Mental health promotion and public mental health: moving forward in Europe

1. Mental health promotion and public mental health: moving forward in Europe Dr Lynne FriedliEMIP National WorkshopPrague, Czech Republic 22nd November 2005 lynne.friedli@btopenworld.com

2. Summary • The EMIP project • Mental health promotion in Europe • Public mental health and mental health promotion • Risk and protective factors • Effective interventions • Measuring success • Public debate and engagement lynne.friedli@btopenworld.com

3. EMIP National Workshops • Mapping: what is the present situation for mental health promotion and prevention? For example, in relation to policy, practice, services, resources, training • Opportunities: what are the factors that support progress in mental health promotion? For examplesupporting policies (in all sectors), stakeholders, initiatives and networks • National profile: strategic vision for the future development of mental health promotion and prevention lynne.friedli@btopenworld.com

4. EMIPNational Reports • National mental health data • Policy context: existing mental health and other policies relevant to promoting mental health • Strengths and weaknesses in the position of mental health promotion and prevention • Opportunities and barriers • Key priorities for action • Progress on developing a National Mental Health Action Plan lynne.friedli@btopenworld.com

5. European policy environment • WHO European declaration and action plan (Helsinki) • EU Green paper • MINDFUL (Stakes, Finland) • IMHPA (University of Nijmegen) http://www.imhpa.net/index.php?id=8 • Monitoring positive mental health (Bilbao) • Quality of life/economics of well-being (ESS Wave 3) • Holistic, ecological, sustainable, environmental, ethical • WHO Health assets lynne.friedli@btopenworld.com

6. Public mental health or mental health for all promoting mental health for the whole population preventing mental health problems improved mental health; reduced incidence of mental health problems improving quality of life for people with mental health problems lynne.friedli@btopenworld.com

7. Public mental health “the science, art and politics of creating a mentally healthy society” Addressing the wider determinants of mental health • Whole populations • Individuals at risk • Vulnerable groups • Key settings How people feel is a significant public health indicator lynne.friedli@btopenworld.com

8. What is mental health? “much depends on dinner” Margaret Visser Thinking Physical health and well-being Feeling “The heart has its reasons….” Pascal lynne.friedli@btopenworld.com

9. Mental health: cycles of impact It’s all in the mind, but it’s written on the body…. mental health: how we think and feel genetic inheritance childhood adversity poverty social exclusion inequality behaviour relationships parenting education employment physical health quality of life crime lynne.friedli@btopenworld.com

10. “We haven’t lost faith, we’ve simply transferred it from God to the medical profession”George Bernard Shaw Poverty Exclusion Discrimination Inequality Mental Health Physical Health lynne.friedli@btopenworld.com

11. Sources of support for people with mental health problems Diagnosis Treatment Education Family, friends & neighbours Self help & support groups Employment Sports Faith Communities Housing Leisure lynne.friedli@btopenworld.com

12. Intervention approaches he worked hard for respect but he could not find it. There was in the world a great shortage of respect and Chanu was among the famished (Monica Ali, Brick Lane) Strengthening protective factors Reducing risk factors • Strengthening individuals • Strengthening communities • Reducing structural barriers lynne.friedli@btopenworld.com

13. Strengthening protective factors • Psycho-social, life and coping skills e.g. self-expression, self-esteem, learning new skills, stress or anger management, relaxation, efficacy • Social support as a buffer against adverse life events e.g. building social contacts, self-help groups, drop in, home visits, mentoring, time banks, volunteering • Access to resources and services which protect mental health e,g, benefit uptake, supported employment, access to mainstream services lynne.friedli@btopenworld.com

14. GDP and Life Satisfaction (from nef) A Challenge to the Political Status Quo lynne.friedli@btopenworld.com

15. relationships civic life well-being economy What would policy look like if the goal was well-being? The vision parenting engagement friendship mutuality social networks local democracy education lifelong learning community assets environment sustainability work/life balance lynne.friedli@btopenworld.com

16. Health Assets & Health Needs (from Dominic Harrison 2005) Diseased Healthy Less Healthy Healthy Diseased Less Diseased Saluto-genesis Epidemiology Opportunity Management Risk management lynne.friedli@btopenworld.com

17. Community assets strengthening communities e.g. building capacity, control, engagement, inclusion lynne.friedli@btopenworld.com

18. Mental health impact Mental health promotion Economic capital Pathways of Impact: Human capital Social capital Identity capital health lynne.friedli@btopenworld.com

19. What works in different domains? • feelings: confident, understood, respected, empowered, safe • skills: life skills, relaxation, help seeking, keeping fit, accessing information • meaningful activity: employment, volunteering, education, leisure, creativity, spiritual growth • social support: self-help groups, opportunities for friendship, faith communities • access to resources: paid work, adequate welfare benefits, appropriate services • influence: opportunities to participate, being consulted, shared decision making, advocacy lynne.friedli@btopenworld.com

20. What demonstrates that living in a community promotes mental health? • Access to resources: who doesn’t have access? • Feeling safe: who doesn’t feel safe? • Good place to live: who doesn’t agree? • Influence local decisions: who doesn’t have a say? • Feeling supported: who is isolated? • Hopeful about the future: who isn’t hopeful? • Feeling valued: what makes people feel valued? • Feeling respected: what makes people feel respected? • Being involved: who isn’t involved and why? • Knowing where to get help: who doesn’t know? lynne.friedli@btopenworld.com

21. Moving forward for mental health promotion connecting and mainstreaming public debate and engagement policy and emerging ideas evidence and indicators lynne.friedli@btopenworld.com

22. The five fruit and vegetables of mental health Individuals • Valuing yourself and others • Talking about your feelings • Keeping physically active • Eating well • Drinking in moderation • Keeping in touch with friends/loved ones • Caring for others • Getting involved/making a contribution • Taking a break • Learning new skills • Doing something creative • Seeking Help Communities Policy lynne.friedli@btopenworld.com

23. Notes for policy makers …. • How people feel is a significant public health indicator • Include ‘mental health impact’ in decision making • Quality of life may be a more important indicator of success than symptom reduction • It’s all in the mind, but it’s written on the body • Modify services, not people • Curing illness doesn’t necessarily result in health lynne.friedli@btopenworld.com

24. notes for us all …. Keep on making waves – without which no tide can turn…… lynne.friedli@btopenworld.com