May 14, 2021

Insights from ‘The Interplay Between the Environment and Mental Health’ –  Part II

This article, highlighting the importance of definition of ‘the environment,’ is second in a series covering the National Academies of Science’s workshop, “The Interplay Between the Environment and Mental Health.”

In the workshop’s keynote remarks (Video Playlist 3-D1), Sandro Galea from the Boston University School of Public Health shared that intuition, conceptual frameworks, and increasing evidence point to a role of environmental influences on mental health. He remarked that this is relatively new territory, as much of the study of mental health has been subject to the ‘lamp post effect,’ or looking where the light is, rather than investigating where the problems may be. Dr. Galea highlighted environmental influences of interest that include pathogens/toxins such as lead and pollution, disruptions such as natural disasters or Covid-19, and environmental forms, as evidenced by the value of green spaces. While each of these topic areas will be covered in later articles, an important and groundbreaking feature of the workshop was outlined in its foundational elements.

Essential to the field’s ability to have effective conversations and research around influences on mental health was discussion of the need for clarification and specificity on definition of the term “environment.” The workshop’s broadened use of this term marks an expansion within the field of mental health that may shift considerations and approaches to data and risk factors, as well as promote cross-collaboration and expanded, multi-disciplinary thinking that also incorporates context and culture.

This issue was addressed in Primer 1: Mental Health for Environmental Health Professionals, where one of the workshop organizers, Erika Manczak, highlighted why even talking about ‘the environment’ is a challenge. She noted that in psychology and mental and behavioral health circles, ‘the environment’ generally equates to the social environment, often the family system.  In contrast, in behavioral genetics the environment includes all non-genetic influences. She noted that use of the terms physical, built or natural environment increases specificity and can improve communication and considerations across and within fields.

Exposome is another term that helps to broaden contemplation of the range of influences on a person or population. Recognizing influences on mental health from a broad and multi-faceted view of the environment or exposures, as represented by any external input, is important to expanding considerations for individual and population level risks and resilience in the field. However, this is no easy task.

As Melissa Perry noted in Primer 2: Environmental Health for Mental Health Professionals, measuring effects of the environment, even when just talking about chemicals, is extremely complex. For example, dose, duration, disbursement, toxicity levels, individual genetic and metabolic differences, and cumulative and combining effects are all worthy of consideration. In addition, how any of these exposures cause effect in any individual is also mediated by genetics, as outlined by Daniel Geschwind in Primer 3: The Role of Genetics in Mental and Behavioral Health Disorders.

A broad view of environmental influences is essential in suicide research just as it is in mental health, and JKBF is pleased to see attention to these factors. We support the collaborations and multifactorial thinking that this workshop was designed to promote, and hope that this attention will lead to measures that increase understanding and steps toward improving both individual and population health. As Dr. Manczak reminded us in her presentation, the vast majority of us respond to adversity with resilience; we believe that increasing attention and response to the breadth of environmental factors should increase resilience for those who suffer from mental health and suicidal concerns.