mental health promotion
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Mental Health Promotion. Suzanne F. Jackson, Ph.D. Dalla Lana School of Public Health University of Toronto CPHA – May 28, 2014. Contents. Mental Health Promotion Risk factors, protective factors and determinants of health “Flourishing” as concept - PowerPoint PPT PresentationTRANSCRIPT
MENTAL HEALTH PROMOTION
Suzanne F. Jackson, Ph.D.
Dalla Lana School of Public Health
University of Toronto
CPHA – May 28, 2014
CONTENTS Mental Health Promotion Risk factors, protective factors and
determinants of health “Flourishing” as concept Policy as focus for attention – key
policies Focus on Children and Families
WHY NOT FOCUS ON TREATMENT? “[T]he science of mental illness has
produced effective treatments for more ‘broken-down’ people; it remains ineffective for preventing more people from ‘breaking down.’” (Keyes and Lopez, 2002: 46)
Mental health problems cannot be brought under control by treating individuals one at a time (Nelson et al., 1996: 161).
4 out of 5 people are not mentally ill – but are they mentally healthy?
WHAT IS MENTAL HEALTH PROMOTION? “The process of enhancing the capacity
of individuals and communities to take control over their lives and improve their mental health.
[MHP] uses strategies that foster supportive environments and individual resilience while showing respect for culture, equity, social justice, interconnections and personal dignity.”
(Joubert et al, 1996)
By Evelyn Livia from Indonesia, 9 years old From a collection of drawings and stories from the WHO Global School Contest on Mental
Health (2001)
MENTAL HEALTH PROMOTION (CONT’D) 2 elements in definition:
Power – capacity to take control over one’s life & factors that affect one’s health
Resilience – ability to cope with adversity or stress
Go beyond focus on disease
MENTAL HEALTH PROMOTION (CONT’D)
Shifts the focus to the positive and is asset-based rather than negative or deficit-based.
Flourishing = optimal mental health (Keyes, 2002) Empowerment - people and communities
recognizing their personal strength and control through determining their own destinies, and having the resources to do so in a supportive environment.
Resilience - “the quality that allows an individual or group to function well despite the odds against them.” Two fundamental concepts associated with resiliency: risk and protective factors.
THROUGH CHILDREN’S EYES
Clarence, 18 years, Federated States of Micronesia
“… Being down, identifying why, doing something about it, and bouncing back can give a person a true sense of accomplishment and worth and strengthen his/her mental health in the process.”
From a collection of drawings and stories from the WHO Global School Contest on Mental Health (2001)
RISK FACTORS Risk factors increase likelihood & burden
of mental disease & arise from within individual, family, support networks, broader social & institutional environments e.g. Indiv - physical illness; poor social skillsFam/Supp – parental substance use;
marital disruption; work stress & unemployment;
Social & Inst - poverty & economic strain; violence & abuse; homelessness; discrimination & isolation
PROTECTIVE FACTORS Protective factors buffer a person in times of
adversity & moderate impact of stress – can be internal and/or external e.g. Indiv - optimism; attachment to family;
school/work achievement; problem-solving skills Family Supp - family harmony; strong, supportive
networks; community attachment Soc & Instit - healthy public policies;
community/institutional services The presence of more protective factors,
regardless of the number of risk factors, lowers the risk of developing mental health problems and disorders (Resnick et al 1997, cited in CAMH Guide 55+)
REASON TO FOCUS ON POLICY Need to work “upstream” Need to decrease risk factors, increase
protective factors & reduce inequities Focus on creating environments that
create mental HEALTH or enable people to “flourish”
Focus on social determinants of health that are not under jurisdiction of health sector
Multi-sector Collaboration and Policy are key tools at population level
MOST SIGNIFICANT DOH1. Social inclusion
Connectedness and social ties are protective at individual level
Social network can enhance coping Civic engagement can impact policy
2. Freedom from discrimination and violence
Individual, family & systemic violence
3. Access to economic resources Contributes to sense of personal
competence & worth Remove systemic inequities of access to
income
By Vetiana from Bulgaria, 6 years old From a collection of drawings and stories from the WHO Global School Contest on Mental
Health (2001)
From a collection of drawings and stories from the WHO Global School Contest on Mental Health (2001)
I’m so sad. I wish I had friends.Nobody likes me. I’m so lonely.Get away you mental kid! Hee! Hee!She’s a retard don’t let her play.What if that was you? Let her play. She’s a human being.She’s a stupid head. She does not know how to play!
I’m glad you are my friend. Please forgive them.Sorry for being mean with you. Will you be my friend?Sorry I said you’re a stupid head.
By Brittany from Samoa, 9 years old
• From a collection of drawings and stories from the WHO Global School Contest on Mental Health (2001)
EXAMPLES OF POLICIES Social Inclusion
Require community participation in healthy living & other major health strategies
Implement ‘Healthy School’ approach Freedom from Discrimination & Violence
Positive parenting programs Anti-bullying & anti-discrimination strategies in
school & workplaces Access to Economic Resources
Publicly subsidized high quality daycare Guaranteed annual income Increase in access to safe & affordable housing
RECS FROM NATIONAL THINK TANK ON MHP - 20081. Create a Vision for a comprehensive
Mental Health Strategy (built on an MHP framework)
2. Identify a clear single point of accountability and sustained leadership (including funding & collaboration between all levels)
3. Involve multiple sectors & stakeholders4. Clarify a strong Provincial/Territorial
role
RECS FROM NATIONAL THINK TANK ON MHP – 2008 - 25. Develop a common understanding of
concepts & language (by engaging the public, removing stigma, promoting community inclusion, addressing DOH)
6. Build on strengths (by mapping existing policies & programs & identifying gaps)
7. Create strong research, knowledge & data base (including indicators of positive mental health)
8. Build an effective, wellness-based mental health system
QUOTES FROM COREY KEYES Mental illness is indeed a burden to
society, but too little flourishing is just as serious as too much mental illness.
Loss of mental health precedes mental illness.
Promoting mental health is a “two-for-one” – you get lower rates of mental illness by promoting mental health, and you get lower rates of chronic disease.
CURRENT INTEREST IN MHP CAMH, DLSPH & TPH – Best Practices
Guides for Seniors 55+, Refugees, Children & Youth
CAMH, DLSPH, TPH – interest in indicators of positive mental health re programs
Pan-Canadian Committee on MHP – inventory of MHP programs across Canada, indicators of MHP, sharing approaches that work
PHAC – surveillance indicators re MHP City of Toronto – Measuring the Well-
Being of Children & Families in Toronto CPHA/CMHA – What is needed?
By Ming-qi from China, 7 years old From a collection of drawings and stories from the WHO Global School Contest on Mental
Health (2001)