Mental health is an integral and essential component of health as clearly identified by the World Health Organization who state that “there is no health without mental health” (WHO 2014).

The WHO constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. An important implication of the definition of mental health is that it is more than just the absence of mental disorders or disabilities. However, mental health is largely determined by socioeconomic, biological and environmental factors. (Eaton et al 2014.)

Despite the fact that mental health promotion and promotion programs have been highlighted on the agenda of the WHO and other international and national institutions, mental health services internationally have mostly concentrated on treating people who experience mental health problems (WHO 2002). Little emphasizes is put on the prevention of mental health problems and the promotion of mental health (Thornicroft & Votruba 2014). Research in this area is likewise limited (Herman et al 2007). There is there a need for cost-effective public health and inter-sectorial strategies and interventions to promote, protect and restore the mental health of the population (Jackson et al 2006).

Mental health promotion programs should meet the needs of the population while highlighting vulnerable groups such as children (McKenzie et al.2013). A very successful method to promote general mental health population is to focus on supporting parents of young children to help them to raise emotionally resilient children (McGrath et al 2013).

The aim of the material collected in this unit is to help the learner to understand the cornerstones of health and mental health promotion programs. Moreover, the goal is to support students when they are developing, implementing and evaluating health education and health promotion programs across diverse settings and populations on primary -, secondary - and as well in tertiary mental health services.

After engaging with this material, you will be able to:

  • Discuss the key-elements of successful and comprehensive mental health promotion programs.
  • Critically assess existing policy and mental health programs
  • Discuss the guidelines for developing material for mental health education and promotion programs, projects and campaigns.

In this podcast director Vikram Patel from WHO gives an overview of the challenges facing global mental health, including a lack of resources and existing stigmatization. Further relevant information is available in the center of Global Mental Health.

What are the lessons to be learned from Patel´s lecture in order to create mental health promotion programs on a global level? What are the biggest challenges?

In 2011, the WHO launched the worldwide mental health promotion program: Mental Health Action Plan for the years 2013-2025. This program is a comprehensive paper including the main necessary guidelines for global mental health promotion targeting not only mental health professionals but also the policy makers in each country. The following six principles were highlighted in the action plan.

  1. Universal health coverage
  2. Human rights
  3. Evidence-based practice
  4. Life course approach
  5. Multisector approach
  6. Empowerment of persons with mental disorders and psychosocial disabilities

Discuss the implications of these six principles for mental health promotion programs focusing on a) Children and young people b) Adults c) Elderly population.

Health Promotion Europe (HPE) is the core high level network, that brings together bodies at national and subnational level that are responsible for health promotion, including mental health. As previously identified, Mental Health is a fundamental element of general health and that is why we should increasingly see mental health from a holistic point of view as all elements of health have an impact on each other.

According to Euro Health Net (2014) it is clear that many illnesses and diseases affecting EU citizens are largely preventable, or that their onset can be delayed. However, spending on health promotion and disease preventions remains at only 3% of total health budgets across the EU and spending on promotion services are even lower level. Health Promotion Europe therefore aims to identify and implement effective health promotion policy and practice and to strengthen the resource base for health promotion activities and the impact of these activities (HPE 2014).

Read the article: “Integrated health promotion strategies: a contribution to tackling current and future health challenges”. (Jackson et al 2007).

After reading this article, firstly discuss the challenges inherent in promoting health and mental health in Europe. Secondly identify what kind of health promotion challenges exist for particular groups within the population. Thirdly, in your opinion identify how these challenges could be addressed in a mental health promotion program.

This Green paper (2006) “Improving the mental health of the population: Towards a strategy on mental health for the European Union” is still the fundamental program identifying the main critical areas within European mental health policy. The purpose of this Green Paper was to launch a debate within European institutions including governments, health professionals, patient organisations and the research community about the importance and relevance of mental health for the EU and the need for a strategy identifying priorities at EU-level. This paper sets the main goals and guidelines for Mental Health policy in EU countries.

