MENTAL HEALTH

Class exercise
• What are the characteristics of a mentally healthy person?
• What are the characteristics of a mentally unhealthy person?
WHO Health definition
• Mental health is described by WHO (2001) 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 community.
• Since its inception, WHO has included mental well-being in the
definition of health
• This core concept of mental heath is consistent with its wide and
varied interpretation across cultures.
• Mental health is more than the absence of mental illness: it is vital
to individuals, families and societies
• Mental health is still portrayed by some as a luxury.
• The misunderstandings on which this view is based are now
clearer than they were in the past, and WHO and other
international organizations identify the improvement of mental
health as a priority concern for low and middle income
countries as well as for wealthier nations and people (WHO,
2001).
• The adoption of the Comprehensive Mental Health Action Plan
in 2013
• Sustainable development goals- UN General Assembly in
September 2015
• Mental health is a continuum, ranging from states of well-being to
stressful life experiences to severe mental disorders.
Concepts of mental health
 Well-Being
• In the past, mental health treatments focused
largely on reducing symptoms or returning the
individuals to their previous level of functioning.
Today, however, treatment may also focus on
increasing individuals’ functioning, resilience,
and prevention. This focus is known as well-
being.
• Well-being is defined as how individuals think
about and experience their lives. It is an
indicator of how well individuals perceive their
lives to be going. It reflects several health, job,
family, and social outcomes.
 Positive affect
• In the 1960s, Bradburn viewed
psychological well-being as the balance
between two independent dimensions
which he termed positive and negative
affect.
• In his view, an individual will experience a
high degree of psychological wellbeing if
positive affect dominates. Likewise, a low
degree of well-being is characterized by
negative affect (Bradburn, 1969).
 A personality trait
• Antonovsky: the salutogenic approach
• Antonovsky (1979) proposed the
“salutogenic approach”, which focused on
coping rather than stressors and
“salutory” (beneficial protective) factors
rather than risk factors.
• He rejected the notion that stressors
always have pathogenic consequences,
since people have to survive transitions
and stress in their daily lives- eustress/
good stress
 Optimism/pessimism
• In 1985, Scheier and Carver proposed
the optimism/pessimism dimension,
which they described as a tendency to
believe that one will generally experience
either good or bad outcomes in life.
• Working on the effect of expectations on
actions and affects, they developed the
Life Orientation Test (LOT).
 Coping strategies
• Leighton and Murphy (1987) proposed that non-symptomatic
individuals from general population classified according their
personality types and their coping strategies into three groups:
■ “cabbage”: individuals who have low aspiration and achievement;
■ “Elizabethan”: individuals who have an intense emotional life
characterised by periods of intense happiness and unhappiness;
and
■ “hermit crab”: individuals who have built up a shell that protects
them against stress emanating from family, social network and
professional life. People in this group have a high risk of breakdown
when the protective barrier fails.
 Resilience
• The capacity to cope with adversity and to
avoid breakdown or diverse health problems
when confronted by important stressors
differs tremendously among individuals
(Rutter, 1985).
• Rutter warned that protective factors do not
always exist as a result of pleasurable
happenings. There is evidence that acute
stress in early life, for example, leads to
changes that enhance an animal’s
resistance to later stress experiences; this
effect – referred to as the “steeling effect” of
stressors
MODELS OF MENTAL HEALTH
MODELS OF MENTAL HEALTH
• First, mental health can be conceptualized as above normal
• Second, from the viewpoint of healthy adult development, mental
health can be conceptualized as maturity.
• Third, positive psychology— as epitomized by the presence of
multiple human strengths.
• Fourth, emotional intelligence and successful object relations.
• Fifth, mental health can be conceptualized as subjective well-
being
• Sixth, mental health can be conceptualized as resilience
Model A: Mental Health as Above
Normal
• In this medical model, if one were to put all
individuals on a continuum, normality would encompass a significant
portion of adults, and abnormality would be the small remainder.
• This definition of health correlates with the traditional role model of
the doctor who attempts to free his patient from grossly observable
signs of illness.
• In other words, in this context, health refers to a reasonable, rather
than an optimal state of functioning.
• However, as already pointed out, mental health is not normal; it is
above average. Some believe that true mental health is the exception,
not the rule.
