Mental health promotion: concepts and strategies for reaching the population

Abstract

There have been many attempts to define mental health promotion. To date, there is no consensus in the field as to what it entails. While some understand it as a holistic concept including intervening at structural, societal and political levels to positively influence mental health, others conceptualise it basically as strategies with an individual focus to improve personal competencies. Many of these differences are related to the distinct understanding of the concepts of mental well-being and positive mental health. The lack of clarity on the boundaries of mental health promotion has divided professionals and is a missed opportunity, as momentum is moving mental health promotion on to political agendas. In Europe, two important milestones for mental health, the WHO Ministerial Conference and the EC Green Paper on Mental Health, have moved mental health promotion into the political landscape, recognising positive mental health and mental well-being as fundamental to the quality of life and productivity of Europeans and a contributor to sustainable development. Although proven efficacious, ad hoc implementation of mental health promotion programs alone is not sufficient to ensure improvement of the population's mental health. Co-ordinated action that includes efficient ways to deliver such interventions in a sustainable way is essential. Two such delivery mechanisms in the search for efficiency are discussed in this paper: a) identifying co-occurrence of mental and physical health problems in order to include mental health promotion components into existing health promotion interventions; and, b) supporting the inclusion of mental health indicators into sound public policy options in order to prove that efficacious policies in labour, education, environment, etc, also bring about positive mental health outcomes. To support the current interest to bring about positive mental health it is essential that evaluation of existing initiatives is put in place, as well as exploring more efficient ways for program delivery. Clearer concepts and understanding of mental health promotion's scope among practitioners would support the development of the field and the inclusion of mental health action across sectors.