The International Journal of Psychosocial Rehabilitation
 

Social Determinants of Mental Health in Organizations

Montoya Hurtado Olga lucia
Martinez Patino Karent Valentina


Faculty of Physiotherapy, Specialization Program Physiotherapy in Neuro-Rehabilitation,
Research Department, Colombian School of Rehabilitation Bogotá, Colombia,
Email: omontoya@ecr.edu.co

 

Citation:
Montoya-Hurtado OL (2020)  Social Determinants of Mental Health in Organizations.
International Journal of Psychosocial Rehabilitation. Vol 23 (1)



Abstract
Mental health is structured through the interaction between inter-institutional, intercultural and intersectoral systems that translate into social determinants of health. The World Health Organization mentions some such as social inclusion, lack of discrimination, violence, economic participation, health systems, society, community, relationships and individual; it is important to take into account from the actions as individual or collective, the analysis of these determinants as strategy for the decision making from the primary care of the mental health. It presents a qualitative investigation that made the contextualization and analysis of contents of documents with respect to three theoretical supports (social determinants, mental health and organizations), then an analysis of the discourse of Semiestrucutadas interviews was carried out to people with knowledge on the subject, in order to analyze the perspective that have different professions on the mentioned and finally it was made triangulation of the Information where the purpose of the discussion was to generate awareness in the readers about the importance of the social determinants of mental health in organizations.

Key words: Social determinants, Mental health, Organization, Well-being, Prevention



 


Introduction

The World Health Organization defines the social determinants of health as circumstances that people pass through the course of life; they are characterized by the socio-economic level, schooling, social strata, income, resources, gender, age and occupation they have. The model of Danhigren and Whitehad (1991), establishes how social inequalities in health are the result of interactions between different levels of causal conditions, and also at the level of health policies. They point to four interrelated levels, which are: strengthening of individuals; strengthening communities, improving access to essential media and services, and the fourth level aims to encourage macro-economic or cultural changes.

Figure 1: Model of Dahigren and Whitehad of production of concerns in health.

The human being behaves and relates to the context that surrounds him and in some way is the result of the different perceptions, emotions, feelings and other components that affect the mind, may be predisposed to both negative and positive factors, is say, social determinants.

Mental health is understood as a state of emotional and physical wellbeing that a person has, which generates an influence on their way of thinking and acting. In the Colombian context, according to Law 1616 (2013) Mental health is "a dynamic state that is expressed in everyday life through behavior and interaction in a way that allows individual and collective subjects to deploy their emotional resources, Cognitive and mental to travel through daily life, to work, to establish meaningful relationships and to contribute to the community "(Ministry of Health and Social Protection, 2014). Mental health is not individual on the contrary is built collectively; in other words, it has to do with organizational systems, with systemic behaviors that involve building social fabric and teamwork.

WHO defines a healthy working environment as "the one in which workers and managers collaborate in using a process of continuous improvement to protect and promote the health, safety and well-being of workers and the sustainability of the Work space" (p, 15), quoted by Herrera, et al (2017). It is important to establish at this point that the fundamental thing in an organization is its worker, because when the individual has a good quality of life, his work performance is greater, but this depends on the labor burden imposed and its management, also of the factors intrinsic motivations that involve in their daily lives.

At the organizational level, it is very important to understand that community mental health is manifested when community members build common interests, generate social fabric and care for everyone's health. This situation can be analysed from the context of public health, for example primary health care programmes, are primarily aimed at addressing those needs and problems faced by communities in mitigating risks. Community mental health is important in the area of organizational psychology, as it strengthens the health conditions of all members of an organization, takes into account the actions that promote and prevent mental disorders such as burnout, anxiety, eating disorders, suicidal conditions, and depression.

Understand the needs of workers in organizations and seek solutions, strengthen their capacities, skills and quality of life (Cano and Castisano, 2012), primary care of mental health generates spaces for prevention of Mental disorders and accessibility of timely treatment. The promotion of mental health in workers is a subject not only to Governments but also to the community in general and especially to the actors who make up and run the organizations. Workplaces are important and effective scenarios for the promotion of mental health because most people spend more than half of their daily hours at work, so a working environment that generates well-being reduces the negative impact of multiple risk factors affecting health (Burrows M, 2005).

