Betting on a different horse: a qualitative analysis of mental health in health promotion policies
| Published date | 01 September 2004 |
| Date | 01 September 2004 |
| DOI | https://doi.org/10.1108/17465729200400015 |
| Pages | 8-17 |
| Author | Pia Solin,Juhani Lehto |
| Subject Matter | Health & social care |
Betting on a different horse: a qualitative
analysis of mental health in health promotion
policies
Pia Solin
Researcher
Tampere School of Public Health
University of Tampere
Juhani Lehto
Professor of social and health policy
Tampere School of Public Health
University of Tampere
journal of mental health promotion •volume 3•issue 3 •september 2004 © Pavilion Publishing (Brighton) Ltd
8
ABSTRACT
The aim of this study is to analyse the position and role of mental health in health promotion policy. Policy documents from Finland,
Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is
problematic in policy terms. A range of arguments are put forward, making the case for the importance of mental health within the health
promotion agenda, including the classification of mental illness as a public health problem, socio-economic and individual costs of mental
health problems and the view that mental well-being is a crucial element of overall health. However problems of definition, measurement and
a traditional focus on treatment and care continue to make mental health promotion problematic for policy makers.
Mental health promotion as an umbrella term covers
different strategies aiming to produce a positive effect
on mental health (WHO, 2001). However ongoing
debate and methodological concerns about defining
mental health and delineating the relationship between
mental health and overall health have hampered efforts
to position mental health in health promotion policies
and have also raised questions about what constitutes
‘effective mental health promotion’ (Braidwood, 1997;
Munk-Jorgensen, 1996).
Jenkins et al (2002) argue that mental health suffers
from a lack of integration within overall health policy.
Mental health policy is planned separately from
physical health policy, reducing opportunities for
concerted action favourable to both mental and
physical health. Physical health is also likely to enjoy
the lion’s share of available resources (Jenkins et al,
2002). Health promotion generally has had a low status
in comparison with treatment of illness. According to
Rogers and Pilgrim (2001): ‘Health promotion and
prevention overall have had only a limited place in
health policy [and] this trend is even more pronounced
in the area of mental health. Traditionally the focus of
health promotion policy has been predominantly on
preventing physical ill health.’ A further problem is that
mental health promotion is distinct from illness
prevention. In contrast to prevention, the promotion of
mental health is based on a different set of
assumptions, which focus on generating or preserving
mental health. This requires different policy design to
medicine-based illness prevention. Government mental
health policy is generally focused on organisational
arrangements for treatment and care, whereas physical
health promotion strategies have been more focused on
the social causes and prevention of physical ill health,
although recently, across Europe, there has been a
greater focus on the socio-economic determinants of
mental health (Rogers & Pilgrim, 2001).
Many countries have recently recognised that mental
health policy to enhance public mental health has
significant potential in terms of improving their economic,
social and human capital (Jenkins, 2003; Jenkins &
Review
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