Living in a neighbourhood where people trust each other is linked to an increased risk of severe mental illness among people from ethnic minority groups, despite the opposite being true for white majority populations, finds a new study in Sweden led by UCL researchers.
People in Stockholm who live in neighbourhoods where they feel safe and supported have a lower risk of psychotic disorders and bipolar disorder - but only for people of Swedish or European origin, according to the Nature Mental Health study by researchers from UCL and Karolinska Institutet.
For people of African or Middle Eastern origin, an increased risk of psychosis was seen in the same high-trust neighbourhoods.
The researchers investigated how different forms of social capital in residential areas affect the risk of developing serious mental illnesses, such as psychosis and bipolar disorder. The study is based on data from over 1.4 million people born in Sweden and living in Stockholm County, who were followed for up to 15 years.
The researchers focused on three types of social capital: political trust, welfare trust and personal trust, i.e. the experience of being able to get help when needed and feeling safe in one's neighbourhood.
The results show that higher levels of personal trust in the neighbourhood were associated with either a reduced or increased risk of developing psychotic disorders and bipolar disorder without psychosis, depending on the person's origin. Among residents with parents from Sweden or Europe, high personal trust had a protective effect, while the opposite effect was seen among residents with parents from Africa and the Middle East.
The explanation may lie in who experiences trust in the neighbourhood.
Lead author Professor James Kirkbride (UCL Division of Psychiatry) said: "The levels of personal trust measured in the study were based primarily on responses from people with Swedish-born parents. This means that people from different backgrounds may not have the same experiences or access to social networks that foster safety and trust.
Co-author Dr Anna-Clara Hollander (Karolinska Institutet) said: "Our results indicate that high personal trust in the residential area does not automatically benefit everyone. To promote mental health among the entire population, we need to create inclusive environments for everyone."
The researchers emphasise that the results cannot be interpreted as a causal relationship, but that they provide important clues as to how social factors affect mental health.
The study also shows that political and welfare-related trust had no clear link to mental illness.
Previous research has shown that foreign-born people living in Sweden and other high-income countries have an increased risk of developing psychosis, schizophrenia and other psychotic disorders. There is also evidence suggesting that the risk is lower among people living in areas with a high proportion of individuals from the same country of origin.
Professor James Kirkbride added: "Population interventions that aim to improve neighbourhood cohesiveness could be effective in protecting against severe mental illnesses, but that these need to be created sensitively and equitably to ensure that all groups can benefit from positive social resources and connections in a community."
The study was conducted in collaboration with Region Stockholm. It was funded by the Swedish Research Council, Forte, Wellcome, and the Royal Society, among others.
