Mental health promotion and public mental health moving

Mental health promotion and public mental health: moving forward in Europe Dr Lynne Friedli EMIP National Workshop Prague, Czech Republic 22 nd November 2005 EMIP Czech Republic lynne. friedli@btopenworld. com

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 EMIP Czech Republic lynne. friedli@btopenworld. com

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 example supporting policies (in all sectors), stakeholders, initiatives and networks • National profile: strategic vision for the future development of mental health promotion and prevention EMIP Czech Republic lynne. friedli@btopenworld. com

EMIP National 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 EMIP Czech Republic lynne. friedli@btopenworld. com

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 EMIP Czech Republic lynne. friedli@btopenworld. com

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 EMIP Czech Republic improving quality of life for people with mental health problems lynne. friedli@btopenworld. com

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

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

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 behaviour relationships parenting education employment physical health quality of life crime EMIP Czech Republic genetic inheritance childhood adversity poverty social exclusion inequality lynne. friedli@btopenworld. com

“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 EMIP Czech Republic lynne. friedli@btopenworld. com

Sources of support for people with mental health problems Education Diagnosis Treatment Family, friends & neighbour s Employmen t Sports Self help & support groups Faith Communities EMIP Czech Republic Leisure Housing lynne. friedli@btopenworld. com

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 EMIP Czech Republic lynne. friedli@btopenworld. com

Strengthening protective factors • Psycho-social, life and coping skills e. g. selfexpression, 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 EMIP Czech Republic lynne. friedli@btopenworld. com

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

What would policy look like if the goal was wellbeing? engagemen t mutuality parenting friendship relationships The vision social networks civic life local democrac y education well-being economy community assets sustainability EMIP Czech Republic lifelong learning environment work/life balance lynne. friedli@btopenworld. com

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

Community assets strengthening communities e. g. building capacity, control, engagement, inclusion • know how • creativity • resilience • resourcefulness • tradition • intergenerational solidarity • cohesion EMIP Czech Republic • equity • control • safety • participation • local democracy • social networks • mutuality • cultural assets • lifelong learning • built and natural environment • access to resources • public spaces lynne. friedli@btopenworld. com

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

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 EMIP Czech Republic lynne. friedli@btopenworld. com

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? EMIP Czech Republic • Knowing where to get help: wholynne. friedli@btopenworld. com doesn’t know?

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

The five fruit and vegetables of mental health • • • 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 EMIP Czech Republic Individuals Communities Policy lynne. friedli@btopenworld. com

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 EMIP Czech Republic lynne. friedli@btopenworld. com

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