In this article, we explore challenges and opportunities in research oriented to understanding the relations among elements of socio-economic life and mental health (MH) and the development and evaluation of mental health promotion (HP) initiatives. We review the population health intervention research (PHIR) literature and respond to recommendations regarding social determinants of health and health inequities-focused research. We discuss three inter-related issue areas: first, the continued dominance of linear and individually oriented theories within predominantly quantitative research approaches and the underdevelopment of ontological and theoretical perspectives that capture complexity; second, the inconsistent use of measures of socio-economic status and health with a lack of attention to taken for granted assumptions; and third, the continued focus on measuring MH challenges to the neglect of exploring the meaning of MH in a positive sense. We extend recommendations within the PHIR literature by sharing our application of a historical–dialectical ontological perspective within a process of social praxis with diverse Canadian young people with varying degrees of access to socio-economic resources. Young people were engaged to explore the relations among socio-economic processes, young people’s MH and implications for mental HP. We argue that this ontological perspective can support the development of structurally oriented critical qualitative research approaches in PHIR.

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