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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;
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