Promotion of mental well-being

“Defining” mental well-being

There is no universally accepted “definition” of mental well-being. This is probably because mental well-being may have different connotations for different individuals, groups and cultures. For some, it may be the notion of happiness or contentment. For others it may be the absence of disease. For some it may be economic prosperity. It could be based on the goals sought to be achieved and the challenges placed on an individual or a culture. It also may mean the absence of negative determinants in the life of an individual or a community. Mental well-being includes cognitive, emotional and behavioural responses at a personal level. Some may also interpret mental well-being as determined by external stimulants and factors, sometimes beyond the control of individuals, such as housing and employment. Thus, mental well-being should be interpreted in the sociocultural context of the individual. It should be considered as a continuum and as operating within a spectrum, rather than a state that is present or absent. An individual, group or community can be at any given point within this spectrum.

Promotion of mental well-being through primordial prevention

In programmes on promotion of mental well-being, the concept of primordial prevention should be used. In 1978, Strasser coined the term "primordial prevention" to mean activities that prevented the penetration of risk factors into populations. The basic idea is to intervene in order to stop the appearance of risk factors in the population. For example, stress management at the workplace may be considered as a strategy of primary prevention of executive burn-out, but programmes to prevent stress from occurring would be considered primordial prevention of executive burn out.

Concepts related to mental well-being

The World Health Organization describes mental well-being as 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 community1. This description asserts that mental well-being is more than an absence of mental illness. There are relative and subjective elements in this description which are necessary in trying to encapsulate mental well-being.

There are other concepts available in literature which are related to mental well-being.

Resilience: Resilience is described as the capacity to cope with adversity and to avoid breakdown when confronted with stressors. Many internal and external factors have been found to increase personal resilience. For example, resilience in children is strengthened through good relations with parents. Resilience also depends on a person’s cognitive make up – a sense of self esteem – which could change along a spectrum depending on diverse factors.

Positive psychology: The term “positive psychology” is based on the idea that if people are taught to be resilient and optimistic they will be less likely to suffer from depression and will lead happier and more productive lives. Building on human strengths can be described as building psychological “potency” before problems occur.

Salutogenic perspective of mental health: Antonovsky’s salutogenic perspective of mental health also contains concepts related to mental wellbeing2. Factors promoting health, not disease are considered. Here, health is considered a relative state, is projected as a continuum in the presence of life’s stress, chaos etc. In this concept individuals use resources to resist negative determinants of health. Some examples of these resources are money, knowledge, experience, social support, culture, intelligence, traditions and ideologies. Added to this is the concept of sense of coherence which encapsulates factors that enable a person to use these resources optimally.

Social capital: The concept of “social capital” that came into being during the past decade has been known and experienced in many communities in the South-East Asia Region. This concept states that “social capital” consists of social life such as institutions, networks, norms, reciprocity and social trust that shape the quality and quantity of social interactions and facilitate collective action, coordination and mutual benefit3. It asserts that such social cohesion is critical for societies to prosper economically and their development to be sustainable. Aspects of social capital such as trust, social support and social networks are also considered important determinants of mental health and well-being of individuals. Therefore, it consists of both structural and cognitive aspects. Such support, networks, trust and reciprocity and protective norms have always been embedded in cultures of the Region. They have perhaps played an unrecognized role in maintaining well-being of societies of this Region despite severe financial and other constraints. Some believe that such factors are being eroded by the western concepts of materialism and “development” that is becoming more widely apparent in countries of this Region.

Quality of life: A wide ranging and inclusive description relevant to mental well-being is the concept of “quality of life” expounded by the WHO Quality of Life Group. This description was developed following work in several culturally diverse centres over a period of time. It conceptualizes that the quality of life is an individual’s perception of his or her position in life in the context of the culture and value systems in which he or she lives, in relation to his or her goals, expectations, standards and concerns4. This reflects a broad view of mental well-being encompassing social indicators, happiness and health status. It also captures positive aspects of coping, resilience, satisfaction and autonomy, among other issues.