26th TMIMS International Symposium

Social Determinantsof Mental Health,
2024
Date

2024
Venue

3.15 Fri.

10 : 00 17 : 30

Tokyo Metropolitan Institute ofMedical Science, Auditorium
Organized by

Atsushi Nishida

Tokyo Metropolitan Institute of Medical Science

Kiyoto Kasai
University of Tokyo

Speakers

Marcus Richards
University College London, UK

Vikram Patel
Harvard Medical School, USA

Tanya M. Luhrmann
Standford University, USA

Deidre Anglin

The City College of the City University of New York, USA

Stephani Hatch
King’s College London, UK

Atsushi Nishida

Tokyo Metropolitan Institute of Medical Science, JAPAN■26th TMIMS International Symposium

Program
10:00-10:10

Welcome & Opening Comments
Atsushi Nishida, Tokyo Metropolitan Institute of Medical Science, Japan
Kiyoto Kasai, The University of Tokyo, Japan

10:10-11:05
Presentation
45min
Discussion
10minSocial determinants and social consequences of mental health: a life course
approach
Presenter : Marcus Richards, University College London, UK
Chair : Kiyoto Kasai, The University of Tokyo, Japan

11:05-11:15

Break

11:15-12:10

Acting early: the key to promoting mental health across the life course

Presentation
45min
Discussion
10min

Presenter : Vikram Patel, Harvard Medical School, USA
Chair : Toshi A Furukawa, Kyoto University, Japan

12:10-13:00

Lunch

13:00-13:55

How culture shapes voices（On-line Lecture）
Presenter : Tanya M. Luhrmann, Standford University, USA

Presentation
45min
Discussion
10min

Chair : Junko Kitanaka, Keio University, Tokyo, Japan

13:55-14:05

Break

14:05-15:00

Racism and Social Determinants of Psychosis Risk

Presentation
45min
Discussion
10min

Presenter : Deidre Anglin,The City College of the City University of New York, USA
Chair : Shinichiro Kumagaya, The University of Tokyo, Japan

15:00-15:15

Coffee Break

15:15-16:10

Why utilising anti-racist practice and tackling discrimination are crucial for
addressing inequities in mental health and mental health services

Presentation
45min
Discussion
10min

16:10-16:20

Presenter : Stephani Hatch, King’s College London, UK

Chair : Mariko Hiraiwa-Hasegawa, Tokyo Metropolitan Institute of Medical Science, Japan

Break

1

Social Determinants of Mental Health, 2024 ■

16:20-17:10
Presentation
40min
Discussion
10min

17:10-17:30

Social Determinants of Adolescent Mental Health: Findings from Tokyo
Teen Cohort
Presenter : Atsushi Nishida, Tokyo Metropolitan Institute of Medical Science, Japan
Chair : Kanna Sugiura, Mental Health and Welfare Center, City of Yokohama, Japan

Discussion Session
Chair : Mitsuhiro Miyashita, & Syudo Yamasaki, Tokyo Metropolitan Institute of Medical Science, Japan

Marcus Richards, University College London, UK
Vikram Patel, Harvard Medical School, USA
Deidre Anglin, The City College of the City University of New York, USA
Stephani Hatch, King’s College London, UK
Kiyoto Kasai, The University of Tokyo, Japan
Shinichiro Kumagaya, The University of Tokyo, Japan
Toshi A Furukawa, Kyoto University, Japan
Mariko Hiraiwa-Hasegawa, Tokyo Metropolitan Institute of Medical Science, Japan

Closing remark
Atsushi Nishida, Tokyo Metropolitan Institute of Medical Science, Japan
Mariko Hiraiwa-Hasegawa, Tokyo Metropolitan Institute of Medical Science, Japan2

■26th TMIMS International Symposium

Social determinants and social consequences ofmental health: a life course approach

