We examine epidemiological evidence for the central role of inequalities (principally economic) in driving the onset of mental disorders, physical ill health and premature mortality. We locate the search for solutions in current UK contexts, and include known and likely effects of the COVID-19 pandemic. Prevention of mental disorders and adverse outcomes such as premature mortality must begin with efforts to mitigate rising poverty-inequality.

Inequality is a significant and reversible risk factor for mental disorders which demonstrates the essentially political nature of psychiatry. The BJPsych Bulletin is pleased to make space for those at the frontline of this inequality. Two experts by experience explain how financial concerns exacerbated their distress and the benefit of social interventions.

This article examines the relationship between poverty and mental health problems. We draw on the experience of Glasgow, our home city, which contains some of Western Europe's areas of greatest concentrated poverty and poorest health outcomes. We highlight how mental health problems are related directly to poverty, which in turn underlies wider health inequalities. We then outline implications for psychiatry.

Research on the bi-directional relationship between mental health and homelessness is reviewed and extended to consider a broader global perspective, highlighting structural factors that contribute to housing instability and its mental ill health sequelae. Local, national and international initiatives to address housing and mental health include Housing First in Western countries and promising local programmes in India and Africa. Ways that psychiatrists and physicians can be agents of changes range from brief screening for housing stability to structural competence training. Narrow medico-scientific framing of these issues risks losing sight of the foundational importance of housing to mental health and well-being.

We review basic science research on neural mechanisms underlying emotional processing in individuals of differing socioeconomic status (SES). We summarise SES differences in response to positive and negative stimuli in limbic and cortical regions associated with emotion and emotion regulation. We discuss the possible relevance of neuroscience to understanding the link between mental health and SES. We hope to provide insights into future neuroscience research on the etiology and pathophysiology of mental disorders relating to SES.

This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.

Smoking rates among people with common mental health conditions remain around 50% higher than those in the wider population; this is a significant cause of the 10–20-year reduced life expectancy of people with mental health conditions. However, the effects of smoking go far beyond physical health. Research estimates that smokers with mental health conditions could be spending as much as £2200 a year on tobacco, pushing an estimated 130 000 people with a common mental disorder into poverty. The Government has set a target for England to be smokefree by 2030; however, without a dramatic increase in support, smokers with mental health conditions risk being left behind. Action on Smoking and Health provides the secretariat for the Mental Health & Smoking Partnership. The Partnership aims to reduce the inequality in smoking rates between people with mental health conditions and the wider population. It brings together Royal Colleges, third-sector organisations, trade unions and academia to review progress and highlight areas for further action.