Mental Health Promotion: An Evidence Base?
| Published date | 01 September 2000 |
| Date | 01 September 2000 |
| Pages | 19-23 |
| DOI | https://doi.org/10.1108/13619322200000026 |
| Author | Elizabeth Burtney,Michael Ross |
| Subject Matter | Health & social care |
Mental Health Promotion: An Evidence Base?
Elizabeth Burtney
Health Education Board for Scotland
Dr Michael Ross
Ayrshire and Arran Health Board
Focus on…
ental health is a leading priority for
the National Health Service in Scotland. For some
time, mental health has been gaining in importance
in the national policy agenda and the recent White
Paper on public health, Towards a Healthier Scotland
(SODOH, 1999), clearly identified the vital signifi-
cance mental health holds for Scottish society.
Although this document recognises the value of
the enhancement of mental health for the general
population, it combines this with the desire for
improvements in service provision and rehabilitation
for people with mental health disorders.
Progress in service provision (defined as an
increase in financial resources and the development
of appropriate policy support networks) was reported
at a recent summit meeting of key stakeholders
convened by the Scottish Executive. The enhance-
ment or promotion of mental health is being advanced
through less direct routes in the wider policy agenda
such as the social inclusion and community develop-
ment agenda and specific health initiatives such as
the Starting Well Health Demonstration Project.
As a result, the potential efficacy of mental health
promotion, as a field of practice, is less well recognised.
Part of the reason for the lack of recognition currently
experienced within the field is the lack of understanding
among policy makers and practitioners in mental
health services regarding the evidence base for
effectiveness in mental health promotion. This paper
will attempt to define the field of mental health
promotion, will describe the current evidence base
and will consider implications for the mental health
agenda available through mental health promotion.
Defining mental health promotion
Mental health promotion has been defined as ‘any activity
which actively fosters good mental health, through increasing
Mmental health promoting factors, such as meaningful employ-
ment, and decreasing those factors which damage or reduce good
mental health such as abuse and violence’ (Health Education
Authority, 1997).
In this context, the definition of ‘good mental
health’ is a problematic construct. In Britain, although
conceptualisation of mental health is a dominant
theme in mental health promotion, there has been
little consensus on a standard definition (Tudor, 1996;
Trent, 1997; Money, 1997). In fact, Money (1997)
has argued that: ‘The notion of some conclusive and final
definition of mental health is illogical as well as impossible.’
Increasingly, in the British literature, there is a tendency
to replace the concept of mental health with a more
general concept of emotional well-being (McDonald
& O’Hara, 1998; Health Education Authority, 1997).
The important consideration, however, is, as stated
by Mrazek and Haggerty (1994), that ‘mental health
promotion activities are offered to individuals, groups or
large populations to enhance competence, self-esteem and
a sense of well being rather than to intervene to prevent …
mental disorders’.
The broad goals of mental health promotion
remain an area of contention in Britain (Tudor, 1996).
In essence, the role of prevention of disorder within
a mental health promotion framework remains in
dispute (Hosman, 1994). However, in practice, within
the NHS, both the promotion of well-being and the
prevention of disorder are identified goals which are
both health and non-health based as stated above.
‘Good housing, having a job, access to services and
buildings, activities which are directed to promoting health
generally, such as family planning, sexual health and CHD
programmes, as well as services directly targeted at the
primary prevention of mental health problems, are all able
to deliver benefits for mental health’ (Health Education
Authority, 1997). This broad range of influences on
mental health has been expanded by the Health
Education Authority (1997) and is illustrated in
Tables One and Two overleaf.
The Mental Health Review Volume 5 Issue 3 September 2000 ©Pavilion Publishing (Brighton) 2000 19
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