1. If You Want Mentally Healthy Children, Start Promoting It Corey Keyes Professor of Sociology

2. Mental Health

3. Why Conception Matters –From trephening, exorcism, whirling, confinement, bloodletting, burning at the stake; –To asylums; –To mesmerism, hypnosis, and psychoanalysis; –To institutionalization, sedating, restraining, shocking; –To de-institutionalization; –To community mental health centers; –To proliferation of talk therapies; –To SSRI’s and deep brain stimulation; –To …?

4. Prognosis: Mental Illness ca 21 st Century Good News 10-14 Disorders 80-90% Benefit SSRIs  fewer side-effects  helps 7 of 10 Public awareness Bad News Brief Remission 3 of 10 Drug-Resistant Prevalent  20 to 30% Annually  50% Lifetime Comorbid Age-of-Onset Recurrent

5. Prognosis: Mental Health ca 21 st Century Palliative

6. How Would You Describe the Current Approach to Population Mental Health?

7. The definition of insanity is doing the same thing over and over and expecting different results Benjamin Franklin

8. What We Say The mission of public health is “to protect and improve American health” – (www.surgeongeneral.gov)... assure society’s collective interest in creating the conditions in which people can be healthy – (Institute of Medicine, 1988, 1996, 2003)... ensure that good health, as well as long life, are enjoyed by all – (www.healthypeople.gov)

9. What We Do Reduce leading causes of death Reduce incidence and prevalence of illness The NIMH seeks “To improve this nation’s mental health... “ by supporting ”... a wide range of research related to the etiology, diagnosis, treatment, and prevention of mental disorders “ –(National Institute of Mental Health, 1995, p.1). – Cure therapeutics (Insel & Scolnick, 2006)

10. We Must Stop Saying One Thing and Doing Another

11. PathosSalus Hale Triangulation of Health

12. Flourishing Eudaimonia Hedonia Mental Health From the Salutogenic Perspective ? ?

13. Appetite or Weight Change Insomnia or Hypersomnia Worthlessness or Guilt Fatigue, Loss of Energy Indecisiveness, Lack Concentration Psychomotor Agitation, Retardation Major Depression MalfunctioningAnhedonia Loss of Pleasure or Interest in Life Depressed Mood Suicide Ideation Mental Health from the Pathogenic Perspective

14. Hedonia Positive Affect cheerful in good spirits happy calm and peaceful satisfied full of life Avowed QOL Satisfaction with life Happy with life Interest in life Emotional Well-Being

15. Eudaimonia 1.Self-Acceptance 2.Personal Growth 3.Purpose in Life 4.Environmental Mastery 5.Positive Relations 6.Autonomy 1.Social Acceptance 2.Social Growth/Potential 3.Social Contribution 4.Social Interest/Coherence 5.Social Integration Psychological Well-Being Me or I Social Well-Being We or Us

16. During the past two weeks, how often did you feel … NEVER ONCE OR TWICE ABOUT ONCE A WEEK ABOUT 2 OR 3 TIMES A WEEK ALMOST EVERY DAY EVERY DAY 1. happy 2. interested in life 3. satisfied 4. that you had something important to contribute to society 5. that you belonged to a community (like a social group, or your neighborhood) 6. that our society is becoming a better place for people like you 7. that people are basically good 8. that the way our society works makes sense to you 9. that you liked most parts of your personality 10. good at managing the responsibilities of your daily life 11. that you had warm and trusting relationships with others 12. that you have experiences that challenge you to grow and become a better person 13. confident to think or express your own ideas and opinions 14. that your life has a sense of direction or meaning to it Mental Health Continuum-Short Form

17. Flourishing Eudaimonia Hedonia Mental Health From the Salutogenic Perspective Psychological Well-Being Social Well-Being Emotional Well-Being

18. Feeling and Functioning Well Three Factor Structure –In U.S. Adolescents (Keyes, 2004) –In U.S. College Students (Robitschek & Keyes, in press) (Keyes and Eisenberg, in progress) –In U.S. Adults (Keyes, 1996) –In Black Setswana-speaking South African Adults (Keyes et al., 2008) –In Dutch Adult Population (Westerhof & Keyes, in progress)

19. The DSM Approach to the Mental Health Continuum Flourishing –“almost every day” or “every day” 1 of 3 emotional well-being 6 of 11 positive functioning Moderate Mental Health Languishing –“once or twice” or “never” 1 of 3 emotional well-being 6 of 11 positive functioning

20. Are We Stuck in One Dimension?

21. The Dual Continua Model High HDL Low HDL High LDL Low LDL

22. Mental Health -.68 Emotional Well-Being Psychological Well-Being Social Well- Being Mental Illness CDI-10 Item 1 CDI-10 Item 9 CDI-10 Item 10... The Structure of Mental Health and Illness U.S. Adolescent Population (Keyes, 2008)

