５．Why utilising anti-racist practice and tackling discrimination are crucial for addressing inequities in mental health and mental health services

【Presenter】

Stephani Hatch
King’s College London, UK

Stephani Hatch is Professor of Sociology and Epidemiology at King’s College London.

She leads the Health Inequalities Research Group, working across sectors, locally and nationally, to deliver interdisciplinary research on inequalities in mental health in marginalised communities and across health services with an emphasis on race at the intersection of other social identities.

She has expertise in sociology and psychiatric epidemiology, using mixed quantitative and qualitative methods to study the impact of discrimination, social adversity, social determinants over the life course on mental health and multimorbidity.

She has also been co-leading initiatives promoting and changing policies to insure the embeddedness of inclusive research culture, equality, diversity and inclusion at KCL since 2014.

Stephani co-leads the Marginalised Communities and Mental Health programme within the ESRC Centre for Society and Mental Health, focused on working in close partnership with communities that have often been ignored, to examine and disrupt structures maintaining social inequities in mental health.

【Chair】

Mariko Hiraiwa-Hasegawa
Tokyo Metropolitan Institute of Medical Science

【Abstract】

Mental ageing encompasses emotional psychiatric and cognitive function.

Most relevant measures are continuously distributed in the general population, from emotional and behavioural stability and optimum cognitive function at one extreme, to affective and externalising disorders and dementia at the other extreme.

Life course epidemiology, based on birth cohort studies, has consistently shown that these outcomes have strong social determinants.

For depression, by far the strongest determinants are stressful life events, even after taking account of adolescent depression.

These social factors can also be consequences of mental ill-health. This is striking in the case of adolescent conduct problems, which are associated with low educational and occupational attainment, intimate relationship problems, and trouble with the criminal justice system.

Social determinants are also important for cognitive impairment and dementia, above all education, where effects are independent of early cognitive development and sensitive to broader social factors such as school leaving age.

Education has been the historical focus for the cognitive reserve model of dementia since it can modify the relationship between pathology and functionality.

These factors will be reviewed in detail during this presentation.