Mental illnesses are thought to be caused by both biological and environmental factors in complex interaction. Among the environmental contributors are a wide range of social, economic, and demographic factors known as “social determinants.” Adam Skinner and colleagues used dynamic Bayesian network analysis to infer the complex causal networks that link social determinants to mental health in a nationally representative sample, consisting of around 25,000 participants in the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The authors identified variables that directly predicted mental health problems: physical health, loneliness, satisfaction with local community, and satisfaction with personal finances. In addition, the authors found that mental health problems influenced many of these same variables, suggesting feedback loops. According to the authors, these results can be used to identify the social and economic interventions that could most efficiently and effectively reduce mental illness at a population scale. For example, if every participant was satisfied with their financial situation, rates of mental illness would drop by around 3 percentage points, eliminating almost a third of mental illness in Australia. Significant public health gains could also be achieved by promoting local community engagement, physical wellbeing, and participation in volunteer or charity work and paid employment, perhaps through a nationally funded job guarantee program.
Journal
PNAS Nexus
Article Title
Dynamic Bayesian network analysis of the social determinants of mental health
Article Publication Date
22-Jul-2025
COI Statement
J.-A.O. is Head of Systems Modelling, Simulation and Data Science at the Brain and Mind Centre, University of Sydney and Managing Director of Computer Simulation and Advanced Research Technologies (CSART). I.B.H. was an inaugural Commissioner on Australia’s National Mental Health Commission (2012–2018). He is Co-Director, Health and Policy at the Brain and Mind Centre, University of Sydney. The Brain and Mind Centre operates an early-intervention youth service at Camperdown under contract to headspace. He has previously led community-based and pharmaceutical industry-supported (Wyeth, Eli Lily, Servier, Pfizer, AstraZeneca) projects focused on the identification and better management of anxiety and depression. He was a member of the Medical Advisory Panel for Medibank Private until October 2017, a Board Member of Psychosis Australia Trust, and a member of the Veterans Mental Health Clinical Reference group. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, InnoWell Pty Ltd. InnoWell was formed by the University of Sydney (45% equity) and PwC (Australia; 45% equity) to deliver the $30 M Australian Government-funded Project Synergy (2017–2020, a 3-year program for the transformation of mental health services) and to lead transformation of mental health services internationally through the use of innovative technologies. The remaining authors declare no competing interests.