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1. Promotion of Mental Health
:Concepts and intervention
Shyni k B
I year Mphil Clinical psychology

2. • Definition
• Mental health promotion
• Need for mental health promotion
• Mental Health promotion:Implementation
• Settings and strategies
• PROVEN AND PROMISING INTERVENTIONS
• Specific ways to promote mental health
• Resilience
• Triple P

3. Definition
• Mental health is a state of complete physical,
mental and social well-being and not merely the
absence of disease or infirmity (WHO, 2001b,
p.1).
• mental health is an integral part of health,
• mental health is more than the absence of
mental illness
• mental health is intimately connected with
physical health and behaviour

4. • … a state of well-being in which the individual
realizes his or her own abilities, can cope with
the normal stresses of life, can work
productively and fruitfully, and is able to make
a contribution to his or her community

5. Mental Health Promotion
• Mental health promotion focuses on enabling and achieving
positive mental health at the population level. It seeks to
build competencies, resources and strengths and to address
the broader determinants of mental health. Mental health
promotion is not about the prevention of mental illness,
which aims to reduce the incidence, prevalence or
seriousness of specific disorders and problems. It is a
desirable activity in itself that contributes to promoting
personal and social development (Barry, 2001; Orley & Birrell-
Weisen, 1998).

6. Need for Mental health promotion
• prevention of mental disorders and the
treatment and rehabilitation of people with
mental illnesses and disabilities involves
actions that allow people to adopt and
maintain healthy lifestyles and create living
conditions and environments that support
health

7. • A growing body of international evidence points
to the interplay between mental and physical
health and improved health and social outcomes,
such as higher educational achievement, greater
productivity at work, improved interpersonal
relationships, reduction in crime rates and
decreased harms associated with substance use.
• can lead to safer and healthier families,
workplaces and communities, as well as lower
rates of certain mental disorders and improved
physical health (WHO, 2005a).

8. Mental Health
promotion:Implementation
• General Principles
• Sound theoretical and research base
• Clarifying key goals and objectives
• Comprehensive professional development Training
and support)
• Infrastructure and management support
• Systematic rigorous evaluation and monitoring
• Program fidelity
• Transferability across countries and cultures

9. • The personal, social and environmental factors
that determine mental health and mental illness
may be clustered conceptually around three
themes (HEA, 1997; Lahtinen et al., 19 99;
Lehtinen,Riikonen & Lahtinen, 1997):
• The development and maintenance of healthy
communities
• Each person's ability to deal with the social world
through skills like participating, tolerating
diversity and mutual responsibility
• Each person's ability to deal with thoughts and
feelings, the management of life and emotional
resilience

10. Settings
1.School
2.Work place
3.Community

11. Strategies
• Build healthy public and private policy
• Create supportive environments for positive
mental health
• Strengthen community action
• Develop personal skills and coping capacities
• Re-orient health and social services

12. PROVEN AND PROMISING
INTERVENTIONS
• Life Stage Interventions
• Effective mental health promotion influences
developmental pathways across the life course by
addressing social and structural determinants, reducing
individual risk factors and increasing protective factors.
• pregnancy and postpartum, early childhood and the
transition to school, adolescence and the transition to
high school, young adulthood and the transition to
independence (e.g., workforce entry or post-secondary
education) and later adulthood with transitions related
to family and occupation (e.g., changes in family
structure and retirement).

13. Structural Interventions
• One of the key tasks of mental health promotion is to
engage in policy-related advocacy to increase the value
of positive mental health at the societal level and to
create social and economic environments that support
mental health. Policies that relate to the public good
are understood to have an indirect effect on enhancing
mental health, including policies to address education,
employment, income, housing and other socio-
economic factors. However, given the challenges
associated with evaluating structural interventions,
there is little available evidence of the effectiveness of
these interventions in promoting positive mental
health

14. Community level interventions
• Community-level determinants focus attention
on social participation, social inclusion, civic
engagement and the impact of the local
environment. Interventions that address
community determinants include improving
people’s sense of social belonging, strengthening
community networks, building social capital,
improving neighbourhood environments and
community safety, promoting self-help networks
and community services which support mental
health.

15. Specific ways to promote mental
health include:
• Early childhood interventions (e.g. home visits for pregnant
women, pre-school psycho-social activities, combined
nutritional and psycho-social help for disadvantaged
populations)
• support to children (e.g. skills building programmes, child and
youth development programmes)
• socio-economic empowerment of women (e.g. improving
access to education and microcredit schemes)
• social support for elderly populations (e.g. befriending
initiatives, community and day centres for the aged);
• programmes targeted at vulnerable groups, including
minorities, indigenous people, migrants and people affected
by conflicts and disasters (e.g. psycho-social interventions
after disasters)

16. • mental health promotional activities in schools
(e.g. programmes supporting ecological changes
in schools and child-friendly schools)
• mental health interventions at work (e.g. stress
prevention programmes)
• housing policies (e.g. housing improvement)
• violence prevention programmes (e.g.
community policing initiatives)
• community development programmes (e.g.
'Communities That Care' initiatives, integrated
rural development)

17. Resilience
• Resilience has been defined as the "ability to persevere and
adapt when things go awry".
• Masten and Coatsworth define resilience globally as
"manifested competence in the context of significant
challenges to adaptation or development".
• changing how we think about challenges and adversities
• Families today are exposed to high levels of daily stress and
the incidence of childhood depression is
increasing.Introducing children to resiliency skills that
promote accurate and flexible thinking can help
• Resilience is important to success and satisfaction in life; it
allows us to overcome life's stresses and adversities, steer
through troubled waters and bounce back from tough
times.

