1. Dr Lynne Friedli EMIP National Workshop Prague, Czech Republic
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

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
EMIP Czech Republic

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 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

4. 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

5. European policy environment
WHO European declaration and action plan (Helsinki)
EU Green paper
MINDFUL (Stakes, Finland)
IMHPA (University of Nijmegen)
Monitoring positive mental health (Bilbao)
Quality of life/economics of well-being (ESS Wave 3)
Holistic, ecological, sustainable, environmental, ethical
WHO Health assets
IMHPA to become European platform
Mindful – european mental health information and monitoring system
Monitoring positive mental health – indicators
European social survey – personal and social well-being
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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
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7. Addressing the wider determinants of mental health
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
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8. What is mental health? “much depends on dinner” Thinking
Margaret Visser
Thinking
Physical health
and well-being
Feeling
“The heart has its reasons….”
Pascal
EMIP Czech Republic

9. mental health: how we think and feel
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
A key rationale for evaluating mental health i.e. the impact of an intervention on mental health is because psycho-social factors are among the most important determinants of health in developed countries e.g. early childhood experience, anxiety and worry, quality of social relationships, amount of control we have, social status – these factors, broadly described as ‘well-being’ influence a very wide range of outcomes
EMIP Czech Republic

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
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11. Sources of support for people with mental health problems
Diagnosis
Education
Treatment
Family, friends & neighbours
Self help & support groups
Employment
Sports
Faith Communities
Housing
Leisure
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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
EMIP Czech Republic

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
EMIP Czech Republic

14. GDP and Life Satisfaction (from nef)
A Challenge to the Political Status Quo
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15. The vision What would policy look like if the goal was well-being?
parenting
engagement
civic life
relationships
well-being economy
friendship
mutuality
social networks
local
democracy
education
lifelong learning
community assets
environment
sustainability
work/life balance
EMIP Czech Republic

16. Health Assets & Health Needs
(from Dominic Harrison 2005)
Healthy
Diseased
Less Healthy
Healthy
Diseased
Less Diseased
Saluto-genesis
Epidemiology
Opportunity Management
Health and disease are not at both ends of a single continuum . Disease can always be reduced and health always improved. Interventions to tackle disease may not increase health and vice versa.
Risk management
EMIP Czech Republic

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

18. Mental health promotion
Mental health impact
Pathways of
Impact:
Mental health promotion
Economic capital
Human capital
Social capital
Identity capital
human capital (knowledge and skills)
social capital (trust and interdependency);
identity capital (self image, assertiveness and confidence).
health
EMIP Czech Republic

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
EMIP Czech Republic

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?
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21. Moving forward for mental health promotion
connecting and mainstreaming
public debate and
engagement
policy and emerging ideas
evidence and indicators
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22. 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
Individuals
Communities
Policy
EMIP Czech Republic

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
EMIP Czech Republic

24. notes for us all …. Keep on making waves – without which
no tide can turn……
EMIP Czech Republic