Practical Implementation of Social Determinants of Mental Health in the Healthcare Setting-View Presentation

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Video Summary

Dr. Vivian Pender, former president of the American Psychiatric Association, presented on the practical implementation of social determinants of mental health in healthcare. She emphasized how current sociopolitical upheavals—including social unrest, political conflict, economic uncertainty, racism, and reduced healthcare access—negatively impact mental health and the psychiatric clinical setting. Using the Tavistock Institute’s group relations model, Dr. Pender illustrated how unconscious group dynamics such as dependency, fight-flight, and pairing affect both psychiatrist-patient relationships and broader healthcare systems. She highlighted that these unconscious defense mechanisms (projection, splitting, transference) can impair therapy and contribute to burnout among psychiatrists. Addressing burnout requires system-level changes, peer consultation, personal therapy, advocacy, and self-care strategies like engaging in the arts and moderating news exposure. Dr. Pender also discussed the cautious use of AI in mental health, noting potential harms from unregulated apps while recognizing their growing role, especially among youth. She advocated for fostering interdisciplinary collaboration among mental health professionals and enhancing education on relational and unconscious processes in psychiatric training. Ultimately, she called for systemic reforms to address social determinants, promote equity, and reduce moral injury for clinicians, underscoring that an unadjusted culture harms both patients and providers. Her approach encourages integrating systems thinking and awareness of unconscious dynamics to improve mental health care amid society’s complex challenges.

Keywords

social determinants of mental health

psychiatric clinical setting

unconscious group dynamics

defense mechanisms in therapy

psychiatrist burnout

system-level changes in healthcare

AI in mental health

interdisciplinary collaboration

mental health equity