According to Castillo (2017) all human beings are influenced by the characteristics that have a society, the time and the space that compose it. The context is of paramount importance for the occupational performance, in the same way it can restrict or disqualify it, therefore, it is transcendental that the analysis of this one recognizes the peculiarities both physical, temporal, sociocultural of the environment in the That the occupations are developing, in order to adapt it to their requirements or also to implement strategies that allow a change in the conditions of the environment.

According to Siporini (1999), he says that the work can offer a sense of dominance over the environment, as well as a sense of achievement and competence that lead to a better quality of life. Work is the door to good mental health, although this also has to do with other components, some research proves that a person spends the most of his time at work than at home, which generates identity, ideals and a perspective Influenced by his work.

An investigation that aimed to address the relationship between working conditions and their impact on mental health factors, determined as important factors the organizational climate, motivation, job satisfaction, professional wear and Possible alcohol-consuming disorders, it can be seen that the lack of identification with the company is given in workers from 10 to 15 years old, which generates in the workers a apathetic personality before the mission of the company. In the same way, a communication disorder between chiefs and grassroots workers was seen. As a conclusion corroborated the influence between low motivation and labor disputes, in donate both occupational risk factors can trigger professional wear and alcohol consumption (Gonzales & Pérez, 2011). Given the foregoing, we can show that the motivation and the organizational climate are fundamental aspects in the quality of life the workers. According to the International Labour Organization and the World Health Organization, they determined that psychosocial risk factors at work have to do with the interactions between the working environment and mental health. A positive organizational climate, provides achievements, afflictions, power, productivity, low turnover etc. if they are negative, it can lead to maladjustment, absenteeism and low productivity (Gonzales & Pérez, 2011).

Lalonde, (1974) quoted by Álvarez, et al, (2013), established that the most relevant determinants in relation to Labor are, lifestyle, environment, human biology and health services. Similarly, structural and environmental determinants have been established influencing workers, the structural determinants are those that generate social stratification, and include factors such as: income, education, gender, group ethnic and sexuality they are social stratifications and the environmental determinants are living conditions, labor and food availability (Álvarez, et al, 2013).

Work is fundamental in human development because it transcends the economic sphere that is conditioned by different income that determines the hierarchical position of the workers, which establishes a network of relationships that are expressed through the Social capital is to say that the influence of the socioeconomic position of the individual on his health is not direct, but the product of the act of intermediary factors Álvarez, et al, (2013).

"Poor health, the social health gradient within countries, and large health inequalities among countries are caused by unequal, global and national distribution of power, income, goods and services, and Consequent injustices affecting the living conditions of the population in an immediate and visible way (access to health care, schooling, education, working conditions and free time, housing, community, towns or cities) and the possibility of a prosperous life. This unequal distribution of health-damaging experiences is not, in any case, a ' natural ' phenomenon... The structural determinants and living conditions constitute the social determinants of Health ". (WHO Commission on Social Determinants of Health, 2008) For all of the above, the objective of this research was to interpret the social determinants of mental health in the organizations, thinking about how to answer the question of: ¿How to interpret the social determinants of the mental health at level organizational?

Method

A qualitative investigation is presented. First, a context analysis was carried out from three theoretical referents (social determinants, mental health and organizations). Later, semiestrcuturadas interviews were designed with the aim of investigating with experts the perspective they have against the social determinants of mental health. 5 interviews were made to 5 people, 4 of them were from the city of Bogotá and one from the city of Pamplona (Colombia). (Hernandez, 2014).

Their participation was voluntary and they gave permission to analyze their interviews and mention their names. To choose the participants, it was considered people who were experts in some of the theoretical referents, was used recorder and informed consents. During the field work the interviewees agreed to be recorded and use the information for purely academic purposes.

Presentation Participants:

  • Doctor Alfonso Rodriguez-psychiatrist. He belongs to the Faculty of Medicine of El Bosque University, in Bogotá Colombia, he is the director of the psychosocial area of the El Bosque University. Representative of the faculties of Health before the National Council of Health Menltal of Colombia.Participante n°
  • Sonia Carolina Mantilla - Physical therapist. Professor at the University of Pamplona, a specialist in university pedagogy and public health.
  • Juan Javier Vesga: Organizational psychologist. It belongs to the Faculty of Psychology of the Catholic University of Colombia in Bogotá, is director specialization in psychology of the organizations, in UCC.
  • Sandra Liliana Joaquí – Physiotherapist, instructor of the International Classification of Functioning, disability and health, teacher of the Colombian School of Rehabilitation and Magister in health and safety at work
  • Nicolás Gómez. Systems engineer, specialist in management development, expert in Moodle. Expert in systems theory. He is currently working at the Family Welfare Institute, designing a program for the mother heads of households. Amateur photographer.

