Policy Report: Working to improve mental health and wellbeing

Abstract

Caitlyn Donaldson, Policy Officer at the Royal Society for Public Health, looks at positive mental wellbeing and how it is being promoted through the work of the RSPH.Mental health and wellbeing is increasingly becoming key topic for the RSPH, and we support the recent NHS Mandate for England1 which states that there needs to be parity between mental and physical health, acknowledging that there can be 'No health without mental health'2The WHO defines mental health as a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make contribution to his or her community. As in the WHO's definition of health (a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity) mental health is not just the absence of illness, but requires an additional positive 'something' to be present in the individual. Thus, the concept of an individual's mental health state is increasingly being uncoupled from mental illness, and being seen to consist of psychological, emotional and social components.The highest state of subjective wellbeing is seen by many experts as the place where emotional, psychological and social wellbeing are combined, enabling individuals to flourish.3 Thus, rather than simply focusing on preventing and treating mental illness, there is potential to actively promote positive mental health.Mental health and wellbeing impacts upon an individual's physical health, relationships, education, work and ability to reach their potential. At population level, it has consequences for the country's economy, levels of crime, drug and alcohol dependence and homelessness,4 and as Friedli states: health is also key pathway through which social inequality impacts on health.5Many of the key determinants of mental health are located within social and economic domains,6 which provides opportunity for intervention.In 2011 nef published report to address the question of how flourishing mental health could be promoted and increased.7 The result was their five ways to wellbeing: 'connect'; 'be active'; 'take notice'; 'keep learning'; and 'give'. These five ways are easily applied at individual, community, organizational and strategic levels; and evidence suggests that they are being used in many different settings to encourage improved mental wellbeing.The RSPH believes that policymakers at national and local level have responsibility to ensure that policies help address, not increase, inequalities in mental health and wellbeing. The Department of Health's mental health implementation framework8 provides an important perspective on translating policy into practical actions for improving mental health and we support the use of mental wellbeing impact assessment (MWIA), to ensure that policy, programme, service or project has maximum equitable impact on people's mental wellbeing - at individual, community or national level. We also endorse the Guidance for Commissioning Public Mental Health Services,9 which provides the rationale for spending on mental health and also explains what good quality public mental health interventions look like. …