This is an American book about policies and legal framework, using thought-provoking case studies and the experience of the editors and authors. The refreshing perspective will engage, inform and hopefully energise readers wherever they are, especially mental health professionals who are looking for insight into the wider influences on the mental health of their patients.

The editors are psychiatrists rather than epidemiologists, planners or politicians. Their background shows through in a passionate and humane overview of societal influences on the mental health of populations. The social determinants of mental health are also the determinants of mental and physical illness. Informative and readable chapters from expert authors cover early life, education, employment, poor housing, poverty, food insecurity, various aspects of neighbourhood deprivation and access to healthcare. There is a welcome chapter on discrimination, an essential topic to address when describing the impact of the maldistribution of power, resources and policy focus. Historical perspectives and illuminating case studies illustrate the epidemiological points throughout.

Not content with describing the problem, and having gained an understanding of how their patients live beyond the consulting room, the authors want to bring about change. The final chapter outlines the desired policy direction and suggests how clinicians can play their part. The imperatives are succinctly summarised: to address the social, economic and environmental factors that impact on the population, to put mental health at the heart of all health policies, and health at the heart of all policies. Health and well-being impact assessments are rightly cited as workable tools to promote the approach. The almost overwhelming barriers to progress, that are not unique to but perhaps particularly entrenched in the USA, are well described. These barriers are stigma, lack of political will, competing priorities, cultural and political focus on ‘individual responsibility’ and the unconducive political process.

Nevertheless, in The Social Determinants of Mental Health ‘behavioural health professionals’ are called upon to be system and community leaders, to work across boundaries and with diverse stakeholders at all levels. When clinicians speak of an unwell and unfair society it should be a wake-up call to us all.