Marcus Richards

University College London, UK

Abstract

Biography

Mental ageing encompasses emotional psychiatricand cognitive function. Most relevant measures arecontinuously distributed in the general population,from emotional and behavioural stability andoptimum cognitive function at one extreme, toaffective and externalising disorders and dementia
at the other extreme. Life course epidemiology,
based on birth cohort studies, has consistently
shown that these outcomes have strong social
determinants. For depression, by far the strongest
determinants are stressful life events, even after
taking account of adolescent depression. Thesesocial factors can also be consequences of mental
ill-health. This is striking in the case of adolescentconduct problems, which are associated withlow educational and occupational attainment,
intimate relationship problems, and trouble withthe criminal justice system. Social determinants
are also important for cognitive impairment anddementia, above all education, where effects are
independent of early cognitive development andsensitive to broader social factors such as school
leaving age. Education has been the historical focus
for the cognitive reserve model of dementia since
it can modify the relationship between pathology
and functionality. These factors will be reviewed indetail during this presentation.

Marcus Richards is a Programme Leader at the MRC
Unit for Lifelong Health and Ageing at UCL, anda Professor of Psychology in Epidemiology at theFaculty of Population Health Sciences, University
College London. He read Experimental Psychology
at Oxford University, and obtained a PhD at London
University in the physiology of human learning.
He has held appointments at Columbia University
in New York and King’s College London Instituteof Psychiatry, Psychology and Neuroscience toconduct research into neurodegenerative diseasesof ageing, and was one of the first recipients ofan Alzheimer’s Society Research Fellowship. He
joined the MRC National Survey of Health andDevelopment team in 1996.

3

Social Determinants of Mental Health, 2024 ■Acting early: the key to promoting mental healthacross the life course

Vikram Patel

Harvard Medical School, USA

Abstract

Biography

The most consistently demonstrated risk factor
for poor mental health across the life course is
the experience of adversities, typically related
to deprivation and violence, during developmentally sensitive periods of early childhood andadolescence. This lecture will consider how the
well-described social determinants of mental healthexert some of their effects through these early life
developmental pathways. The lecture will then use
an ecological model to describe the implicationsof this science for the promotion of mental healthand consider the potential for a range of evidencebased interventions, from income support andsocial protection to parenting and mental healthinterventions.

Vikram Patel is Paul Farmer Professor and Chair of
Global Health and Social Medicine in the Blavatnik
Institute's Department of Global Health and Social
Medicine at Harvard Medical School. He co-leads
the Department’s Mental Health for All lab andco-leads The GlobalMentalHealth@Harvard
initiative. His work has focused on the burden ofmental health problems across the life course, theirassociation with social disadvantage, and the useof community resources for their prevention andtreatment. He is a co-founder of the Movement
for Global Mental Health, the Centre for Global
Mental Health (at the London School of Hygiene &Tropical Medicine), the Mental Health Innovations
Network, and Sangath, an Indian NGO which won
the WHO Public Health Champion of India prize
and the MacArthur Foundation’s InternationalPrize. He is a Fellow of the UK’s Academy of Medical
Sciences and member of the US National Academyof Medicine. He served on the Committee which
drafted India’s first National Mental Health Policy
and the WHO High Level Independent Commission
for Non-Communicable Diseases. He co-led theLancet Commission on Global Mental Health& Sustainable Development and the LancetWorld Psychiatric Association Commission on
Depression; he serves as co-chair of the Lancet
Citizens Commission on Reimagining India’s Health
System. He was listed in TIME Magazine’s 100 mostinfluential persons of the year in 2015.
4■26th TMIMS International Symposium

How culture shapes voices

Tanya M. Luhrmann
Standford University, USA

Abstract

Biography

They are strange experiences - a voice whisperedon the wind, a god who speaks from on high - but
far more common than we think. At the beginningof most great religions lies a voice. Who hears suchvoices? I have spoken to hundreds of people, inmany countries, who have heard voices, someonly once, some more often. Most of these people
are not psychiatrically ill. Some are. In this talk I
will discuss what we know about the difference
between mad voices and sane voices, and what
traits and practices and cultural ideas make sane
voices more likely. I will also talk about the evidence
that the way we think about voices changes our
experience of them - and may soften the impact of
psychosis. In the process I will discuss the culturaldifferences between the voices heard by persons
with schizophrenia in the US (San Mateo, San
Francisco); India (Chennai); Ghana (Accra, Cape
Coast); Russia (Khazan); China (Shanghai); andThailand (Chiang Mai).

