Editorial
| DOI | https://doi.org/10.1108/17465729200000008 |
| Published date | 01 February 2000 |
| Date | 01 February 2000 |
| Pages | 2-5 |
| Author | Michael Murray |
| Subject Matter | Health & social care |
EDITORIAL
Michael Murray
The Clifford Beers Foundation
All of us do not have equal talent, but all of us should have the
opportunity to develop our talents.
John F Kennedy (1917–1963)
ost of us, meaning the readers of the Journal, choose to
live in a democratic society, a society which purports to be governed
by and for the people. Success or otherwise of such a society is to a
significant degree determined by the level of participation by mem-
bers of the community. Within the health care literature, including
that relating to the promotion of mental health, there is much to
support the idea that community participation geared to improving
the quality of life of citizens has significant synergy with those sys-
tems used to promote the mental health of the population. There is
also a growing bodyof research to suggest that the case for mental
health promotion goes far beyond the prevention of mental disorders
(Stewart-Brown,1998), and in fact it must embrace the political
agenda in s uch issues as housing, social exclusion and employ-
ment. These are facets of life thatare fundamentally connected to
mental well-being. Consequently, as we search for ways to promote
mental health more effectively it may well be fruitful to consider this
relationship between mental health promotion and the socially sup-
portive community.
When Alexis de Tocqueville visited the USA in the 1830s he was
extremely impressed by the propensity of the people to participate in
civic associations and sawthis as a key to make democracywork.
‘Americans of all ages, all stations in life and all types of dispo-
sitions … are forever forming associations.There are not only
commercial and industrial associations, but others of a thou-
sand different types – religious, moral, serious, futile,ver y gen-
eral and very limited, immensely large and minute … Nothing
in my view deserves more attention than the intellectual and
moral
associations in America.’ De Tocqueville (1969)
Of course, social scientists have since revealed an extensive field of
empirical evidence to support the idea that the quality of public life
and the successful functioning of social institutions are, to a signifi-
cant degree, strongly influenced by the norms, standards and net-
M
works of civic engagement.
Research in such areas as urban poverty, crime control and
reduction, unemployment, substance abuse, health and education has
found that the more civically engaged communities are, the more like-
ly to experience successful outcomes. The research
evidence is that the better the community one lives in from a ‘socially
supportive’ and cohesion point of view, the better the health of the
people in it (Pransky, 1991) and on a wide variety of measures mental
health is found to be better when people feel efficacious, strong and
socially supported.
Money (1994) concurs with this when he emphasises that neigh-
bours and social networks are important for the mental health of the
individual and the community. In pressing this home Parry (1988)
highlights that there is a good deal of evidence that, while social
isolation and the lack of confiding intimacy do affect mental health, so
do mental health and personality affect the amount and quality of
social support.
However,from a negative perspective, not all social groups foster
community development in a very effective manner.Wuthnow (1994)
emphasises thatsmall groups may not be fostering community as
effectively as many of their proponents would like. Some small
groups merely provide occasions for
individuals to focus on themselves in the presence of others. The
social contract binding members together asserts only the weakest of
obligations. Consequently critics of psychiatry may call upon Illich
(1976) to support this view, in their antagonism towards the medical
model of care; he states thatthe medical profession tends to mystify
and expropriate the power of the individual to heal himself and to
shape his or her environment.Illich goes on to say that this
gathering of power is done for the benefit of the
profession rather than the patient.
Leaving that negative stance to one side, we now appear to ha ve
aconsensus in the social support
literature that the larger and more diverse an
individual’s social network, the more access he or she will have to
functional relationships and the more potential benefits for health
(Cooper et al., 1999).
House (1981) and Cohen & McKay (1984) develop this theme by
suggesting that this support may have a more positive effect on
health or health behaviour, especially in times of stress,if it is provid-
ed by people of the same sex, age and socio-economic background or
2International Journal of Mental Health Promotion VOLUME 2 ISSUE 2 • MAY 2000 © Pavilion Publishing (Brighton) Limited.
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