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Since I began my mental health activism in 2008, the dialogue has been predominantly around mental health/illness as being in your brain. I do not dispute the brain’s role in mental wellness. The critical skeptic in me has wondered if the large focus on the brain is a way to avoid the social determinants of health. The social determinants of health, and ultimately our community and governments, must be held accountable for their affect on people’s mental health.

If you are not familiar with social determinants of health, the concept states that a variety of social factors influence a person’s physical and mental health. Some examples of these factors are:

  1. Income/Social status
  2. Social support networks
  3. Education
  4. Employment/Working conditions
  5. Social environments
  6. Physical environments
  7. Personal health practices/Coping skills
  8. Healthy child development
  9. Race
  10. Gender
  11. Sexual orientation
  12. Disability

I recognize my privilege as a white Canadian-born heterosexual, cis woman who was raised in a middle-income family. I have had access to education, food, shelter, positive role models and environments, healthcare and more. This did and does set me up for improved physical and mental health.

Since graduating from university in 2011, I have found my mental health being debilitated because a few of these social determinants of health are not being met:


I’m a millennial. The employment of a millennial is characterized by instability. I have never been able to find a full-time permanent job with benefits like what my parents have.  I have been chronically underemployed, working low paying contract jobs, always searching for the next job. This instability has smashed my self-esteem and increased my feelings of hopelessness. It feels very demoralizing to be entering my 30s, with a 9-month-old child and still be in the same position in terms of employment that I was in when I was in my early 20’s. Employment provides income, stability, pride, health benefits, and purpose. This helps maintain or improve mental wellness. I imagine it would feel good to wake up in the morning and know you have a job to go to that won’t end in 3 months, and that you are contributing to society and your family.


Directly tied to employment, when you experience chronic unemployment, underemployment, or work contract jobs, you do not have the income or do not know if you have the income to live. I have frequently found myself dependent on others (sometimes abusive partners) for money to meet my basic needs. I have been dependent on family to provide me with housing twice in my life (including right now). I am very aware that if my family didn’t want me to live with them anymore that I would be completely homeless and be living in a shelter or on the street. I often find myself unable to pay debts or buy what my family needs. To depend on others for money, to apply for hundreds of jobs (seriously, hundreds) and not even get an interview, or to finally get a job and not make a living wage, is the cause of much of my depression these days. It is anxiety inducing to wonder how you are going to get through the month on a small budget, especially when you have a little human to care for. To make a living wage is to be able to provide for your basic needs. A living wage means you can find a home of your own. It means you can live instead of always trying to scrape by. Having a good income can ease your anxiety and provide comfort and safety.

As I stated above, I must acknowledge my privilege. This is what has helped my mental wellness even when things are stacked against me:

Personal health practices/coping skills

Learning coping skills from DBT, CBT and other therapy models is what makes the difference between the above unmet needs a little more bearable.

Social support networks

Having family, friends and peer support groups has helped me remain stable during the times I feel very low.


Even though my university education has not yielded the job I want and need, I acknowledge that having a degree is a solid foundation for employment that some do not have.




About Kristen Bellows

Kristen lives in Southern Ontario with her partner and their new baby boy! She identifies as Mad and believes that her emotional differences are a part of who she is. Kristen is a registered social work, working as a dialectical behaviour therapy (DBT) skills group facilitator. She is also training to become a birth and postpartum doula. Since giving birth, Kristen has become interested in exploring how mental health issues intersect with motherhood. Kristen identifies as Mad and believes that her emotional differences are a part of who she is. She loves cats, reading, singing, pickles and learning. You can read more of Kristen's blog posts on her personal blog

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