Positive mental health : measurement, relevance and implications

Abstract

The professionalization of psychology yielded many advantages, but also led to a main focus on psychopathology in mental health care. This thesis investigated an additional positive approach to mental health, focusing on positive feelings and life satisfaction (emotional well-being) and optimal functioning in both individual (psychological well-being) and social life (social well-being). This approach fits in with the definition of mental health by the World Health Organization. The thesis investigated the measurement, relevance and implications of this positive approach to mental health through a longitudinal study in a representative sample of Dutch adults (LISS-panel, CentERdata, Tilburg). First, the thesis shows that the Mental Health Continuum-Short Form (MHC-SF) is a valid and reliable self-report questionnaire to measure emotional, psychological and social well-being. Second, it demonstrates the relevance of this positive approach. Traditionally, the presence of psychopathology implied the absence of positive mental health, but this thesis shows that positive mental health and psychopathology are two related continua of mental health (two-continua model). This indicates that a person with many symptoms of psychopathology has a greater chance on experiencing low well-being, but this relation is not perfect. An individual may be suffering from mental illness and experience a relatively high positive mental health as well. Third, the implications of positive mental health as an additional indicator of mental health were examined. The thesis shows that emotional well-being is predictive of recovery and survival in physically ill patients and that changes in positive mental health predict future levels of psychopathology. In sum, this thesis indicates that it is insufficient in mental health care to only pay attention to symptoms of psychopathology. Neither the alleviation of psychopathological symptoms nor the promotion of positive mental health is sufficient for good mental health. A broad approach is necessary, which also focuses on positive mental health in both diagnostics and treatment.