Tanya Marie Luhrmann is the Albert Ray Lang
Professor of Anthropology at Standford University,with a courtesy appointment in Psychology. Her
work focuses on the edge of experience: on voices,
visions, the world of the supernatural and theworld of psychosis. She has done ethnography on
the streets of Chicago with homeless and psychotic
women, and worked with people who hear voices
in Chennai, Accra and the South Bay. She has alsodone fieldwork with evangelical Christians whoseek to hear God speak back, with Zoroastrians
who set out to create a more mystical faith, andwith people who practice magic. She uses a
combination of ethnographic and experimental
methods to understand the phenomenology ofunusual sensory experiences, the way they areshaped by ideas about minds and persons, andwhat we can learn from this social shaping that canhelp us to help those whose voices are distressing.
At the heart of the work is the sense of being called,
and its possibilities and burden. She was named
to the American Academy of Arts and Sciences in
2003, received a John Guggenheim Fellowshipaward in 2007 and elected to the American
Philosophical Society in 2022. When God Talks Backwas named a NYT Notable Book of the Year and a
Kirkus Reviews Best Book of the Year.

5

Social Determinants of Mental Health, 2024 ■Racism and Social Determinants of Psychosis Risk

Deidre Anglin

The City College of the City University of New York, USA
Abstract

Biography

Social determinants of mental health include thephysical and social environmental conditions
populations develop within across generations.
This talk will provide a critical overview of the roleof structural racism in shaping social determinantsof psychosis risk and outcomes and ethnoracialdisparities in these outcomes. There is increasing
evidence that racial discrimination and relatedsocial determinants in neighborhoods may increaserisk for psychotic experiences in ethnoracial
minorized populations—experiences that may or
may not lead to a clinical psychotic disorder, but
are a transdiagnostic marker of mental morbidity.
Accumulating evidence from non-treatment
seeking, nationally representative, clinical highrisk, and first episode psychosis studies will be
reviewed. Qualitative examples from a Photovoice
study with Black young people with first episodepsychosis will be used to illustrate how social andcultural isolation in neighborhoods and racial
discriminatory experiences can be triggering forvulnerable youth. Community and family supports
identified through this study and suggestions forenhancing coordinated specialty care services will
also be highlighted.

Deidre Anglin, PhD is an Associate Professorof Clinical Psychology in the Department of
Psychology and in the Doctoral Clinical Program at
The City College of New York (CCNY). She received
her postdoctoral research training in psychiatricepidemiology at Columbia University’s Mailman
School of Public Health. Generally, Dr. Anglin’s
work has focused on reducing mental health racialdisparities and studying the social epidemiologyof psychosis. She is the lead investigator of astudy funded by Columbia University’s Center for
Excellence and Cultural Competence, to studysocial and cultural determinants of psychosis risk.
She is also the principal investigator of an NIHfunded study that utilizes experimental methods
to study the physiologic effects of racial exclusion
among racial minority young adults presenting
with attenuated psychotic symptoms. She is oneof the First 100 doctoral scholars in the Leadership
Alliance and a member of NIH’s National Research
Mentoring Network (NRMN). Dr. Anglin has several
first-author publications in well-recognized journals
such as Schizophrenia Research and PsychiatricServices and has presented her work all over thecountry.

6

■26th TMIMS International Symposium

Why utilising anti-racist practice and tackling
discrimination are crucial for addressing
inequities in mental health and mental health services

Stephani Hatch

King’s College London, UK

Abstract

Biography

Mental ageing encompasses emotional psychiatricand cognitive function. Most relevant measures arecontinuously distributed in the general population,from emotional and behavioural stability andoptimum cognitive function at one extreme, toaffective and externalising disorders and dementia
at the other extreme. Life course epidemiology,
based on birth cohort studies, has consistently
shown that these outcomes have strong social
determinants. For depression, by far the strongest
determinants are stressful life events, even after
taking account of adolescent depression. Thesesocial factors can also be consequences of mental
ill-health. This is striking in the case of adolescentconduct problems, which are associated withlow educational and occupational attainment,
intimate relationship problems, and trouble withthe criminal justice system. Social determinants
are also important for cognitive impairment anddementia, above all education, where effects are
independent of early cognitive development andsensitive to broader social factors such as school
leaving age. Education has been the historical focus
for the cognitive reserve model of dementia since
it can modify the relationship between pathology
and functionality. These factors will be reviewed indetail during this presentation.

