Mental Health Improvement Master Presentation


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Key slides on mental health improvement

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  • One key message…mental health means different things to everyone. The simple thing thing is that mental health underpins wverything that we are, say and do.
  • Determinants of mh
  • Difference between the two…one is about making the whole population a bit more mentally healthy…the other is about preventing mental ill health where possible, and targeting support to those most at risk
  • Increasingly thinking about Mental Capital as a colleague of social capital and economic capital as a measure of how countries, and areas/societies are measured…GDP or measures of gross national happiness (NEF)
  • Mental Health Improvement Master Presentation

    1. 1. Perspectives on Mental Health and Well-being Chris O’Sullivan Scottish Development Centre for Mental Health
    2. 2. Areas to Cover <ul><li>A forest of mirrors: definitions and terminology </li></ul><ul><li>Why mental health improvement is important at all levels </li></ul><ul><li>The relationship between inequality and mental health </li></ul><ul><li>Stigma, discrimination and social exclusion </li></ul><ul><li>Bringing it together locally </li></ul>
    3. 3. A Forest Of Mirrors: Definitions and Terminology
    4. 4. Mental Health <ul><li>The World Health Organisation describes mental health as: </li></ul><ul><li>“ a state of well-being in which the individual realises his or her 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”. </li></ul><ul><li>Mental health encompasses the abilities to develop emotionally, psychologically, intellectually, socially and spiritually. It includes concepts such as resilience , a sense of mastery and control, optimism and hope as well as our ability to initiate and sustain relationships and to play a part in our social world. (Barry and Jenkins, 2007) </li></ul>
    5. 5. But looking just at the individual doesn’t help much… © Scottish Development Centre for Mental Health
    6. 6. Mental Health <ul><li>Mental health is therefore a measure of how people, organisations, and communities think, feel, and function, individually and collectively. </li></ul><ul><li>Communities, organisations, and societies benefit socially and economically where people have good mental health. </li></ul><ul><li>(Keyes, 2007) </li></ul>
    7. 7. Mental Health <ul><li>Mental health is shaped by wider societal structures, processes and values </li></ul><ul><li>Mental health derives from a combination of and interaction between: </li></ul><ul><ul><li>Endowment (genes) </li></ul></ul><ul><ul><li>Experience (how a person deals with life) </li></ul></ul><ul><ul><li>Environment (social and physical) </li></ul></ul><ul><ul><ul><li>(Foresight Report, 2008) </li></ul></ul></ul>
    8. 8. Mental Health Problems <ul><li>Mental health problems are emotional and psychological difficulties, which cause distress and interfere with how people go about their everyday lives. ‘ Mental illnesses’ are mental health problems that meet established diagnostic criteria. </li></ul><ul><li>There are debates about the medical model, and where the user movement and the disability movement connect. </li></ul>
    9. 9. Promotion and Prevention <ul><li>Mental health promotion - aims to protect and support emotional and social well-being and create the conditions that increase mental capital of individuals, families, communities, and societies. </li></ul><ul><li>Prevention of mental health problems – is about reducing the risk factors associated with mental health problems in order to reduce the incidence, prevalence, and recurrence of mental illnesses, and to diminish the impact of illness on individuals and their families. </li></ul>
    10. 10. Mental Capital <ul><li>“ This encompasses a person’s cognitive and emotional resources. It includes their cognitive ability, how flexible and efficient they are at learning, and their “emotional intelligence”, such as their social skills and resilience in the face of stress. </li></ul><ul><li>It therefore conditions how well an individual is able to contribute effectively to society, and also to experience a high personal quality of life.” </li></ul><ul><li>Foresight (2008) </li></ul>
    11. 11. So how does mental illness relate to mental health?
    12. 13. Low Levels of Mental Illness Great Mental Health (Flourishing) Poor Mental Health (Languishing) High Levels of Mental Illness Dual Axis Model of Mental Health
    13. 14. Low Levels of Mental Illness Great Mental Health (Flourishing) Poor Mental Health (Languishing) High Levels of Mental Illness Dual Axis Model of Mental Health
    14. 15. Dual Axis Model of Mental Health Low Levels of Mental Illness Great Mental Health (Flourishing) Poor Mental Health (Languishing) High Levels of Mental Illness After Tudor (1996) Services often move people this way Promote recovery, and expectation of good MH MH improvement at population level Risk factors can reduce MH, and risk illness People can be medically ‘mentally ill’ but enjoy good MH…also a valuable recovery outcome Even when symptoms/signs remain
    15. 16. What influences mental health in Scotland?
    16. 17. Influences on Mental Health In Scotland
    17. 18. And we have to look at life from the beginning to the end…
    18. 19. From Bedlington et al (2008) Mental Capital Through Life: Future Challenges ( ) All these people have a view to express, and their own set of perspectives…so ALL mental health improvement should involve stakeholders. This includes people with lived experience of mental ill health!
    19. 21. How do we measure mental health?