According to the Green paper (2006) the mental health of the European population is a resource for the attainment of some of the EU’s strategic policy objectives, such as to put Europe back on the path to long-term prosperity, to sustain Europe’s commitment to solidarity and social justice, and to bring tangible practical benefits to the quality of life for European citizens.

Mental ill health affects every fourth citizen and can lead to suicide, a cause of too many deaths. Mental ill health causes significant losses and burdens to the economic, social, educational as well as criminal and justice systems. Stigmatization, discrimination and non-respect for the human rights and the dignity of mentally ill and disabled people still exist, challenging core European values. However, the mental health of the EU population can be considerably improved.

On the basis of the Green Paper what would be your advice for the politicians of your country when they are allocating pubic money in mental health promotion programs.

a) What arguments would you use when asking for more resources for mental health promotion programs from political decisions makers of your country?

b) In your opinion: What areas should be highlighted and why?

On the webpages of the Canadian Centre of Addiction and Mental Health nine successful mental health programs are presented. All these programmes are identified as examples of good practice and have been shown to be useful in terms of improving the mental health of the population.

Pick three of these programs and identify why they have been successful?

Mental health promotion programmes are projects and campaigns aiming to improve both the experienced (subjective) and measurable (objective) mental health and wellness outcomes of the whole population. Programmes are developed on both national and international levels. Often programmes focus on a targeted groups of individuals such as young or older people.

Mental health promotion is not placed on the top of policy makers´ agenda of any country, which could be easy seen by observing the invested financial resources in mental health promotion generally. Research on mental health promotion is likewise quite poor.

Programmes are tightly connected with the social and economic contexts within society. Nonetheless, there might be some difficulties to show the cost-effectiveness of mental health promotion programmes, mainly because the results are rather difficult to measure directly with statistical estimates, however they could better be observed in the long-term. This lack of immediate results is likely one reason why such programmes are often the first target of financial cutbacks.

Nevertheless comprehensive and relevant mental health promotion programmes, campaigns and projects are fundamental when trying to promote mental health and wellbeing. Mental health promotion programmes and public campaigns could play a crucial role in making change in public attitudes towards mental health. Programmes focusing on promoting the mental health wellbeing of families with young children should be highlighted, because research has shown that most of the mental health problems get their onset before age of 14.

Finally it can be stated that good mental health goes hand in hand with peace, stability and success, and promoting mental health presents a powerful case for including mental health promotion programmes in the public health policies of all countries. Moreover, it can be considered that such programmes are warranted especially for raising public awareness about mental health promotion in addition to identifying the mental health issues of vulnerable groups, such as immigrants or easing the stigmatization of people with mental health problems.

Eaton, J., DeSilva M., Regan, M. Lamichhane, J. & Thornicorft G. (2014) There is no wealth without mental health. Lancet Psychiatry Sep; 1(4):252-3. Epub 2014 Sep 10.

Euro Health Net (2014) Health and Mental Health Promotion in Europe

Global Mental Health (2013)

Green paper (2006). Improving the mental health of the population: Towards a strategy on mental health for the European Union

Herman, H., Saxena, S. & Moodie R eds. (2007). Promoting Mental Health. WHO Library Cataloguing-in-Publication Data. Promoting mental health: concepts, emerging evidence, practice: report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne.

Jackson, S., Perkins, F. Khandor, E., Cordwell, S., Hamann, S., & Buasal, S. (2006). Integrated health promotion strategies: a contribution to tackling current and future health challenges. Journal of International Health Promotion Dec; 21 Supplement 1:75-83.

McGrath PJ, Sourander A, Lingley-Pottie P, Ristkari T, Cunningham C, Huttunen J, Filbert K, Aromaa M, Corkum P, Hinkka-Yli-Salomäki S, Kinnunen M, Lampi K, Penttinen A, Sinokki A, Unruh A, Vuorio J, Watters C. (2013). Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada). BMC Public Health 13:985.

Thornicroft & Votruba (2015). The Journal of Epidemiological Psychiatry. Oct;24(5):458-60. Epub 2015 May 8.

Vikram, P. (2014 ). (Podcast).

WHO (2002) Prevention and promotion in Mental Health.

WHO (2014)

The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.