the social elements involved at different moments of some mental disorders.
The article by Jensen García and Natera Rey, entitled Inferential Confusion in the Worldview of Individuals with Obsessive Compulsive Disorder (OCD): a Qualitative Approach, takes up the Inference-Based Model (OʼConnor & Robillard, 1995), which proposes the existence of erroneous inductive reasoning (inferential confusión, IC) as a factor of origin and persistence of OCD. In the article, the authors analyze the potential effect of IC on non-obsessive constructs both in people with OCD and in comparative subjects, and how these influence the participantsʼ cosmovision. A very interesting proposal since the concept of cosmovision by itself (Dilthey, 1954) is broad and complex, because it arises from life itself and from experience; moreover, being an group concept, it nurtures and is nurtured by the social context. They found the influence of IC on non-obsessive components of OCD and, as expected, on the cosmovision of OCD sufferers. It would be necessary to think about the implications of this finding for the psychotherapy process and for the community life of this population.
For a deep and detailed exploration of a study phenomena as complex as cosmovision, qualitative research methods or mixed methods are very useful since they allow an approach to the subjectivity of the participants.
This was the methodology chosen by da Costa Maynart and his team of collaborators in the article called The qualified listening to family members of users in Psychosocial Care Center. In this qualitative research, the authors evaluated a novel technique in a clinical setting that seeks a more humanized and closer approach to patients and family members. Through the testimonies, they were able to analyze the meanings and experiences of the family members with the qualified listening, which gives them tools to be able to evaluate whether or not the initially proposed objectives are met and thus strengthen not only the listening technique but the general proposal of the psychosocial care center which, as postulated from its origins, aims to be a space for the production of new social practices to deal with mental illness (Amarante, 2003; 2007), a valuable initiative for the comprehensive approach to the patient with a mental disorder.
It is interesting to reflect on how knowledge of the above-mentioned social aspects in combination with the many other elements of a person can provide a broader and more integrative space for analysis. In the articles by Santana Campas and Bañuelos Barrera, the factors that influence the complex spectrum of suicidal behavior in university students are analyzed. On the one hand, Marco Antonio Santana and collaborators, in Protection and risk factors for attempted suicide in Mexican students of the bachelor of psychology, investigate those psychological variables related to suicide attempts; however, their discussion raises questions about those sociocultural elements that nuance the symptoms at the psychological level explored and which remain to be worked on. Yolanda Bañuelos and her group, in the study entitled Predictive factors of suicidal behaviors among university students in the North-Central Region of Mexico, carried out an exploration of sociodemographic and psychosocial components to identify which components could have a relationship with suicidal behavior, which provided the research team with a broader profile of variables that may be at play, allowing the recognition that points such as perceived stress and the absence of social support may imply a risk for the manifestation of such behaviors.
Finally, in a research that included students from several health care careers in different countries, Ulloa Flores and his team sought to identify the presence of disorders such as depression, anxiety and substance use in health care students, reviewing those factors potentially associated: Factors associated with the presence of depression, anxiety, and substance use in health students from 10 Latin American countries during the COVID-19 pandemic. The fact that the field of this research was conducted in the midst of a pandemic involves consideration of individual, community, biological, psychological, and social factors. As with studies working with mental health issues during COVID-19, it is evident how a humanitarian crisis brings into play all our different areas of function and action, and how the imbalance between them makes us more vulnerable to mental health conditions that compromise our well-being.
In these paragraphs, I sought to continue with the visibilization of our multifactoriality. We are independent individuals inserted in community contexts with important social ties, therefore, as has been reiterated in the previous lines, talking about mental health also implies talking about the economic, labor, academic, political, geographical, historical, cultural and social pieces that constitute us. As Lewis (1953) mentioned, mental health requires that the internal state of a person has a certain balance to be able to interact harmoniously with her/his environment and aspire to develop freely and effectively, which can eventually give her/him a sense of a valuable life.
REFERENCES
Alegría, M., Alvarez, K., Cheng, M., & Falgas-Bague, I. (2023). Recent advances on social determinants of mental health: looking fast forward. American Journal of Psychiatry, 180(7), 473-482. doi: 10.1176/appi.ajp.20230371.
Amarante, P, org. (2003). Archivos de Saúde Mental e Atenção Psicossocial. NAU Editora.
Amarante, P. (2007). Saúde Mental e Atenção Psicossocial. SciELO-Editora FIOCRUZ.
Dilthey, W., Emery, S. A., & Emery, W. T. (1954). The essence of philosophy (p. 96). University of North Carolina Press.
Hachinski, V. (2022). The new brain age. Neurology, 99(11), 468-472. doi: 10.1212/WNL.0000000000201059
Lewis, A. (1953). Health as a social concept. The British Journal of Sociology, 4(2), 109-124. doi: 10.2307/587206
Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099-1104. doi: 10.1016/S0140-6736(05)71146-6
OʼConnor, K., & Robillard, S. (1995). Inference processes in obsessive-compulsive disorder: Some clinical observations. Behaviour Research and Therapy, 33(8), 887-896. doi: 10.1016/0005-7967(95)00042-v