Developing and Using Social Capital In Public Mental Health
| Pages | 34-44 |
| DOI | https://doi.org/10.1108/13619322200700029 |
| Published date | 01 October 2007 |
| Date | 01 October 2007 |
| Author | Paul Falzer |
| Subject Matter | Health & social care |
Paul R Falzer
Assistant Clinical Professor, Department of Psychiatry, Yale School of Medicine
Clinical Epidemiology Research Center, VA Connecticut Healthcare System
Developing and Using Social
Capital In Public Mental Health
Abstract
Social capital has played a prominent role in recent initiatives to improve mental health and enhance the quality of
services. However, efforts to substantiate a link between social capital and mental health have been daunted by
equivocal findings and conceptual confusion. These consequences are in part due to having two prominent
approaches that offer disparate and inconsistent accounts about what comprises social capital, how to increase it
and how to use it to benefit mental health policy and practice. This paper lays the groundwork for a rapprochement.
Key words
Social capital, mental health, schizophrenia, self-efficacy, opinion leadership, community-based treatment, recovery
number of investigators have noted that social capital
is such a vague and indefinite concept that the task
of gleaning the relationship between social capital
and health is like ’tip-toeing through a minefield of
evidence’ (Whitehead & Diderichsen, 2001; also see
Onyx & Bullen, 2000).Henderson and Whitefold
(2003) suggest that current knowledge about this
relationship is encouraging but inconclusive. Their
view is supported by De Silva and associates (2005),
whose review of the literature concluded that while
there appears to be a connection between social
capital and mental health – a product principally
of cognitive factors such as such as trust, sense of
community and reciprocity – evidence to date is
insufficient to guide the use of social capital in
addressing problems related to mental illness.
Such findings, buttressed by conceptual confusion
and ambiguity, are responsible in part for social
capital having become a polarising, perhaps Jesuitical,
concept (Almedom, 2005).While some mental
health policy-makers are persisting doggedly to
formulate strategies to increase social capital, reduce
stigma and promote social inclusion (Huxley &
Thornicroft, 2003; Sayce, 2001; Berman & Phillips,
2000), others are denigrating it as promoting an
economistic approach to social relations that seeks
to transform grassroots empowerment into grist for
the workfare state (see Wakefield & Poland,2005,
p2820). Concomitantly, there are efforts to predicate
Considerable evidence has been accumulated about
the effects of the social environment on health,
longevity and quality of life. Recent studies have
demonstrated that the social environment’s impact
on health remains significant even after factors such
as crime, poverty and the physical environment have
been taken into account (Pickett & Pearl,2001; Diez
Roux, 2002; Kawachi and Berkman, 2001; Cattell,
2001). For mental health, a sound social support
system has demonstrable benefits, including greater
longevity, less inpatient service use, greater functional
ability, and better treatment outcomes (Howard et al,
2000; Goldberg et al, 2003; Christensen et al, 1999;
Sakiyama et al, 2002; Anthony, 2003).Such findings
are promoting a variety of research and policy efforts,
including studies to identify the mechanisms that are
responsible for the connection between health and
the social environment (Hou & Myles, 2005),and
applications of extant knowledge to public policy
and community-based programming (Kopelowicz
& Liberman, 2003; Corrigan, 2003).
Social capital has played a prominent role in
several of these initiatives. Particularly among mental
health services researchers, social capital has been
vaunted for its ability to account for the connections
among psychiatric disorders, health and the social
environment. Nonetheless, efforts to substantiate
these links have been daunted by problems of
conceptualisation, clarity and measurement. A
Mental Health Review Journal Volume 12 Issue 3 October 2007 © Pavilion Journals (Brighton) Ltd
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RESEARCH
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