Stephani Hatch is Professor of Sociology andEpidemiology at King’s College London. She
leads the Health Inequalities Research Group,working across sectors, locally and nationally, todeliver interdisciplinary research on inequalities
in mental health in marginalised communities
and across health services with an emphasis on
race at the intersection of other social identities.
She has expertise in sociology and psychiatricepidemiology, using mixed quantitative andqualitative methods to study the impact of
discrimination, social adversity, social determinants over the life course on mental healthand multimorbidity. She has also been co-leading
initiatives promoting and changing policies toinsure the embeddedness of inclusive research
culture, equality, diversity and inclusion at KCL
since 2014. Stephani co-leads the Marginalised
Communities and Mental Health programmewithin the ESRC Centre for Society and Mental
Health, focused on working in close partnershipwith communities that have often been ignored, toexamine and disrupt structures maintaining social
inequities in mental health.

7

Social Determinants of Mental Health, 2024 ■Social Determinants of Adolescent Mental Health:Findings from Tokyo Teen Cohort

Atsushi Nishida

Tokyo Metropolitan Institute of Medical Science, JAPAN
Abstract

Biography

Adolescence is a pivotal phase for the cultivation ofsocial and emotional well-being, integral to mental
health. Recent years have witnessed a notable
increase in depression, psychological distress,
anxiety, and suicidal behaviors among adolescents.
Addressing this concern necessitates an explorationof causative factors and an understanding of social
determinants influencing adolescent mental healthto formulate effective preventive measures.
Our ongoing Tokyo-based birth cohort study,
tracking approximately 3,000 adolescents now
aged 20, has yielded valuable insights. Notably,
the study has unveiled environmental factors
crucial to fostering adolescent mental health.
Significantly, our findings emphasize the pivotal
role of the school environment in alleviating stressand mitigating the impact of adverse childhood
experiences on both physical and mental healthduring adolescence.
This presentation aims to share the results from theTokyo Teen Cohort (TTC) study, highlighting theaffirmative influence of school climate on the healthand developmental trajectory of adolescents. Our
research underscores the importance of schools
as a proactive and protective force in shaping thewell-being of the younger generation.

Atsushi Nishida, PhD is a chair of the ResearchCenter for Social Science and Medicine at theTokyo Metropolitan Institute of Medical Science(TMiMS). He has expertise in psychiatric epidemiology and mental health policy, and he has also
been a co-lead of the Tokyo Teen Cohort (TTC)
which is following up with approximately 3,000
adolescents. He also leads the Unit for Mental
Health Promotion in TMiMS, working acrosssectors, locally and nationally to deliver evidencedbased mental health services in the community.
He has been committed to policy making as amember of various expert panels for the Tokyo
Metropolitan Government and the Japanese
National Government. In recognition of his
contributions to social policy, he received the 2012
Symbol of Tomorrow Award, which honours young
professionals in the medical and health fields inJapan.

8

■26th TMIMS International Symposium

Biography of the chair for each session

Kiyoto Kasai

Prof Kasai gained experience at the University of Tokyo Hospital and National Center of Neurology andPsychiatry, before an appointment as visiting instructor at Harvard Medical School, USA, from 2000 to 2002.
He was appointed Professor and Chair of the Department of Neuropsychiatry at the University of Tokyo in
2008. His research focuses on the biological mechanisms underlying psychosis onset and the developmentof effective early intervention strategies. His group’s expertise includes a wide range of neuroimaging
techniques, and extended his studies to adolescent brain neuroscience via the launch of the Tokyo TEEN
Cohort in 2012. He is also organizing an all-Japan multi-site MRI research framework in psychiatric disorders.
Toshi A Furukawa

Prof. Toshi A. Furukawa is currently Professor and Chair of the Department of Health Promotion and Human
Behavior, Kyoto University Graduate School of Medicine / School of Public Health, since 2010. Prof Furukawa’s
major areas of interest and expertise include clinical psycho-pharmacology and cognitive-behavior therapy
of mood and anxiety disorders, evidence-based psychiatry, psychometrics and systematic reviews. He is
also a Diplomate of the Academy of Cognitive Therapy and Editor of the Cochrane Collaboration Common
Mental Disorders Group.
Junko Kitanaka