18. • Research has shown that how we think about
adversity and opportunity affects our success in
school and work, our health and longevity, and
our risk for depression
• resilient people are healthier, live longer, are
more successful in school and jobs, are happier in
relationships and are less prone to depression.
• Resilience helps people deal with stress and
adversity, overcome childhood disadvantage and
reach out to new opportunities

19. • Stress and adversity are an inevitable part of
life-therefore it makes good sense to
introduce resiliency-building strategies to
children at an early age.
• Resiliency promotion programs for children
have focused primarily on building self-
esteem, increasing school readiness and
supporting the parent-child relationship

20. Promoting resilience through new
thinking skills
• Recognizing that our beliefs about adversity affect how we
feel, and consequently what we do (the ABC model)
• Challenging our beliefs about why things happen -
uncovering our thinking style
• Developing an awareness of common thinking traps or
errors
• understanding that our core beliefs about the world may be
preventing us from taking opportunities
• Gathering evidence to dispute/support beliefs - generating
other alternatives
• Putting stresses/adversities into perspective
• Calming and focusing

21. • The Penn Resilience Program (PRP) for
school-age children and adolescents is a 12-
session protocol comprised of cognitive
behavioural and social problem-solving
components.One important piece of the PRP
skills training helps participants become more
aware of their habitual way of explaining
"why" things happen to them - their
explanatory style.

22. Triple P – Positive parenting
programme
• family risk factors such as poor parenting, family conflict,and
marital breakdown are powerful early predictors for the
development and maintenance of behavioural and emotional
problems in children and adolescents
• lack of a warm, positive relationship with parents; insecure
attachment; harsh, inflexible, rigid, or inconsistent discipline
practices; inadequate supervision of and involvement with
children; marital conflict and breakdown; and parental
psychopathology (particularly maternal depression and high
levels of parenting stress), increase the risk that children
develop major behavioural and emotional problems, including
conduct problems, substance abuse, antisocial behaviour, and
participation in delinquent activities

23. • The program aims to prevent severe
behavioural, emotional and developmental
problems in children by enhancing the
knowledge, skills, confidence and teamwork
of parents. The program has five levels of
intervention on a tiered continuum of
increasing strength for parents of children
from birth to age 16.

24. The Triple P System of Parenting and
Family Support

25. Theoretical basis of Triple P
• A form of behavioural family intervention
based on social learning principles
• Triple P aims to enhance family protective
factors and to reduce risk factors associated
with severe behavioural and emotional
problems in preadolescent children.

26. • aims to :
1) Enhance the knowledge, skills, confidence, self
sufficiency and resourcefulness of parents of
preadolescent children
2) promote nurturing, safe, engaging, non-violent,
and low conflict environments for children
3) Promote children’s social, emotional, language,
intellectual, and behavioural competencies
through positive parenting practices

27. The program content draws
on:
1) Social learning models of parent-child interaction
2)Research in child and family behaviour therapy and
applied behaviour analysis
3) Developmental research on parenting in everyday
contexts.
4) Social information processing models
5) Research from the field of developmental
psychopathology
6) A population health perspective to family intervention

28. Self regulation and parental
competence
• capacity for self-regulation as a central skill.
• Karoly (1993) defined self regulation as follows:'Self-
regulation refers to those processes, internal and
transactional, that enable an individual to guide his/her
goal directed activities over time and across changing
circumstances (contexts)
• Self sufficiency
• Parental self efficacy
• Self management
• Personal agency

29. Principles of positive parenting

31. Core features of Triple P
• Targets meaningful social contexts for
parents(Media,PHS,school,work)
• Developmentally-sensitive information(based
on the developmental needs).
• Principle of program sufficiency(Minimally
sufficient level of support).
• Flexible tailoring(programmes of varying
intensity).
• Varied delivery modalities.

32. Characteristics of successful mental
health promotion programmes
• programme development based on underpinning
theory, research principles of efficacy and needs
assessment of the target population and setting
• a focused and targeted approach to programme
planning, implementation and evaluation
,adoption of a competence enhancement
approach and an implementation process that is
empowering,collaborative and participatory,
carried out in partnerships with key stakeholders

33. • addressing a range of protective and risk factors
• employing a combination of intervention
methods operating at different levels
• comprehensive approaches that intervene at a
number of different time periods rather than
once-off
• including provision of training and support
mechanisms that will ensure high-quality
implementation and sustainability.

34. References
• Margaret M. Barry(2009). Addressing the Determinants
of Positive Mental Health: Concepts, Evidence and
Practice. International Journal of Mental Health
Promotion VOLUME 11 ISSUE 3
• Evidence review:mental health promotion, Population
Health and Wellness BC Ministry of Health ,May 2007
• Matthew R. Sanders, Triple P - Positive Parenting
Program: A population approach to promoting
• competent parenting, Australian Network for
Promotion, Prevention and Early Intervention for
Mental Health (Auseinet)

35. • Thank You