In 2002, my colleagues and I at the then Center for Mental Health Policy and Services Research at the University of Pennsylvania published a paper in Psychiatric Services on the role of social disadvantage in explaining mental illness and mental health status (Draine, Salzer, Culhane, Hadley, 2002). In the paper, we argued that the mechanisms of social disadvantage were underappreciated in research on the lives of people with mental illness living in communities. We asserted that mental illness was being overly blamed for some social conditions such as homelessness, unemployment, and criminal justice involvement, when, in many cases, the causal order for poor mental health status (however defined) could be easily argued the other way around-that endemic social distress and exclusion was making recovery from mental illness more challenging that it otherwise would be.
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