Social Capital and Mental Health

Kwame McKenzie, Trudy Harpham

• Publisher: Jessica Kingsley Publishers
• Year: 2006
• Print ISBN: 9781843103554
• eBook ISBN: 9781846424946
• Topic: Social Sciences
• Subtopic: Mental Health in Psychology
• Index: Social Sciences

`The effects of social context and social structure on health are well documented. The concept of social capital provides a slightly different take on the issue, as it attempts to discover the features of populations in different areas that are crucial in determining the extent and the quality of social interactions and the social institutions within society. Such factors as social networks, levels of participation in civil life (as a citizen) and levels of trust within communities are all associated with social capital.

This book provides a detailed exploration of the concept, on its effects on psychological functioning and on the risk factors for mental health that are associated with communities that have either high or low levels of social capital.' - Community Care

Why do some areas have a higher prevalence of mental illness than others? How does the structure of a society affect its inhabitants' mental health? This remarkable book is the first to explore in detail the concept of social capital and its implications for mental health policy.

Drawing on evidence from international research and fieldwork, the contributors examine the risk factors for mental health associated with both low and high social capital communities. They discuss the importance of relationships between individuals, groups and abstract bodies such as the state and outline different systems of social capital, for example intra-group `bonding' and inter-group `bridging'. The authors challenge the notion of community as a strictly area-based concept and call for broader-based studies of communities built around race, faith or even around a common social exclusion. Social Capital and Mental Health also reviews methods of measuring social capital, analyses the implications of research findings for future policy developments and makes clear recommendations for future practice and research.

This book will be an informative and engaging read for sociologists and psychiatrists, and an incisive resource for policy makers and practitioners.

PART 1

Theory and methods

CHAPTER 1

Meanings and uses of social capital in the mental health field

Kwame McKenzie and Trudy Harpham

Introduction: why is social capital important to mental health?

People in some places have better mental health than people in other places. This is not just because of their genetic vulnerability, the physical environment or their socioeconomic status. It also reflects the fabric of society – the way in which communities are set up and people live.

The effect of the structure of society on psychological health has been described for some time. Durkheim’s (1951) theories on suicide from the 1890s are notable, and Faris and Dunham (1939) argued in the 1930s that the level of ‘disorganisation’ within a neighbourhood was a factor that could explain differential rates of mental disorder within the city of Chicago. These are just two examples of the strong tradition of research and innovation in psychiatry concerning the effects of social context on health. However, such theories generally have not led to developments in health policy.

More recently, another way of conceptualizing the social world – social capital – has captured the imagination and has been written into national and international health policies. It is considered an important, some would say pivotal, idea in social policy and health, and all of this has happened despite a relative lack of empirical investigation.

Social capital is a concept explored in disciplines as diverse as criminology, political science and international development. It attempts to describe features of populations such as the level of civic participation, social networks and levels of trust. Such forces shape the quality and quantity of social interactions and the social institutions that underpin society.

If you consider social capital to be a continuous variable, then areas with high social capital may be expected to have a lower rate of illnesses associated with problems of social cohesion compared with areas of low social capital. Indeed, there are reports that areas with high levels of social capital have lower suicide rates, lower all-cause mortality and longer life expectancy.

Some believe that building social capital could decrease health spending and decrease the rates of illness. Their specific interest in mental health is twofold because:

•mental health is one of the top three causes of life-years lost to disability worldwide

•psychological mechanisms are likely to be the way in which social capital affects physical health.

Investigating the social world is complex. Social capital cannot simply be considered as a single continuous variable; areas and people cannot simply be categorized as having high or low social capital; different mental health problems are likely to be linked to different aspects of social capital in different ways, and these links may be direct or through other, poorly defined physical, environmental and societal mechanisms.

But complexity should not be a deterrent given the possible prize. Mental health problems usually can be managed or put into remission but often are not cured. Relapse is common. Where cure is not possible and an illness is chronic, prevention is important. There are wide variations in the rates of mental health problems in different areas and countries. These variations are not due simply to the physical environment or to genes. The social environment is increasingly being implicated and proffered as the cause. Better understanding of the social factors that cause or perpetuate psychological problems is vital if preventive strategies are to be developed to counter these factors. If aspects of social capital prove to be as powerfully associated as has been postulated with even some mental health problems, then it is important that they are studied urgently.

What is social capital?

Before we go further, we need to explore the concept of social capital in more depth. There are a number of competing definitions, some of which are more popularly used than others. Jane Jacobs is claimed to have been the first person to make an explicit reference to the term ‘social capital’ (Jacobs 1961; Whitley and McKenzie 2005). However, Hanifan (1920) may have described it earlier. Jacobs states: ‘Underlying any float of population must be a continuity of people who have forged neighbourhood networks. These networks are a city’s irreplaceable social capital.’

Since then, a number of sociologists have tried to define social capital more precisely. With many new concepts, there is a settling-down period during which theorists disagree. Social capital is no different. The most notable disagreement is whether social capital is a property of groups or a property of individuals.

Individual or ecological?

Sociologist Bourdieu’s (1986) view of social capital may be considered to reflect an assumption that it is a property of an individual. A person’s individual social relationships allow differential access to resources (e.g. healthcare and education) and these relationships define social capital.

Social capital has also been considered as ecological (see McKenzie et al. 2002 for review). It would thus relate to groups or areas rather than individuals. Those who follow this definition see social capital as being embodied in relationships between individuals, between groups, and between groups and abstract bodies such as the state.

The problem that many people have with the individual definition is that it is unclear where the existing and well-researched concepts of social support and social networks stop and that of social capital begins. If social capital is simply a measure of an individual’s access to social networks or social support, then it is not really a new concept.

There has been a significant body of research into the links between access to social support and illness. Mortality rates for people with few social relationships have been shown to be many times higher than for those with larger social networks. Social support protects against a variety of other illnesses, and low levels of social networks are correlated with an increased risk of accidents, suicide and cardiovascular disease. The lack of a supportive confiding relationship is a risk factor for depression. In addition, Durkheim (1951) found that married men had a lower prevalence of neurosis than single men. Social support is believed to buffer an individual against both chronic and acute stress through the provision of emotional, informational and instrumental support. The socially isolated individual lacks this support and suffers the consequent disadvantages.

If social capital is the property of an individual, then it could be considered to act in a similar manner. Its effects on health could be due to preventing isolation, alienation and lack of access to social support. If this is true, then individual social capital may be a proxy variable for access to the active ingredient – social support and social networks. It would be unclear whether anything is to be gained by employing a new term such as ‘social capital’ as a proxy variable rather than using the more accurate descriptions of the factors under observation – accessed social support or social networks.

Some researchers who analyse social capital at the individual level extend the concept to include trust, sense of belonging and civic engagement. This goes further than social suppo...

Table of contents

• Cover
• Of Related Interest
• Title Page
• Copyright
• Contents
• Acknowledgements
• Foreword By Richard Wilkinson, Professor Of Social Epidemiology, University Of Nottingham
• Part 1: Theory and methods
• Part 2: International studies
• Part 3: Conclusion
• Subject Index
• Author Index