mental health promotion and public mental health: moving forward in europe
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Mental health promotion and public mental health: moving forward in Europe. Dr Lynne Friedli EMIP National Workshop Prague, Czech Republic 22 nd November 2005. Summary. The EMIP project Mental health promotion in Europe Public mental health and mental health promotion - PowerPoint PPT PresentationTRANSCRIPT
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Mental health promotion and public mental health: moving
forward in Europe
Dr Lynne Friedli
EMIP National Workshop
Prague, Czech Republic
22nd November 2005
EMIP Czech Republic [email protected]
Summary
•The EMIP project
•Mental health promotion in Europe
•Public mental health and mental health promotion
•Risk and protective factors
•Effective interventions
•Measuring success
•Public debate and engagement
EMIP Czech Republic [email protected]
EMIP National Workshops
•Mapping: what is the present situation for mental health promotion and prevention? For example, in relation to policy, practice, services, resources, training
•Opportunities: what are the factors that support progress in mental health promotion? For example supporting policies (in all sectors), stakeholders, initiatives and networks
•National profile: strategic vision for the future development of mental health promotion and prevention
EMIP Czech Republic [email protected]
EMIP National Reports
•National mental health data•Policy context: existing mental health and other policies relevant to promoting mental health•Strengths and weaknesses in the position of mental health promotion and prevention•Opportunities and barriers •Key priorities for action•Progress on developing a National Mental Health Action Plan
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European policy environment
•WHO European declaration and action plan (Helsinki)•EU Green paper•MINDFUL (Stakes, Finland)•IMHPA (University of Nijmegen) http://www.imhpa.net/index.php?id=8
•Monitoring positive mental health (Bilbao)
•Quality of life/economics of well-being (ESS Wave 3)
•Holistic, ecological, sustainable, environmental, ethical
•WHO Health assets
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Public mental health or mental health for all
promoting mental health for the whole population
preventing mental health problems
improving quality of life
for people with mental
health problems
improved mental health; reduced incidence of mental health problems
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Public mental health
Addressing the wider determinants of mental health
• Whole populations
• Individuals at risk
• Vulnerable groups
• Key settings
How people feel is a significant public health
indicator
“the science, art and politics of creating a mentally healthy society”
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What is mental health?
Physical health and well-beingFeeling
Thinking
“The heart has its reasons….” Pascal
“much depends on dinner” Margaret Visser
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mental health: how we
think and feel
genetic inheritancechildhood adversity
povertysocial exclusion
inequalitybehaviour relationships parenting education
employment physical health
quality of life crime
Mental health: cycles of impact
It’s all in the mind, but it’s written on the body….
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Mental Health
PovertyExclusionDiscriminationInequality
Physical Health
“We haven’t lost faith, we’ve simply transferred it from God to the medical profession” George Bernard Shaw
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Sources of support for people with
mental health problemsDiagnosis
Treatment
Family, friends & neighboursEmploym
ent
HousingLeisur
e
Faith Communities
Education
Sports
Self help & support groups
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Intervention approacheshe worked hard for respect but he could not find it. There was in the world a great shortage of respect and Chanu was among the famished (Monica Ali, Brick Lane)
Strengthening protective
factors
Reducing risk factors
•Strengthening individuals•Strengthening communities•Reducing structural barriers
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Strengthening protective factors
• Psycho-social, life and coping skills e.g. self-expression, self-esteem, learning new skills, stress or anger management, relaxation, efficacy
• Social support as a buffer against adverse life events e.g. building social contacts, self-help groups, drop in, home visits, mentoring, time banks, volunteering
• Access to resources and services which protect mental health e,g, benefit uptake, supported employment, access to mainstream services
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GDP and Life Satisfaction (from nef)A Challenge to the Political Status Quo
GDP and Life Satisfaction 1973 - 2002
0%
20%
40%
60%
80%
100%
120%
140%
160%
180%
200%
1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001
Life Satisfaction
GDP
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The visioncivic life
relationships
well-being economy
parenting
friendshipsocial networks
environment
work/life balance
education
lifelong learning
sustainability
engagement
mutuality
What would policy look like if the goal was well-being?
local democracy
community assets
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Health Assets & Health Needs
Healthy Diseased
HealthyDiseased
Less Healthy
Less Diseased
EpidemiologySaluto-genesis
Risk managementOpportunity Management
(from Dominic Harrison 2005)
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Community assetsstrengthening communities e.g. building capacity, control,
engagement, inclusion
•know how•creativity•resilience•resourcefulness•tradition•intergenerational solidarity•cohesion
•equity•control•safety•participation•local democracy•social networks•mutuality
•cultural assets•lifelong learning•built and natural environment•access to resources•public spaces
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Pathways ofImpact:
Mental health impact
Mental health promotion
health
Human capitalIdentity
capital
Social capital
Economic capital
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What works in different domains?
• feelings: confident, understood, respected, empowered, safe
• skills: life skills, relaxation, help seeking, keeping fit, accessing information
• meaningful activity: employment, volunteering, education, leisure, creativity, spiritual growth
• social support: self-help groups, opportunities for friendship, faith communities
• access to resources: paid work, adequate welfare benefits, appropriate services
• influence: opportunities to participate, being consulted, shared decision making, advocacy
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What demonstrates that living in a community promotes
mental health?• Access to resources: who doesn’t have access?• Feeling safe: who doesn’t feel safe?• Good place to live: who doesn’t agree?• Influence local decisions: who doesn’t have a
say?• Feeling supported: who is isolated?• Hopeful about the future: who isn’t hopeful?• Feeling valued: what makes people feel valued?• Feeling respected: what makes people feel
respected?• Being involved: who isn’t involved and why?• Knowing where to get help: who doesn’t know?
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Moving forward for mental health promotion
public debate and engagement
connecting and mainstreaming
policy and emerging
ideas
evidence and indicators
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The five fruit and vegetables of mental health
• Valuing yourself and others• Talking about your feelings• Keeping physically active• Eating well• Drinking in moderation• Keeping in touch with friends/loved ones • Caring for others• Getting involved/making a contribution• Taking a break• Learning new skills• Doing something creative• Seeking Help
Individuals
Communities
Policy
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Notes for policy makers ….
• How people feel is a significant public health indicator
• Include ‘mental health impact’ in decision making
• Quality of life may be a more important indicator of success than symptom reduction
• It’s all in the mind, but it’s written on the body
• Modify services, not people
• Curing illness doesn’t necessarily result in health
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notes for us all ….
Keep on making waves –
without which
no tide can turn……