Transcript Slide 1

Mental health promotion and public
mental health: moving forward in
Europe
Dr Lynne Friedli
EMIP National Workshop
Prague, Czech Republic
22nd November 2005
EMIP Czech Republic
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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
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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
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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
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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
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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
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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
How people feel is a
significant public health
indicator
• Key settings
EMIP Czech Republic
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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
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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
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“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
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Sources of support for people with
mental health problems
Education Diagnosis Treatment
Family,
friends &
neighbour
s
Employment
Self help
& support
groups
Sports
Faith
Communities
EMIP Czech Republic
Leisure
Housing
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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
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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
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GDP and Life Satisfaction (from nef)
A Challenge to the Political Status Quo
GDP and Life Satisfaction 1973 - 2002
200%
180%
160%
Life Satisfaction
GDP
140%
120%
100%
80%
60%
40%
20%
0%
1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001
EMIP Czech Republic
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What would policy look like if the goal was well-being?
parenting
engagement
friendship
relationships
The vision
mutuality
social networks
civic life
local
democrac
y
education
well-being economy
community assets
sustainability
EMIP Czech Republic
lifelong learning
environment
work/life
balance
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Health Assets & Health Needs
(from Dominic Harrison 2005)
Healthy
Healthy
Diseased
Saluto-genesis
Opportunity
Management
EMIP Czech Republic
Diseased
Less Healthy
Less Diseased
Epidemiology
Risk management
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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
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Mental health impact
Pathways of
Impact:
Mental health promotion
Economic
capital
Social
capital
Identity
capital
Human
capital
health
EMIP Czech Republic
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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
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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?
EMIP Czech Republic
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Moving forward for mental health promotion
public debate and
engagement
evidence and
indicators
EMIP Czech Republic
connecting and
mainstreaming
policy and
emerging ideas
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The five fruit and vegetables of mental health
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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
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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
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notes for us all ….
Keep on making waves –
without which
no tide can turn……
EMIP Czech Republic
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