This chapter uses the history of public health theories of disease causation as a back drop to investigating a new concept, social capital, which attempts to help us understand and compare societies. In its short life so far the original concept of social capital which was floated decades ago has been caught up in a tide of optimistic social renewal, and vaunted as the great new idea. It has punched well above its weight given the relative dearth of research on the topic because it is a “good idea” and so ripe for media spin. As a societal level construct it offers significant challenges to routine psychiatric thinking. To understand these challenges, I will offer an introduction to the concept of social capital and the literature on its associations with mental health and illness. I will include comment on the machinations that the research community have used to make sense and to make use of the concept. I will finish with some thoughts on what this story tells us about the state of the art of social psychiatry and how social capital could help us understand the social course of illness.

Public health causation and risk

The first true public health physicians were the Sanitary Movement in nineteenth-century England.

Infectious diseases were the scourge of the population. They were a significant contributor to the differential life expectancy between rich and poor: there was a significant difference in mortality rates between rich and poor persons.