J Epidemiol Community Health doi:10.1136/jech-2012-202298
  • Commentary

Book Review: Social Perspective: The Missing Element in Mental Health Practice by Richard U'Ren. University of Toronto Press, 2011 (219 pages)

  1. John Frank
  1. Correspondence to Professor John Frank, University of Edinburgh—Scottish Collaboration for Public Health Research and Policy, 20 West Richmond St., Edinburgh EH8 9DX, UK; john.frank{at}

As a social epidemiologist, and former GP in clinical settings with major psychiatric caseloads, I confess that I tend to avoid scholarly books about mental health. My bias is that mental health professionals are typically unenlightened healthcare providers, on the subject of the social determinants of health. This cynical view arises from nearly 40 years as a physician, watching modern psychiatry bend itself out of shape at least a few times. Psychiatry first embraced and then largely rejected psychoanalysis, with its relative inattention to social position as an important contributor to lifelong health and function—only to then fall head over heels in love with modern neurobiology and pharmacotherapy, again with little emphasis on the social roots of much mental (and physical) illness.

However, at last here is an enlightening book that even the most psychiatrically critical health practitioners and researchers can read with pleasure. For it brings to the front and centre the enormous and convincing (but largely ignored) global literature on the social origins of the most common mental health problems, especially the ‘neuroses’. As well, the book expertly traces the profound influence of social and economic factors on the natural history of very severe mental illnesses (such as bipolar disorder and schizophrenia) which science now believes …

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