Model B: Mental Health as Maturity
• Unlike other organs of the body that are designed to stay the same, the
brain is designed to be plastic.
• Therefore, just as optimal brain development requires almost a
lifetime, so does assessing positive mental health.
• A 10 year-old’s lungs and kidneys are more likely to reflect optimal
function than are those of a 60-year-old, but that is not true of a 10-
year-old’s central nervous system.
• To some extent, then, adult mental health reflects a continuing process
of maturational unfolding.
• Statistically, physically healthy 70-year-olds are mentally healthier
than they were at age 30 years; for example, Laura Carstensen found
through prospective studies that individuals are less depressed and
show greater emotional modulation at age 70 years than they did at age
30 years.
• longitudinal studies that have come to fruition only recently, illustrate
the association of maturity with increasing mental health.
• After age 50 years, of course, the association between mental
health and maturity is contingent on a healthy central nervous
system.
• For example: The ravages of illnesses like brain trauma, major
depression, arteriosclerosis, Alzheimer’s, and alcoholism must all be
avoided.
• The association of mental health to maturity is probably mediated not
only by progressive brain myelination into the sixth decade but also by
the evolution of emotional and social intelligence through
experience.
• Erik Erikson conceptualized that such development produced a
“widening social radius.”
• In Erikson’s model, the adult social radius expanded over time
through the mastery of specific tasks such as
• “Identity versus Identity Diffusion,”
• “Intimacy versus Isolation,”
• “Generativity versus Stagnation,” and
• “Integrity versus Despair.”
Model C: Mental Health as Positive or
“Spiritual” Emotions
• This model defines mental and spiritual health as the amalgam of
the positive emotions that bind us to other human beings.
• Love, hope, joy, forgiveness, compassion, faith, awe, and gratitude
comprise the essential positive and “moral” emotions included in
this model.
• Of great importance, these selected positive emotions all involve
human connection.
• None of the emotions listed is just about the self.
• These positive emotions appear to be a common denominator of
all major faiths.
Model C cont’d
• Negative emotions originating in the hypothalamus, such as fear
and anger, are elaborated in the human amygdala (larger in
humans than in other mammals). Of tremendous importance to
individual survival, the negative emotions are all about “me.”
• In contrast, positive emotions, apparently generated in the limbic
system and unique to mammals, can free the self from the self.
• Negative emotions are crucial for survival in the present time. The
positive emotions are more expansive and help us to broaden and
build. In the future, they widen one’s tolerance for strangers,
expand one’s moral compass, and enhance one’s creativity.
Model D: Mental Health as Socioemotional
Intelligence
• High socioemotional intelligence reflects above-average mental health
in the same way that a high IQ reflects above-average intellectual
aptitude. Such emotional intelligence lies at the heart of positive
mental health.
• In the Nicomachean Ethics, Aristotle defined socioemotional
intelligence as follows: “Anyone can become angry—that is easy.
However, to be angry with the right person, to the right degree, at the
right time, for the right purpose, and in the right way—that is not easy.”
• The capacity to identify these different emotions in ourselves and
others
• The benefits of reading feelings from nonverbal cues
• Empathy
Model E: Mental Health as Subjective Well-
Being
• Positive mental health does not just involve being a joy to others;
one must also experience subjective well-being.
• For example, objective social support accomplishes little if,
subjectively, the individual cannot feel loved.
• Thus, the capacity for subjective well-being becomes a vital
model of mental health. Subjective well-being is never
categorical.
• Healthy blood pressure is the objective absence of hypotension
and hypertension, but happiness is less neutral. Subjective well-
being is not just the absence of misery, but the presence of
positive contentment.
Model F: Mental Health as Resilience
• There are three broad classes of coping mechanisms that humans
use to overcome stressful situations.
• First, there is how an individual elicits help from appropriate
others: Namely consciously seeking social support.
• Second, there are conscious cognitive strategies that individuals
intentionally use to master stress.
• Third, there are adaptive involuntary coping mechanisms (often
called “defense mechanisms”) that distort our perception of
internal and external reality to reduce subjective distress, anxiety,
and depression.
Healthy Involuntary Mental Mechanisms.

Longitudinal studies from both Berkeley’s Institute of Human