INTERNATIONAL CONSORTIUM for MENTAL HEALTH POLICY and SERVICES
MENTAL HEALTH POLICY TEMPLATE

Social Capital

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POLICY TEMPLATE WITH EXPLANATIONS

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SOCIAL CAPITAL
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Although there is not a definitive definition of social capital it is generally conceptualized as "the features of social organization such as civic participation, norms of reciprocity and trust in others that facilitate cooperation for mutual benefit". (125) Social capital emerges from social interactions and shared norms that are external to the individual. It includes the nature and extent of relationships and networks within communities and between communities and also between communities and formal institutions. Social capital resides in relations rather than individuals and is a resource that can generate a stream of benefits for society over time. (126) Social capital is greater than the sum of the individual contributions to it, it is shared by a group and as a consequence it is a public (as opposed to private or individual) good that in turn enables the supply of other important public goods and the enhancement and amplification of other capital. Social capital is thought to have the capacity to bond or 'glue' like groups, create bridges between different groups in society and to create vertical links between groups of people and government and formal institutions. Social capital when combined with a "well-functioning state, compliments the state's abilities and produces the fertile soil necessary for social and economic development." (127)

Correlations between social capital and health outcomes have been researched. There is good evidence that more socially cohesive societies are healthier with lower mortality. (128,129,130) The mechanisms by which this social capital is beneficial to health are not clearly delineated, but social networks are believed to promote better health education, better access to health services, informal caring and enforcing or changing societal norms that impact on public health.

"In terms of mental health, little work has been done to specifically explore how it may interface independently with social capital, although this body of knowledge is growing" (131) The relationship between mental health and social structure, social isolation, poverty, life events and psychological stress has been demonstrated. (132,133,134)

It is argued that social capital affects the mental health of individuals and groups. Social capital is thought to mediate against the downward social drift caused by mental illness and to reduce the impact of psychosocial stressors experienced by vulnerable people in socially disadvantaged situations, that trigger mental illness. Whether reduction and prevention of mental illness in turn generates benefits for the wider social group by increasing the store of social capital available within the community has yet to be investigated. (135) "In the context of mental health, adding the dimension of social capital integrates the biopsychosocial determinants of mental disorder (genetics, neurobiology, psychological factors, social environment etc) in a way which brings an understanding of population mental health beyond the aggregation of individual health characteristics or risk factors." (136)

Social capital mechanisms for improvement of mental health may occur at different levels of society. At the national level social mechanisms can address inequalities in political participation that lead to a lack of political commitment to improving services for vulnerable groups. At a community level, community cohesion can facilitate the organization of groups and movements that agitate for increased access to services and amenities that can address the immediate and long-term needs of the mentally ill. (137) Bridging social capital can also unite marginalized groups with the mainstream and promote a more inclusive approach to the provision of mainstream services and resources to people with a mental illness. Social capital also promotes rapid diffusion of health information and therefore may affect mental health well being and may address issues of stigma and discrimination of the mentally ill. (138) At the individual level bridging social capital facilitates social integration that contributes to better health for the individual.

Social capital is important for mental health policy makers to consider because it is a potential mechanism for preventing mental illness within the community. It is also thought to influence the health of individuals via psychosocial processes providing effective support and acting as a source of self-esteem and mutual respect (139) Social capital is also important to consider as a prerequisite for effective policy and successful policy implementation. Well-formed policy will, in turn, increase the store of social capital that will impact on individual and community well-being including mental health.

Policy makers may therefore wish to consider the importance of social capital in the following areas:

a) Its contribution to the overall mental health and well being of the population;
b) Preventing social decline in individuals with mental illness
c) Improving access to mental health services
d) Improvement of mental health status and its impact on the building of social capital (eg in post-conflict populations).
e) How the concept of social capital may inform social policy in general, including mental health policy and it's implementation, including:

  • Policies that strengthen social networks;
  • Policies that build social organizations;
  • Policies that strengthen community ties;
  • Policies that strengthen civil society;
  • Policies that address inequalities in political participation;
  • Policies that increase community access to services;
  • Policies that focus on individual social integration and reduction in exclusion;
  • Policies that facilitate bridging social capital and thereby facilitate inclusion of minorities e.g. people with mental illness;