Once the interviews were completed, the transcription was carried out and after that was the analysis for each interviewee. Considering that the main objective of the interviews was to investigate the perspective or knowledge that has on the subject, we established relationships between interviews and the conceptual framework.

Results

We started with the analysis of the interview of Dr. Alfonso Rodriguez, which has been called "Public politics and mental health" due to the understanding that provided on the importance of public policy entities that govern Mental health.

 The context in which it develops a person is of utmost importance since this determines a good or a bad quality of life; for example, in our country, violence or to what it termed the Dr. Alfonso Rodriguez as noncommunicable diseases; in others words, forms or features that affect the mental health of a person, not necessarily with a gene infectious, the gene infectious in this case is the violence that embraces different contexts, makes the social determinants that surround a person become contaminated and reach affect your mental health. Being able to know that there are laws that are interested in good mental health and that are in favor of seeking a prevention and control against the subject, is a right and duty that all citizens have, a clear example is the National Mental Health Council, to which the interviewee belongs, it is important, starting from this point, to know the history, objective, principles, laws that blankets, etc., that has to do with the mental health in Colombia. (Rodriguez, 2018).

A law and National Mental Health Council that thinks in terms of promoting, preventing and strengthening public mental health policy in a country with more than 60 years of armed conflict, socioeconomic inequalities, transgenerational traumas that Makes us behave in a particular way, of studies such as the National Mental Health survey that shows that teenagers in Colombia maso less than 80%, they do not know how to read the facial expression of someone who has it in front, especially if this facial expression is different from one related to joy or to the Rage It is absolutely necessary to prevent the mental disorders of a society that already sees the effects of its history. In Colombia there are social determinants that do not help much and, on the contrary, contribute to an additional bad mental health to the war; the form of employment hiring, the minimum motivations of life plan, the lack of sense of community among others. (Rodriguez, 2018).

The National Council of Mental Health, is not recent, has 5 sessions in its configuration of the health law of 2013, but since 1967, is trying to set up, ie have been making attempts 50 years from the ministry to form an entity that orients the policies In mental health, but it has not been possible.

Dr. Alfonso counts as under the idea of a global awareness of political exercise, countries have realized the value of meeting regularly to expand the economic policy in the world, opens the forum Davos in Switzerland, the richest countries meet each year , every two years to make the World Economic Forum and decide on thousands and millions of people on the planet, those 8 presidents of the countries of more development makes decisions on all of us, and 6 years ago the Davos economic forum spent time analyzing the subject of mental health, that is, economists began to realize that failing to address the poor mental health of the world's population is a socioeconomic risk. (Rodriguez, 2018).

WHO, has seen a change in the epidemiological profile in the last 20 years, the burden of disease was very focused on communicable diseases i.e., contagious, currently the most cost of disease, are in chronic diseases, they would all be part of all non-communicable diseases; Finally, the great conclusion that DR Alfonso leaves is to think about the social problems that are transmissible as the violence that is considered noncommunicable because there is no infectious agent that can be passed from one individual to another, for him, the infectious agent in These non-contagious diseases are lifestyles, i.e. the inadequate circumstances of social determinants. He mentions that the most affective model in health is the primary care model; then, it is important to be able to start with laws, to continue with the history that constitutes the mental health and the social determinants in Colombia and to be able at the end to land in the companies and in the actors of these, not only posing problematic, but also mechanisms aimed at preventing possible disorders or illnesses.

After the perspective presented from the public policy, we continue with a systemic look that allows to follow the conductive thread of the above mentioned. The interview made to Eng. Nicolás Gómez has been called Social determinants and Systems theory Engineer Nicolás made clear that his strength was not the computer, but his knowledge base revolved around systems theory focused as a form of thinking; A systemic thought. To be able to understand the systems that surround us is essential, social systems, family finances, etc. Nicolás made emphasis in a problematic that exists nowadays the individualism and how from the comprehension of different systems can develop strategies that change that cultural perspective that one has, and one begins to build a collectivity for to generate social transformations that seek the common good.

