Building recovery and resilience in severe mental illness: Leveraging the role of social determinants in illness trajectories and interventions

严重精神疾病（SMIs）是生物、心理和社会因素复杂相互作用的结果。然而，大多数针对SMIs的一线治疗针对的是生物和心理因素。该中心将重点关注“社会决定因素”：人们出生、成长、工作、生活和衰老的条件，以及塑造日常生活条件的更广泛的力量和制度。我们将利用多学科和跨部门的专业知识和经验，将这些见解与生活经验相结合，以a)产生关于社会决定因素在影响SMIs过程和结果中的作用的新知识；b)探索我们如何利用“保护性”社会因素来建立SMIs患者的适应能力和恢复能力。计划了三个工作流。工作流程1将使用机器学习预测模型来分析包含各种smi个体数据的纵向次要数据集。我们将探讨基于地域的结构性社会决定因素如何聚集和相互作用，以预测各种SMIs的过程和结果。工作流程2将从一组SMIs患者中收集新信息，以衡量跨社会领域的人际交流、关系和支持网络的数量和质量如何有助于SMIs患者的康复之旅。我们将探讨社会因素发挥其作用的生物学和认知机制。工作流程3将探讨社会处方和社区组织在支持重度精神分裂症患者方面的潜力。有亲身体验参与者、社区组织和其他利益相关者参加的创意研讨会和沙坑将使参与者分享他们的经验，以塑造这些协议/项目的发展。解决中小自杀者的主要社会决定因素可解决保健不平等问题，这为政策变革提供了机会，以集体支持中小自杀者。

Severe Mental Illnesses (SMIs) arise from a complex interplay of biological, psychological, and social factors. Yet most frontline treatments for SMIs target biological and psychological factors. This hub will focus on "social determinants": the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems that shape the conditions of daily life. We will draw on multi-disciplinary and cross-sectoral expertise and experience, interweaving these insights with lived experiences to a) generate new knowledge on the role of social determinants in influencing the course and outcomes of SMIs and b) explore how we can leverage "protective" social factors to build resilience and recovery in people with SMIs. Three workstreams are planned.Workstream 1 will use machine learning predictive models to analyse longitudinal, secondary datasets containing data on individuals with various SMIs. We will explore how locality-based predictors of structural social determinants cluster and interact to predict the course and outcomes of various SMIs.Workstream 2 will collect new information from a cohort of patients with SMIs to measure how the quantity and quality of interpersonal exchanges, relationships and support networks across social spheres contributes to the recovery journeys of people with SMIs. We will explore the biological and cognitive mechanisms by which social factors exert their effects. Workstream 3 will explore the potential of social prescribing and community organising in supporting patients with SMIs. Creative workshops and sandpits with lived experience participants, community organisations, and other stakeholders will allow participants to share their experiences to shape the development of these protocols/programmes. Addressing key social determinants of SMIs tackles health inequalities invites an opportunity for policy change to collectively support people with SMIs.