• Overview
• Definition
• Incidence, prevalence and trends
• Risk factors
• Health consequences
• Costs
• Contributors

Overview

Mental health promotion has been described as “the art, science and politics of creating a mentally healthy society”. ¹ It involves the promotion of positive mental health and the prevention of mental illness.

It is not just mental illness that has an impact on life chances. A lack of positive mental health (as opposed to not being mentally ill) is associated with a significant impact on social functioning and health. ^{2 3 4 5} Evidence is growing that mental illness and mental health occupy different axes, though it is well established that they are correlated. This means that it is possible to have both a mental illness and features of good positive mental health and vice versa.

Languishing individuals (those without positive mental health but also without mental illness) have fourfold higher rates of cardiovascular disease, more than double the risk of limitations to their daily living from health problems, and have more days off work over the course of a month. One study found that mortality over a seven-year follow-up period was associated with the absence of satisfaction and enjoyment of life rather than the presence of anxiety or depression. ⁴

Depression itself causes the largest number of non-fatal years lived with disability, worldwide. ⁶ In the UK, depression is the second highest cause for fatal and non-fatal years lost to disability after ischaemic heart disease: 993 disability adjusted life years (DALYs) per 100,000 compared to 1106 per 100,000 for ischaemic heart disease. ⁷ This is even higher than years lost to common illnesses such as asthma and diabetes.

Emotional and behavioural problems occurring in childhood can have profound effects on risks in adulthood. These include a higher risk of substance abuse, academic problems, impaired social relationships, cigarette smoking, high-risk sexual behaviour, physical health problems, and depression in adult life. Indeed, there is a thirty-fold increased risk of completed suicide among adults who had behavioural problems. ^{8 9}

The public health community must therefore consider preventing mental illness and promoting positive mental health as a high priority in order to both promote mental wellbeing and achieve gains in mortality and disability from physical illness linked to mental health. There is now robust evidence that mental health promotion programmes are effective and this new and emerging evidence base needs to be championed by all in public health.