    20. 23. HIGH LEVEL CONSTRUCTS Positive mental health (2) Mental health problems (7) CONTEXTUAL CONSTRUCTS Individual Community Structural/policy Learning and development (1) Participation (3) Equality (2) Healthy living (4) Social networks (1) Social inclusion (2) General health (3) Social support (2) Discrimination (3) Spirituality (1) Trust (2) Financial security/debt (2) Emotional intelligence (1) Safety (4) Physical environment (6) Working life (6) Violenc e (3)
    21. 24. The Relationship Between Inequality and Mental Health
    22. 25. © Scottish Development Centre for Mental Health
    23. 26. Poor Mental Health and Inequality <ul><li>Inequality can be a driver or poor mental health, and provokes risk factors. </li></ul><ul><li>Key risk factors for poor mental health include exposure to: </li></ul><ul><ul><li>Early years difficulties </li></ul></ul><ul><ul><li>Discrimination and stigma (including multiple discrimination) </li></ul></ul><ul><ul><li>Violence and abuse </li></ul></ul><ul><ul><li>Poor housing </li></ul></ul><ul><ul><li>Poverty, disadvantage, exclusion and isolation </li></ul></ul><ul><ul><li>Lack of opportunities to participate, exercise control and be heard </li></ul></ul><ul><ul><li>Long standing illness / disability </li></ul></ul>
    24. 28. Income Inequality Definition: The ratio of total income received by the 20% of the population with the highest income (top quintile) to that received by the 20% of the population with the lowest income (lowest quintile). Income must be understood as equivalised disposable income. Source: Eurostat
    25. 30. Cost of Depression: EU Wide Sobocki et al , J Mental Health Policy & Econ, 2006 Leal et al, European Heart Journal, 2006 € 41 billion direct costs € 77 billion productivity losses € 35 billion productivity losses for cardiovascular disease
    26. 31. Equally Well (2008) <ul><li>Improving life circumstances in order to boost health </li></ul><ul><li>Reducing exposure to factors in the physical / social environment that cause stress, are damaging to health and wellbeing, and lead to health inequalities </li></ul><ul><li>Addressing inter-generational factors that risk passing on Scotland’s health inequalities (particular focus on early years) </li></ul><ul><li>Engaging individuals, families and communities most at risk of poor health in services and decisions relevant to health </li></ul><ul><li>Delivering public services that are both universal and well targeted </li></ul>
    27. 32. © Scottish Development Centre for Mental Health
    28. 33. Stigma, Discrimination and Social Exclusion
    29. 35. The Cycle of Injustice Adapted from Callard et al (2008)
    30. 36. © Scottish Development Centre for Mental Health
    31. 37. Self-Stigma, or Anticipated Stigma <ul><li>Avoiding or putting off important actions/decisions because of previous failure or anticipation of failure </li></ul><ul><ul><li>Trying for a job or </li></ul></ul><ul><ul><li>Trying new things </li></ul></ul><ul><ul><li>Relationships </li></ul></ul><ul><li>It can be made worse by symptoms of mental ill health </li></ul><ul><li>Hard for people to understand who haven’t been there! </li></ul>
    32. 38. © Scottish Development Centre for Mental Health
    33. 39. User involvement is a great defeater of self-stigma
    34. 40. © Scottish Development Centre for Mental Health
    35. 41. Take Home Messages <ul><li>Mental health means different things to different people…but it is wider than the individual </li></ul><ul><li>Mental health and mental illness are linked but separate…you can have both or neither </li></ul><ul><li>Inequality drives poor mental health and robs us of mental capital </li></ul><ul><li>Stigma, discrimination and social inclusion are subtly different, and all are important to address </li></ul><ul><li>New science, evidence, and policies are implemented and interpreted by people on the ground…they don’t work if they aren’t understood, owned and delivered locally! </li></ul>
    36. 42. © Scottish Development Centre for Mental Health
    37. 43. References and Further Reading <ul><li>Keyes, C.L.M. (2002) The mental health continuum: from languishing to flourishing in life. J Health Soc Res 43 :207-22 </li></ul><ul><li>Friedli L (2009) Mental health, resilience and inequalities – a report for WHO Europe and the Mental Health Foundation London/Copenhagen </li></ul><ul><li>Friedli L and Parsonage M (2007) Mental health promotion: building an economic case Belfast: Northern Ireland Association for Mental Health </li></ul><ul><li>Barry M and Jenkins R (2007) Implementing Mental Health Promotion . London. Churchill Livingstone. </li></ul><ul><li>Keyes C (2007) ‘Promoting and Protecting Mental Health as Flourishing’. American Psychologist. 62:2; 1 – 14. </li></ul><ul><li>Callard F, Main L, Myers F, Pynnonen A (2008) Stigma: An International Briefing Paper; Edinburgh; NHS Health Scotland and WHO Europe </li></ul><ul><li>Sobocki P et al 2006 The Costs of Depression in Europe. Journal of Mental Health Policy Economics. 9:2: 87 – 98. </li></ul><ul><li>Scottish Government (2008), Equally Well Action Plan </li></ul><ul><li>Scottish Government (2009); Towards a Mentally Flourishing Scotland: Policy and Action Plan </li></ul><ul><li>Foresight Mental Capital and Wellbeing Project (2008). Final Project report – Executive Summary. The Government Office for Science, London. </li></ul>
    38. 44. References and Further Reading <ul><li>Pickett KE, James OW, Wilkinson RG. Income inequality and the prevalence of mental illness: a preliminary international analysis. Journal of Epidemiology and Community Health 2006;60(7):646-7. </li></ul><ul><li>Wilkinson RG, Pickett KE. The problems of relative deprivation: why some societies do better than others. Social Science and Medicine 2007; 65: 1965-78 . </li></ul><ul><li>James O. Affluenza , London, Vermilion, 2007 </li></ul><ul><li>Wilkinson RG, Pickett KE. The Spirit Level . Penguin. 2009. </li></ul><ul><li>Myers et al (2009) An evaluation of the operation of &quot;See Me&quot; the national campaign against stigma and discrimination associated with mental ill health; Scottish Government; Edinburgh </li></ul>