Mental Disorder :: Mental health is not just the absence of mental disorder

* The positive dimension of mental health is stressed in WHO’s definition of health as contained in its constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” WHO’s 191 member states have endorsed this sweeping statement.

How does one define mental health?

* It is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

* Mental health promotion is an umbrella term that covers a variety of strategies, all aimed at having a positive effect on mental health. The encouragement of individual resources and skills and improvements in the socio-economic environment are among them.

* Most health care resources are spent on the specialised treatment and care of the mentally ill, and to a lesser extent on community treatment and rehabilitation services. Even less funding is available for promoting mental health.

* Mental health promotion requires multi-sectoral action, involving a number of government sectors such as health, employment/industry, education, environment, transport and social and community services as well as non-governmental or community-based organisations such as health support groups, churches, clubs and other bodies.

Enhancing the value and visibility of mental health

* National mental health policies should not be solely concerned with mental illness but recognise and address the broader issues affecting the mental health of all sectors of society. These would include the social integration of severely marginalized groups, such as refugees, disaster victims, the socially alienated, the mentally disabled, the very old and infirm, abused children and women, and the poor.

Mental health promotion for children and adolescents

* Psychosocial and cognitive development of babies and infants depends upon their interaction with their parents. Programmes that enhance the quality of these relations can improve substantially the emotional, social, cognitive and physical development of children. These activities are particularly meaningful for mothers living in conditions of stress and social adversity. WHO has developed an international programme to stimulate mother-infant interaction that has been widely adopted.

* It is clear that schools remain a crucial social institution for the education of children in preparation for life. But they need to be more involved in a broader educational role fostering healthy social and emotional development of pupils.

* WHO has developed a ‘life skills’ educational curriculum, which teaches a wide range of skills to school age children to improve their psychosocial competency. The skills include problem-solving, critical thinking, communication, interpersonal skills, empathy, and methods to cope with emotions. These skills enable children and adolescents to develop sound and positive mental health.

* “Child-friendly schools” are another WHO mental health initiative to promote a sound psychosocial environment in the school to complement the life skills curriculum. A child-friendly school encourages tolerance and equality between boys and girls and different ethnic, religious and social groups. It promotes active involvement and cooperation, avoids the use of physical punishment, and does not tolerate bullying. It is also a supportive and nurturing environment; providing education which responds to the reality of the children’s lives. Finally, it helps to establish connections between school and family life, encourages creativity as well as academic abilities, and promotes the self-esteem and self-confidence of children.

Working life and employment

* Special emphasis should be given to those aspects of work places and the work process itself which promote mental health. Eight areas of action have been identified: increasing an employer’s awareness of mental health issues; identifying common goals and positive aspects of the work process; creating a balance between job demands and occupational skills; training in social skills; developing the psycho-social climate of the workplace; provision of counselling; enhancement of working capacity, and early rehabilitation strategies.

* Another significant issue is unemployment, in particular, youth unemployment. In this area, mental health promotion strategies seek to improve employment opportunities, for example, through programmes to create jobs, provide vocational training, and social and job seeking skills.

Mental health promotion and the ageing population

* Ageing of the population is a highly desirable and natural aim of any society. By 2025 there will be 1.2 billion older people in the world, close to three-quarters of them in the developing world. But if ageing is to be a positive experience it must be accompanied by improvements in the quality of life of those who have reached – or are reaching – old age.

Measuring and promoting quality of life

* WHO has developed a tool to assess quality of life as an additional measurement, along with the traditional morbidity and mortality data. A primary goal of mental health promotion is to help member states improve the quality of life of their people and to place mental health firmly on the national agenda.

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