Wednesday, Feb 7, 2024

Thinking Bigger About SDOH to Improve Mental Health

Malekeh AminiFounder & CEO, Trayt Health


Two children with the exact same health and demographic profiles could respond very differently to behavioral health treatment. 

How is that possible? One of them may be experiencing a more challenging home environment. A stressful relationship with a sibling, an unsupportive parent, a cultural difference in attitudes toward mental health treatment—factors such as these can significantly impact a child’s therapeutic progress. They are social determinants of mental health.

Traditionally defined Social Determinants of Health (SDOH) are now understood to influence as much as 80% of a person’s modifiable health factors and 50% of their overall health outcomes. SDOH typically include socioeconomic factors such as housing and food insecurity, unemployment, transportation limits, and access to social services.

These social factors are critically important and are rightfully the focus of large-scale government programs and community-based efforts. However, mental health requires a more nuanced approach. Broad ZIP code-base programs to reduce food insecurity or improve access to social services do not go far enough to improve mental health. Meaningful change in mental health requires us to collect and measure personalized environmental data—across a full range of life challenges—and make those insights available to clinicians to improve day-to-day care.

Expanding the definition

To think bigger about social determinants of mental health, we are in fact thinking smaller. We must take a granular approach to non-medical drivers of health, which are the factors in a person’s environment that affect their psychological well-being. 

Again, traditional social determinants of health are a good start—they are the broad building blocks that may impact mental health. However, the brain is much more complicated. Everyone in a particular neighborhood will be experiencing the same broad social determinants of health. To make a meaningful impact on an individual’s mental health, we must understand all the additional factors that combine to create the individual’s unique experience. Do cultural factors make food insecurity particularly traumatic for this person? Is a teen tasked with caring for a disabled sibling in a community that lacks social services? These are the questions not only to ask, but also to measure and track.

Collecting the data

Collecting and reporting granular environmental data has thus far eluded the behavioral health community. Panel discussions lament that environmental observations exist only in unstructured physician notes or paper forms, where they cannot be easily accessed or integrated into diagnoses and treatment plans.

The Trayt platform was built to bring this type of data into day-to-day care. The platform tracks and measures 750 different factors that all influence mental health, including physical symptoms, behavioral symptoms, broad social determinants of health, granular environmental factors, and Adverse Childhood Experiences (ACEs). Clinical data from providers is assimilated with critical between-visit symptom and environment data, which is collected through a patient- and caregiver-facing application from the people who know the individual the best. Together, the data develops a 360-degree personalized view of the patient.

The new paradigm

Behavioral health treatment looks very different through a 360-degree lens. It takes into account a person’s entire experience rather than treating one symptom at a time. It enables providers to collaborate with caregivers and social services agencies in putting the right support systems in place—not broad band-aids—to ensure treatment success. And, it empowers patients with respectful, holistic care.

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