Society, culture
and psychosis

Social and environmental conditions play an important role in peoples’ lives and mental health. Aspects of social disadvantage such as experiencing parental separation or childhood trauma, having low economic resources, being isolated, marginalized and discriminated, as well as living in densely populated areas with high levels of social and material deprivation may put people at higher risk of developing many mental health problems, notably psychosis. All these issues are also likely to impact access to, engagement in and satisfaction with services, and treatment outcomes (symptoms, social functioning, quality of life). Minoritized groups, particularly racialized and immigrant communities, may be more likely to be exposed to social disadvantage and have been described as having higher risk for psychosis, and facing harsher pathways to care and worse recovery prospects.
 

Building on these findings, our studies look at underexplored aspects of psychosis risk, service provision and outcomes among minoritized communities, with particular attention to social determinants of mental health, and the ways in which these intersect and particularly impact some people.

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Our studies (many led by doctoral student, Salome Xavier) focus on area-level exposures (e.g., immigrant integration policies, unemployment rates among migrants) that place the emphasis on society (instead of the individual). We are also exploring the overall experiences of service users from different social and cultural backgrounds (and living in distinct environmental contexts in Canada and the Netherlands) and seeking their opinions and suggestions regarding the higher risk for psychosis among minoritized groups. Iyer is also an active collaborator in the Culture, Community and Psychosis Information Network and its culturally adapted family psychoeducation project. Iyer also contributes to AQPPEP’s working group on improving the capacity of Quebec’s early intervention services for psychosis to serve Indigenous youth.  

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Different methods are being applied to explore these issues, such as knowledge synthesis, perspective pieces presenting issues and recommendations, quantitative multilevel regression analysis, critical discourse analysis of secondary bibliographic sources, life narrative interviews and arts-based methods (cellphilming). Findings from these studies will inform mental health promotion, prevention and better care provision and policies for minoritized communities.