To generate this premise, the interviewer was based on the jailer's game which he applied in his students and where he could show that at the beginning of the game, each student played individually, but that to the development of the game the students realized That to win they had to join, and so it was. By landing this idea in organizations, it is founded that we are all part of a process, and that this collective work is not only important for a potential development of the company, but also for the quality and well-being of the workers within the Companies. One of the strategies to avoid these barriers of individualism, is to develop the collective skills in a company, in order to be able to incentivize to a teamwork, and that some people do not generate overburdens for lack of companionship or of little Interest in his work in his companions. All these characteristics are part of the determinants that compose not only the social context in which the person lives, but also his work environment, which generates influence on his mental health. (Gómez, 2018).

The previous interviews have given a macro support presenting mental health from a political and systemic context; now let's approach the organization, for this is presented the analysis of the interview made to the psychologist Juan Javier Vesga, which is called organizational psychology for his experience.

The interview was directed from its role as organizational Psychology, where I appoint fundamental aspects such as organizational culture, emphasizes the importance of this in companies, as it is essential for a good mental health of workers, in Where the interaction of the different areas of the company, the different co-worker’s generate a significant impact on the lives of the workers. The relationship of importance between work and the family, establishes an emotional homeostasis that allow stability in life of a worker.

Another related aspect is the issue of possible disorders that can be generated when there is no balance in the quality of life of workers, which are stress and burnout, which are characterized by occupational wear. As conclusion you can highlight the importance corporate social responsibility that must be in the organizations since more than a strategy of management, is the responsibility that exists on the voluntary commitment of companies to meet the needs and expectations that workers have about the company, which has to do with your mental health. This responsibility has a lot to do with the balance that the social, environmental and structural determinants that the company must affect the worker and its quality of life must have. (Vesga, 2018). Continuing with this organizational approach, the speech of the physiotherapist Sandra Liliana Joaqui initiated of the theory of the economy, or the organizational theory, which is based on the establishment of the objectives, strategies and organization charts that has A company, and that in a certain way is a social determinant that has influence on the mental health of the workers, so we call Cognitive ergonomics and mental health.

From this premise, we take two fundamental concepts which are: sub loading and mental overload that can be generated in workers, from the social determinants. The satisfaction or lack of motivation in a worker determines his performance at work, but also his welfare of life. It can be deduced, that motivation is a fundamental aspect, and an important development potential for the quality of life at work, both in the internal and external environment of the company. A clear social determinant in a company is the organizational culture that impacts the organization and the mental health of the workers, so it is necessary to develop strategies that generate collective work, culture and communication that contribute to a good health Mental. He mentions that mental health is seen in Colombia as a mental crisis and must be worked in an interdisciplinary way to be a vital component of people, which gives way to their human development. (Joaquí, 2018).

To finalize the understanding of the social determinants of mental health in organizations, an interpretation is presented from the physical health which has been called Our body in the organizations. The physiotherapist Carolina mentions that social determinants are essential in a person's life, and that in turn must exist an interaction between them and other determinants such as biological. Understanding how culture and socioeconomic factors influence social determinants and mental health, we must seek a balance of context and determinants, in order to obtain good metal health or a good quality of life. Human body movement is affected by all these circumstances, the body expresses the life story of each one and the emotional burdens or triumphs. At the labor level having good habits of life, good nutrition and exercising, help mantra good health conditions that favors mental health in workers and this is reflected in the performance that this person has in his work. Therefore, organizations of any kind should promote the care of the body and movement. (Mantilla, 2018).

Conclusion

The social determinants of mental health in organizations are identified in the organizational culture, worker health conditions, intrinsic motivations and knowledge of the company of its workers. From prior knowledge of the subject with community mental health supports, it is possible to structure primary mental health care routes and strategies at the organizational level. We cannot say that these social determinants can become negative, positive or neutral, because this depends on the context in which the person lives, develops, works and dies. The social determinants must have a balance so that these work in a systemic way in the life of a person. In the same way these determinants have direct influence on mental health by generating an occupational or labor burden on the worker that can be evidenced in musculoskeletal and emotional permanent pains or affections. A collective, systemic and non-individual construction in the companies is conducive to the mental health of workers.


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