23. Mental Health -.52 Emotional Well-Being Psychological Well-Being Social Well- Being Mental Illness Major Depression Panic Disorder Generalized Anxiety The Structure of Mental Health and Illness U.S. Adult Population (Keyes, 2005)

24. Although the concept of positive mental health is one worth keeping in mind, it is not very helpful in classifying different persons, groups, or populations. p. 2 Unfounded Biases Continue

25. Low High Mental Health Symptoms High Mental Illness Symptoms #1 Flourishing #2 Moderate #3 Languishing #6 Languishing & Mental Illness Mental Health #4 Flourishing & Mental Illness #5 Moderate Mental Health & Mental Illness The Hale Perspective

26. CDS 2002 Data, Ages 12-18

27. Summary of Research To Date: Anything Less Than Flourishing In Adults Chronic Physical Illness with Age (Keyes, 2005b) Cardiovascular Disease (Keyes, 2004a) Psychosocial Liabilities (Keyes, 2005b) Disability (Keyes, 2002) Productivity Losses (Keyes, 2002, 2007; Keyes & Grzywacz, 2005) Healthcare Use (Keyes & Grzywacz, 2005) –Overnight Hospitalizations –Medical Visits Physical Health Mental-Emotional Professional –Prescription Medications In Adolescents Conduct Problems (Keyes, 2006) Psychosocial Deficits (Keyes, 2006) Missed Days of School (Keyes, in progress) Schooling Aspirations (Keyes, in progress)

28. Working Paper #1: MIDUS Adults in 1995 and 2005

29. Adjusted* Odds Ratio of any 2005 Mental Illness (MDE, GAD or Panic Disorder) by Change in Mental Health Status (*Adjusted for Race, Age, Sex, Education, and Any Chronic Physical Condition in 2005) ns

30. 1995 2005 Flourishing Moderate Mental Health Languishing 19.2% 22.3% 17.2% 63.6%60.4% 17.3% 3.1% 46.3% 50.6% Change in Adults’ Mental Health Status: Destinations and Origins Flourishing

31. 1995 2005 Flourishing Moderate Mental Health Languishing 19.2% 22.3% 17.2% 63.6% 60.4% 17.3% Change in Adults’ Mental Health Status: Destinations and Origins Moderate Mental Health 67.5% 18.6% 13.9%

32. 1995 2005 Flourishing Moderate Mental Health Languishing 19.2% 22.3% 17.2% 63.6%60.4% 17.3% 45.7% Change in Adults’ Mental Health Status: Destinations and Origins Languishing 50.2% 4.1%

33. Surely Most People Are Flourishing?

34. Point Prevalence of Complete Mental Health U.S. Adult Population, ages 35-84 in 2005 (MIDUS follow-up, n = 1,760)

35. Prevalence of Complete Mental Health U.S. Adolescent Population Ages 12-18 in the 2002 CDS Sample, n= 1,290

36. Universities That Participated in Fall 2007 Healthy Minds Study 1.Miami (Ohio) 2.University of North Carolina Greensboro 3.Yeshiva 4.University of Illinois, Springfield 5.Emory 6.New Mexico State 7.UNC, Chapel Hill 8.Chico State 9.University of Michigan 10.Tufts 11.Penn State 12.University of Illinois, Urbana/Champaign 13.University of Illinois, Chicago

37. Association of Prevalence Screen for Depression (PHQ-9) by Diagnosed as Flourishing (MHC-SF) at n=13 Participating Universities in 2007 Healthy Minds Study Pearson r = -.50 p <.05 (one-tailed)

38. Level of Depression (PHQ-9) by Level of Mental Health 2007 Healthy Minds Data

39. Mental Illness by Level of Mental Health in the 2007 Healthy Minds Data

40. Prevalence of Complete Mental Health 2007 Healthy Minds Data (n = 5,750)

41. Scientific Reasons For Closing the “Wanting-Doing Gap” 1. Illness is specific, and health is ‘something positive’; We have population measures for mental health as flourishing 2. Health and illness form a single continuum; Science supports the two continua model 3. Mental illness is a burden; Anything less than flourishing is a burden 4. Too much mental illness; Too little flourishing 5. Treatment and Cures; Promotion ergo I Prevent 6. Illness is more serious; The absence of health is more serious –Pathogenic and Salutogenic ‘strike the balance’

42. Start Where; Do What? Campaign to Increase Awareness, Priorities, and Allure of Ingredients of Flourishing (complement to stigma reduction of mental illness)

43. Texas Tech Undergraduates Perceived Importance of Each Domainof Flourishing (Note: All paired samples t-test contrasts were significant at p <.05) Not at All Important Very Important

44. Texas Tech Undergraduates Perceived Importance of Dimensions of Flourishing Not at All Important Very Important

45. Texas Tech Undergraduates Correlations of Perceived Importance With Level of the Three Components of Flourishing