What and why public mental health?
| Date | 01 June 2004 |
| DOI | https://doi.org/10.1108/17465729200400008 |
| Pages | 6-7 |
| Published date | 01 June 2004 |
| Author | Andrew McCulloch |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 2 •june 2004 © Pavilion Publishing (Brighton) Ltd
What and why public mental health?
Andrew McCulloch
Chief executive
Mental Health Foundation
Guest
editorial
I am very pleased to be writing this guest editorial, for
three key reasons. First, I am excited that the Mental
Health Foundation has been able to take on a new role
as sponsor of this important journal. This fits with our
corporate priorities of public mental health, early
intervention and social inclusion, all three of which can
be supported by and relate to the development of
mental health promotion. Second, I believe the
development of mental health promotion – and,
indeed, of a broader public mental health agenda – has
never been so timely. Yet we are also seeing evidence
that ministers and officials at the Department of
Health continue to ignore the mental health aspects of
public health. Finally, I have a personal, life-time
commitment to both public health and mental health
issues, and I am always encouraged when these can be
brought together under one roof.
I am often asked what I mean – or what the Mental
Health Foundation means – by ‘public mental health’.
Lynne Friedli has defined public mental health as ‘the
science, art and politics of creating a mentally health
society’ (Friedli, 2004). It is, quite simply, the
application of public health activity and thinking to
mental health combined with the recognition that
mental health is an underpinning factor for physical
health. In other words, public mental health is an
essential component of public health – for example, in
combating HIV/AIDS, substance misuse-related
disorders, heart disease etc – as well as in creating
greater mental well-being. There is no public health
without public mental health. This relationship is a
complex one, mediated by stress, risk-taking
behaviours, exclusion, deprivation and biological
factors. We cannot pretend to understand health unless
we can grasp the complexity of this relationship.
Unfortunately, despite overwhelming evidence that
mental and physical health are linked and are both
fundamental to human well-being and the human
enterprise, including our economic enterprise, the
government seems not to recognise this link. The latest
public health consultation by the Department of
Health could be described as naive at very best in terms
of mental health (Department of Health, 2004). It
shows a shocking lack of progress since previous public
health documents – indeed, arguably, it shows a
significant regression in terms of a central
understanding of the importance of public mental
health. The Mental Health Foundation is seeking to do
what it can to marshal the evidence in favour of a full
recognition of the role of public mental health. I would
call on readers of this journal to make the case for
mental health promotion within a public mental health
context before this agenda once again gets swept aside
by narrow conceptions of physical disease processes.
I am also asked what the difference is between
public mental health and mental health promotion.
Essentially it is that public mental health is an over-
arching approach that embraces mental health
promotion activities, however conceived. The
components of a public mental health approach
may include:
•population and community interventions both to
protect and enhance mental health and to prevent
mental health problems. These might include
changes to legal and administrative frameworks and
infrastructure investments
•the development of services that operate so as to
both protect mental health and enhance recovery
but also to promote mental health. These might
include talking treatments in primary health care,
early intervention services and socially inclusive services
•mental health impact assessments of public policies
and agencies’ individual policies with the aim of
creating mentally healthy policies
•public information and education about mental
health issues and the mental health correlates of
physical health issues
•a public mental health research and development
and professional education agenda.
A prolonged debate about the boundaries of mental
health promotion and public mental health would
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