© 2019

Structural Competency in Mental Health and Medicine

A Case-Based Approach to Treating the Social Determinants of Health

  • Helena Hansen
  • Jonathan M. Metzl
  • Each chapter begins with a case study that illustrates a structural competency in practice

  • Includes an appendix with curricular materials and evaluation tools used by leading structural competency practitioners

  • Written by experts with cross-training in clinical and social sciences


Table of contents

  1. Front Matter
    Pages i-xxix
  2. Structural Competency in Classrooms and Clinics

    1. Front Matter
      Pages 1-1
    2. Jonathan M. Metzl, JuLeigh Petty, Philip J. Pettis
      Pages 3-14
    3. Edgar Rivera Colón
      Pages 27-33
    4. Cameron Donald, Fabián Fernández, Elaine Hsiang, Omar Mesina, Sarah Rosenwohl-Mack, Aimee Medeiros et al.
      Pages 35-51
    5. Joshua Neff, Seth M. Holmes, Shirley Strong, Gregory Chin, Jorge De Avila, Sam Dubal et al.
      Pages 53-74
  3. Structural Competency in Non-health Sector Collaborations

    1. Front Matter
      Pages 99-99
    2. Molly Rose Kaufman, Lourdes Rodriguez, Robert E. Fullilove III, Mindy Thompson Fullilove
      Pages 101-108
    3. Andrew F. Beck, Mallory Curran, Adrienne W. Henize, Melissa D. Klein, Donita S. Parrish, Edward G. Paul et al.
      Pages 121-134
  4. Structural Competency in Community Engagement

  5. Structural Competency in Policy Advocacy

    1. Front Matter
      Pages 179-179

About this book


This book documents the ways that clinical practitioners and trainees have used the “structural competency” framework to reduce inequalities in health.  The essays describe on-the-ground ways that clinicians, educators, and activists craft structural interventions to enhance health outcomes, student learning, and community organizing around issues of social justice in health and healthcare. Each chapter of the book begins with a case study that illuminates a competency in reorienting clinical and public health practice toward community, institutional and policy level intervention based on alliances with social agencies, community organizations and policy makers.  Written by authors who are trained in both clinical and social sciences, the chapters cover pedagogy in classrooms and clinics, community collaboration, innovative health promotion approaches in non-health sectors and in public policies, offering a view of effective care as structural intervention and a road map toward its implementation.

Structural Competency in Mental Health and Medicine is a cutting-edge resource for psychiatrists, primary care physicians, addiction medicine specialists, emergency medicine specialists, nurses, social workers, public health practitioners, and other clinicians working toward equality in health.


Healthcare inequalities Correctional system Educational system Clinical interventions Non-health sectors

Editors and affiliations

  • Helena Hansen
    • 1
  • Jonathan M. Metzl
    • 2
  1. 1.New York UniversityNew YorkUSA
  2. 2.Center for Medicine, Health, and SocietyVanderbilt UniversityNashvilleUSA

About the editors

Helena Hansen MD, PhD
Assistant Professor of Psychiatry and Anthropology,
New York University, NY, NY

Jonathan Metzl, MD, PhD
Frederick B. Rentschler II Professor of Sociology and Medicine, Health, and Society
Professor of Psychiatry
Vanderbilt University
300 Calhoun Hall
Nashville, TN

Bibliographic information

  • Book Title Structural Competency in Mental Health and Medicine
  • Book Subtitle A Case-Based Approach to Treating the Social Determinants of Health
  • Editors Helena Hansen
    Jonathan M. Metzl
  • DOI
  • Copyright Information Springer Nature Switzerland AG 2019
  • Publisher Name Springer, Cham
  • eBook Packages Medicine Medicine (R0)
  • Hardcover ISBN 978-3-030-10524-2
  • eBook ISBN 978-3-030-10525-9
  • Edition Number 1
  • Number of Pages XXIX, 230
  • Number of Illustrations 8 b/w illustrations, 13 illustrations in colour
  • Topics Psychiatry
    Emergency Medicine
    General Practice / Family Medicine
    Public Health
  • Buy this book on publisher's site
Industry Sectors
Health & Hospitals


“The book would be a worthwhile addition to any collection on cultural competency; diversity, equity, and inclusion; public health; social determinants of health; or health professions education. Hansen and Metzl’s Structural Competency in Mental Health and Medicine: A Case Based Approach to Treating the Social Determinants of Health will, I hope, inspire further development and implementation of structural competency perhaps involving collaborations with health sciences libraries and librarians.” (Gregory Laynor, Journal of the Medical Library Association, Vol. 109 (2), April, 2021)