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（SMI）是由生物、心理和社会因素复杂的相互作用引起的。然而，大多数SMI的一线治疗都针对生物和心理因素。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系统。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SMI的过程和结果中的作用的新知识，以及B）探索我们如何利用“保护性”社会因素来建立SMI患者的弹性和恢复。工作流1将使用机器学习预测模型分析纵向二级数据集，其中包含有关患有各种SMI的个人的数据。我们将探讨结构性社会决定因素的地域性预测因素如何聚集和相互作用，以预测各种SMI的过程和结果。工作流程2将从一组SMI患者中收集新信息，以衡量人际交流的数量和质量，跨社会领域的关系和支持网络如何有助于SMI患者的康复之旅。我们将探讨社会因素发挥其影响的生物和认知机制。工作流程3将探索社会处方和社区组织在支持SMI患者方面的潜力。与现场体验参与者，社区组织和其他利益相关者的创意研讨会和沙坑将允许参与者分享他们的经验，以塑造这些协议/计划的发展。解决重度医疗保险的关键社会决定因素，解决健康不平等问题，就有机会改变政策，共同支持重度医疗保险患者。

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.