Junko Kitanaka is a medical anthropologist and professor in the Department of Human Sciences, Keio
University, Tokyo. For her McGill University doctoral dissertation on depression, she received a number ofawards including the 2007 Dissertation Award from the American Anthropological Association’s Society
for Medical Anthropology. This has since been published by Princeton University Press as a book titled
Depression in Japan: Psychiatric Cures for a Society in Distress, which won the American Anthropological
Association's Francis Hsu Prize for Best Book in East Asian Anthropology in 2013. The book has beentranslated by Dr. Pierre-Henri Castel at the University of Paris-Descartes and published by D'Ithaque as Dela mort voluntaire au suicide au travail: Histoire et anthropologie de la depression au Japon (2014). She iscurrently working on a new project on health screening, old age, and the psychiatrization of the life cycle.
Shinichiro Kumagaya

Dr. Shinichiro Kumagaya, a medical doctor and associate professor at the University of Tokyo’s ResearchCenter for Advanced Science and Technology since 2015, brings a unique perspective to his research. Dr.
Kumagaya, who has cerebral palsy and has used a wheelchair since childhood, specializes in paediatrics andemploys the innovative tojisha-kenkyu research method. Dr. Kumagaya’s tojisha-kenkyu, often described as"research that interested people do on themselves," offers a unique and insightful approach. His research
focus revolves around understanding the mechanisms that facilitate individuals with diseases or disabilities
to interact and cooperate effectively with their surroundings.

9Social Determinants of Mental Health, 2024 ■Mariko Hiraiwa-Hasegawa

Prof Hasegawa, an anthropologist with expertise in natural anthropology and behavioral ecology, served as
a visiting associate professor at Yale University and later as a professor at Waseda University. Notably, sheheld the position of president at the Graduate University for Advanced Studies from 2006 to 2023.
Her diverse research portfolio includes investigations into the behavior of wild chimpanzees, damselfish in
the United Kingdom, as well as wild sheep and peacocks in Sri Lanka. More recently, Professor Hasegawa
has delved into the intricate realms of human evolution and adaptation. She has been involved in launching
the Tokyo TEEN Cohort study
Kanna Sugiura

Dr. Sugiura is a psychiatrist and has been working at the Mental Health and Welfare Center, City of
Yokohama since 2016. She has been interested in mental health services in Japan and developing countries,
and has worked as an expert officer in the Mental Health and Substance Abuse Division of WHO and as aforeign affairs officer in the International Health Policy Office of the Ministry of Foreign Affairs. She currently
works in an outpatient psychiatric practice and continues to conduct research on the experience of
involuntary hospitalization.
Syudo Yamasaki

Dr Syudo Yamasaki is a member of the Tokyo TEEN Cohort research team. His back ground is in clinicalpsychology and social work in community psychiatry. He started his career providing psychosocial support
for young people with severe mental illness based at The University of Tokyo Hospital. Since 2012, He
has been at Tokyo Metropolitan Institute of medical Science and has been involved in launching andmaintaining the Tokyo TEEN Cohort study.
Mitsuhiro Miyashita

Dr. Miyashita is a psychiatrist and senior investigator at the Tokyo metropolitan Institute of Medical Science,
Research Center for Social Science & Medicine, Unit for Mental Health Promotion. His research in focused on
the influence of biological factors enhanced by social stress on the development of psychosis. His researchinterests also include individual-centered care and support for patients with mental disorders.

10公益財団法人

東京都医学総合研究所
第 26 回都医学研国際シンポジウム事務局〒156-8506 東京都世田谷区上北沢 2-1-6
E-mail symp@igakuken.or.jp

Contact : 公益財団法人 東京都医学総合研究所 社会健康医学研究センター 心の健康ユニット
Co-Sponsored by : 文部科学省科学研究費補助金・学術変革領域研究：「当事者化」人間行動科学
Human behavioral science for subjectification(“tojisha-ka”) by interaction-based &rule-/story-based understanding of the brain & the world