Back to Our Roots: Community Determinants and Pillars of Wellbeing Advance Resilience and Healing

Mental health and wellbeing are critical dimensions of community health. PI’s new report, Back to Our Roots: Catalyzing Community Action for Mental Health and Wellbeing, illustrates how improving community conditions can help activate resilience and reduce the incidence and intensity of mental health concerns. Back to Our Roots showcases community-level strategies that complement ongoing efforts to provide mental and behavioral health services. Addressing the community determinants of health is key to helping people and communities navigate adversity, heal, and flourish.

The report is timely given emerging challenges we face as a society, including trauma and adverse childhood experiences, loneliness and social isolation, institutionalized bias and discrimination, and ‘diseases of despair’ that manifest in depression, suicide, and substance misuse. In searching for solutions, it is important to understand that mental health and mental illness have deep roots in the ways our society is structured and in the places where people live, learn, work, play, and age. 

Back to Our Roots builds on the landmark 1987 monograph Concepts of Primary Prevention, published by the California Department of Mental Health Services. Dr. George Albee observed that “no mass disorder afflicting humankind has ever been brought under control or eliminated by attempts at treating the afflicted individual.” Back to Our Roots examines lessons learned from earlier community-based approaches that acknowledge the ways community-level factors shape mental health. As emphasized by Dr. Stephen Goldston, editor of the monograph, “mental health or ill health of a community is reflected in its institutions – key community agents, such as teachers, police, and clergy, have major impacts on the mental health status of the community.” 

The report identifies six Pillars of Wellbeing, the core elements that people and communities need to thrive – a sense of belonging and connectedness, control over one’s destiny, dignity, hopefulness and aspiration, safety, and trust – and outlines comprehensive strategies to transform the community determinants of health that affect mental health and wellbeing, such as strengthening social networks and rebuilding trust, ensuring access to stable, affordable housing, and improving the look, feel, and safety of neighborhoods. 

We hope that this paper will stimulate dialogue, new strategies, and intentional action in those sectors most accountable for health in our communities – including healthcare, public health, and behavioral/mental health – and point towards critical roles for other sectors, including housing, economic development, business, law enforcement, and criminal justice. This work was supported by the Blue Shield of California Foundation and features work funded by the Movember Foundation. For more information or to speak with the authors, please contact Sheila Savannah, director, at sheila@preventioninstitute.org.