Psychosocial Foundations of Mental Health: A Systematic Review of International Evidence

Abstract

Background: Psychosocial factors such as socioeconomic status, education, employment, family and community dynamics, stigma, culture, gender, and spirituality are increasingly recognized as critical determinants of mental health. This systematic review synthesizes evidence from 2015-2025 on how these factors impact mental health outcomes, guided by frameworks including the Biopsychosocial model and social determinant theories. Methods: Following PRISMA guidelines, we searched major databases (PubMed, Scopus, Web of Science, PsycINFO, etc.) for studies (2015–2025) examining psychosocial influences on mental health. Inclusion criteria favored peer-reviewed articles and credible gray literature addressing social, cultural, or psychological factors and mental health outcomes internationally. Data were extracted and narratively synthesized around key themes. Results: Seventy-two studies met inclusion criteria (global coverage across high-, middle-, and low-income settings). Common psychosocial risk factors for poorer mental health included low socioeconomic status, limited education, unemployment, lack of social support, childhood adversity, and experiences of stigma and discrimination. Protective factors such as high social support, coping skills, and secure family relationships were associated with better mental health outcomes. A PRISMA flow diagram depicts the study selection, and a summary table outline included studies and key findings. Discussion: Psychosocial disadvantage consistently correlates with higher risk of mental health problems, supporting social causation theories, while some evidence of social selection (mental illness contributing to social decline) also emerged. Cultural and gender contexts modulate these relationships, and theoretical models (e.g. Social Capital Theory, Labelling Theory, Diathesis-Stress) help explain underlying mechanisms. Conclusions: Mental health outcomes are profoundly shaped by psychosocial environments. Addressing socioeconomic inequalities, strengthening community and family supports, combating stigma, and integrating cultural and spiritual resources are vital for improving global mental health. Policymakers and clinicians should adopt holistic, multi-factorial approaches as outlined by the Biopsychosocial model to promote mental well-being.