ORIGINAL ARTICLE What makes the difference in people’s lives when they have a mental disorder? Kaloyan Kamenov 1,2 • Marı ´a Cabello 1,2 • Carolina Saskia Ballert 3 • Alarcos Cieza 4,5,6 • Somnath Chatterji 7 • Diego Rojas 8 • Gloria Cero ´n 8 • Jerome Bickenbach 3 • Jose ´ Luis Ayuso-Mateos 1,2,9 • Carla Sabariego 5 Received: 22 November 2016 / Revised: 17 July 2017 / Accepted: 14 October 2017 Ó Swiss School of Public Health (SSPH+) 2017 Abstract Objectives The objective of this study was to identify which environmental factors are the most responsible for the dis- ability experienced by persons with mental disorders and whether they differ (1) from those in cardiovascular diseases, chronic respiratory conditions, diabetes, and cancer, and (2) depending on the capacity level-a proxy for the impact of health conditions on the health state of individuals. Methods Nationally representative data from 12,265 adults in Chile collected in 2015 with the WHO Model Disability Survey was analyzed. Results The availability of personal assistance, frequency of receiving personal assistance, and assistive devices for mobility were the most important environmental factors across mental and other non-communicable diseases. Per- ception of discrimination and use of health services were also prominent factors. There was a huge overlap between the factors found relevant for mental and other non-com- municable diseases, but a substantial variability depending on the intensity of difficulties in capacity. Conclusions This study challenges the appropriateness of disease-specific approaches and suggests that considering intrinsic capacity levels is more informative than focusing on diagnosis alone when comparing needs and barriers that affect the performance in daily life of specific groups of individuals. Keywords Environmental health Á Mental health Á Non- communicable disease Á Disability, public health Introduction Mental disorders (MDs) are highly prevalent worldwide and considered one of the five most burdensome non- communicable (NCD) conditions besides diabetes, cancer, cardiovascular disease (CVD) and chronic respiratory Alarcos Cieza and Somnath Chatterji: The views expressed in this manuscript are those of the authors and do not necessarily represent views or policies of the World Health Organization. & Jose ´ Luis Ayuso-Mateos joseluis.ayuso@uam.es 1 Instituto de Salud Carlos III, Centro de Investigacio ´n Biome ´dica en Red, CIBER, Madrid, Spain 2 Department of Psychiatry, Universidad Auto ´ noma de Madrid, Madrid, Spain 3 Swiss Paraplegic Research, Nottwil, Switzerland 4 Faculty of Social and Human Sciences, University of Southampton, Southampton, UK 5 Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universita ¨t Mu ¨nchen, Munich, Germany 6 Blindness and Deafness Prevention, Disability and Rehabilitation (BDD), World Health Organization, Geneva, Switzerland 7 Department for Information, Evidence and Research, World Health Organization, Geneva, Switzerland 8 Department of Studies, Servicio Nacional de Discapacidad (Senadis), Ministerio de Desarrollo Social, Santiago, Chile 9 Instituto de investigacio ´n de la Princesa, (IIS-IP), Hospital Universitario de la Princesa, C/Diego de Leo ´n 62, 28006 Madrid, Spain 123 Int J Public Health https://doi.org/10.1007/s00038-017-1047-5