From the Margins to the Mainstream: The Public Health Potential of Mental Health Promotion
| Pages | 30-36 |
| DOI | https://doi.org/10.1108/17465729199900015 |
| Date | 01 February 1999 |
| Published date | 01 February 1999 |
| Author | Lynne Friedli |
| Subject Matter | Health & social care |
30 International Journal of Mental Health Promotion VOLUME 1 ISSUE 2 • APRIL 1999 © Pavilion Publishing (Brighton) Limited.
Mental health is the emotional and spiritual resilience which enables us to enjoy life
and to survive pain, disappointment and sadness. It is a positive sense of
well-being and an underlying belief in our own and
others’ dignity and worth.
Health Education Authority (1998a)
Introduction
There are a number of impediments to the development of a
new agenda for mental health promotion. To begin with, mental health promotion
has long been on the margins in terms of status, profile and the allocation of
resources. In the literature, the preoccupation has been with treatment or preven-
tion: identifying those atrisk and developing models to reduce, for example, post-
natal depression in low-income single mothers. It has been difficult to define
mental health and mental health promotion, and difficult to demonstrate the
relevance of mental health promotion to the whole population.
Second, the term ‘mental health’ is often used when in fact what is meant is
‘mental illness’, and indicators for measuring success remain mental illness indica-
tors, such as suicide or rates of depression, as opposed to mental health indicators
–trust, tolerance or participation, for example.This focus on mental illness gives
rise to a myth, strongly promoted by the media and reflected in public policy,that a
small number of people experience mental illness and that mental health is of
public concern only when community care failure threatens public safety.
Amore radical agenda would recognise that we all have mental health needs,
whether or not we have a diagnosis, and for many of us those needs are not being
met. A further problem:as Orley and Birrell Weisen (1998) argued in a previous
issue
of this journal, we tend to see the prevention of mental health problems as the key
rationale for mental health promotion. But there is a growing body of research
which suggests thatthe case for mental health promotion extends far beyond any
impact it may have on the prevalence of depression, anxiety or schizophrenia
(Stewart-Brown, 1998). Manyissues currently high on the political agenda – social
exclusion, housing, transport,crime, discrimination, inequality – are fundamentally
linked to mental well-being, because of their impact on the way people feel. Their
impact on how people feel may be one of the ways in which these factors impact
on morbidity and mortality rates.
Mental health underpins all health and well-being. It influences how we think
and feel, about ourselves and others, how we interpret events, our capacity to
communicate and to form and sustain relationships. Mental health is about being
able to get out of bed in the morning. Mental health also affects our ability to
cope with change, transition and trauma – divorce, rejection,getting drunk, being
arrested, violence, going to prison.In essence, mental well-being underpins
social functioning and productivity.
What is mental health promotion?
Mental health promotion is essentially about promoting the capacity for mental
health atthree levels:
■
strengthening individuals or increasing emotional resilience
■
strengthening communities
■
reducing structural barriers to mental health (Health Education Authority,
1997).
Strengthening individuals includes increasing emotional resilience, through
interventions designed to promote self-esteem, life and coping skills, communicat-
ing, negotiating and relationship and parenting skills. It also includes promoting
From the Margins to the
Mainstream: The Public Health
Potential of Mental Health
Promotion
Lynne Friedli
Health Education Authority
FEATURE
There are encouraging signs that mental health, as opposed
to mental illness, is beginning to move up the political
agenda, but much still needs to be done to challenge
misconceptions. Drawing on the growing literature on
social capital, this paper looks at the case for building a
new agenda for mental health promotion, one which
recognises that we all have mental health needs, whether
or not we have a diagnosis. Such needs underpin all health
and well-being and provide a rationale for placing mental
health at the centre of the new public health debate.
ABSTRACT
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