Migration, Mental Health and the Mega-City - Mechanisms in Urban Mental Disorder

This paper arises from a large scale UK ESRC funded project on Migration, Mental Health and the Mega-city (M3), currently in the field in Shanghai. The project’s background is in the Urban Brain research programme at King’s College London, which directly addresses the theme of this workshop – sociological explorations of the connections between urban settings and mental disorder. In this paper I will draw on our initial literature review, our current ethnography of migrant workers in Shanghai, and our preparations for a new survey instrument for carefully capturing the social conditions of urban migrants, to lay out some of the possible mechanisms by which the urban social setting ‘gets under the skin’ and ‘into the brain’.

The paper addresses ways in which sociological analysis and biological analysis might work together through the identification of ‘mechanisms’, imagined and confirmed through data, of the way in which the urban generates mental disorder. The argument moves from the use of mechanisms in scientific explanation, to the shortcomings of epidemiology, and the possibility of a new ‘mechanism-rich’ epidemiology. A wide range of papers, and actual and possible studies, are presented, including the Network Episode Model (NEM III R), SES as a ‘fundamental cause’, the social psychology of small groups, social capital, interaction ritual chains, stress (and the hypothalamic-pituitary-adrenal (HPA) axis), social support and its effect on the polyvagal parasympathetic part of the autonomic nervous system, trauma and its effect on the life-course, including childhood and PTSD, and gut biome and its effect on inflammation in the immune system.