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      What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey

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          Abstract

          Objective

          Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health?

          Design and participants

          50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience.

          Results

          46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act . The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented.

          Conclusions

          Answers to the question, ‘ What are the core concepts of mental health?’ are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations.

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          Most cited references5

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          Mental Illness and Mental Health: The Two Continua Model Across the Lifespan

          Mental health has long been defined as the absence of psychopathologies, such as depression and anxiety. The absence of mental illness, however, is a minimal outcome from a psychological perspective on lifespan development. This article therefore focuses on mental illness as well as on three core components of positive mental health: feelings of happiness and satisfaction with life (emotional well-being), positive individual functioning in terms of self-realization (psychological well-being), and positive societal functioning in terms of being of social value (social well-being). The two continua model holds that mental illness and mental health are related but distinct dimensions. This model was studied on the basis of a cross-sectional representative internet survey of Dutch adults (N = 1,340; 18–87 years). Mental illness was measured with the Brief Symptom Inventory and mental health with the Mental Health Continuum Short Form. It was found that older adults, except for the oldest-old, scored lower on psychopathological symptoms and were less likely to be mentally ill than younger adults. Although there were fewer age differences for mental health, older adults experienced more emotional, similar social and slightly lower psychological well-being. In sum, today’s older adults have fewer mental illness problems, but they are not in a better positive mental health than today’s younger adults. These findings support the validity of the two continua model in adult development.
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            Grand Challenges: Integrating Mental Health Services into Priority Health Care Platforms

            In the last article of a five-part series providing a global perspective on integrating mental health, Vikram Patel and colleagues discuss the competencies, operational innovation, and packages of care needed, and argue that integration will complement primary care system strengthening. Please see later in the article for the Editors' Summary
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              What is mental health?

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2015
                2 June 2015
                : 5
                : 6
                : e007079
                Affiliations
                [1 ]Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto , Toronto, Ontario, Canada
                [2 ]Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, University of Western , London, Ontario, Canada
                [3 ]Department of Psychiatry, University of British Columbia , Vancouver, British Columbia, Canada
                [4 ]Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University , Jinju, Republic of Korea
                Author notes
                [Correspondence to ] Dr Laurie A Manwell; lauriemanwell@ 123456gmail.com
                Article
                bmjopen-2014-007079
                10.1136/bmjopen-2014-007079
                4458606
                26038353
                480209a3-2b9e-46d5-bacf-a65becbe45fa
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 4 November 2014
                : 21 January 2015
                : 22 January 2015
                Categories
                Mental Health
                Research
                1506
                1712
                1703

                Medicine
                mental health,mental illness,social determinants of health,human rights,agency,primary health care

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