Mental health promotion

Mental Health Promotion (MHP)

MHP is defined most comprehensively and usefully by Joubert and Raeburn in “Building on strengths” as:

“Mental health promotion is the process of enhancing the capacity of individuals and communities to take control over their lives and improve their mental health. Mental health promotion uses strategies that foster supportive environments while showing respect for culture, equity, social justice and personal dignity.”
(Joubert & Raeburn, 1998; Ministry of Health, 2002a) (p19)

How is it different from health promotion?

MHP is similar to the process of community-based health promotion projects that usually focus on improving physical health or reducing smoking or trying to change specific risk factors or behaviours. In contrast to health promotion, MHP explicitly focuses on mental health outcomes such as increased sense of personal control, empowerment, resilience, positive coping strategies and the widening of informal social support networks in the whole range of populations (Willinsky, 1999).

In other words, MHP focuses on enhancing competence and positive mental health rather than reducing deficiencies, disorders and risks. The concept is described as the “competence enhancement model” (Williams, McCreanor, & Barnes, 2003). Mental health promotion applies to the whole population in the context of everyday life, not only to those at risk or with mental illness.

Why we need mental health promotion
Global health issues are rapidly changing. At the beginning of the 21st century, the public health sector is facing new challenges such as globalisation and chronic degenerative diseases (McMichael & Beaglehole, 2000; University of Auckland, 2006). The public health sector is also aware of evidence-based practice and cost-effectiveness (Mathers & Loncar, 2005). Yet unexpectedly, on top of these known challenges, community mental health seems to have become a major health issue around the world with the release of the recent WHO report in which depression is identified as heading the list of the ten leading causes of DALYs (The Disability Adjusted Life Year Lost) (Mathers & Loncar, 2005).

A recent study reports that anti-depressants do not seem to be working (Kirsch et al., 2008). These reports are essentially a powerful driving force behind the upsurge of interest in mental health promotion which is believed to be the best tool for tackling this global health problem.

However, public health seems to remain preoccupied with a limited number of physical diseases instead of setting priorities in pursuit of mental healthiness, happiness and well-being (Ministry of Health, 2002; Population Health Dinner Debates, 2006). Community stress is everywhere. Discrimination, social isolation, depression, anxiety and suicidal thoughts are interrelated with social problems, and eventually, these lead to mental health concerns in the community (Ministry of Health, 2002), especially in disadvantaged population groups such as ethnic minorities and migrants.

Melbourne Charter
From Margins to Mainstream: 5th World Conference on the Promotion of Mental Health and the Prevention of Mental and Behavioral Disorders in Melbourne 10 - 12th September has drafted a charter for MHP to guide future works. The Melbourne Charter is expected to make a real difference in MHP. All delegates to the conference can contribute to the charter. The final document will be available in early 2009. See details at .

Everybody is a mental health promoter
We all can promote positive mental health, which is everybody's business (World Health Organisation, 2003). There is no health without mental health.

Nobody is immune to mental disorders, but the risk is higher among the poor, homeless, the unemployed, the uneducated, victims of violence, migrants and refugees, indigenous populations, children and adolescents, abused women and the neglected elderly (World Health Organisation, 2003).

Mental health promotion at the community level can concentrate on three themes: social inclusion, freedom from discrimination and violence, and access to economic resources such as work, money, education and housing (VicHealth, 2005). Mental health promotion tool kit is available from the Canadian Mental Health Association, National Office.

Mental health promotion can take many forms, because positive mental health is the result of many interacting factors, there is no single way to promote it (Willinsky, 1999). However, having an established evidence-based framework is very helpful, for example, Mental Health Promotion Framework 2005 - 2007 of Victorian Health Promotion Foundation (VicHealth, 2005).

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