Promotion

106 MENTAL HEALTH PROMOTION
and practice should be drawn upon and integrated into frameworks to maximize
positive outcomes for young people.
The critical role of the impact of context is evident in an analysis of what makes
safe environments. Safe social environments such as local communities, schools and
families can contribute to young people’s mental health. Violent behaviour inside the
school and from the surrounding community (see section on built environments)
impacts on young people in schools, environments once considered protective locations.
Developing a sense of safety both physical and psycho-social has become increasingly
important. Intervention points for promoting well-being in young people need to
be focused on peers, schools and families. Witnessing parental domestic violence has
emerged as the strongest predictor of perpetration of violence in young people’s own
intimate relationships (Indermaur 2001). However the concept of a ‘cycle of violence’
presents a fatalistic few of possible outcomes. The majority of those who have grown up
in violent homes do not go on to be violent in their relationships because the link
between witnessing and perpetrating is complex and mediated by a number of social
and situational factors (Indermaur 2001).
The need for the proposed paradigm shift from risk to positive mental health is not
easy to address. Talking about strengths and human capacity to rebuild is difficult
territory for those trained in pathology and DSM IV (APA 1994) paradigms. The challenge
involves a re-orientation of practice to focus on resourcefulness, success, capacity,
hope and competence and a reconceptualization of what created positive mental
health.
Box 5.2 Summary of theories and frameworks related to adolescents and young adults
• Risk factor research has focused mental health on problems rather than strengths and
positive outcomes.
• Reframing mental health through focusing on resilience can be useful but often is
individualistic in focus and ignores the social context.
• Synthesizing research drawn from a broad range of research will advance practice.
• Research on gender, in the areas of violence and loss, highlights the importance of
research that aims to understand young people’s current life worlds.
Determinants of, and influences on, mental health
The influences on mental health are, as outlined in other chapters, multiple, interacting
and operating at different levels. Factors can be grouped in different ways but the broad
division into personal and environmental divided into social, cultural and economic
and the natural plus built environments is followed (see Chapter 4, Figure 4.1).
Personal
As indicated previously a concentration of the early research was on the characteristics
of individuals that put them ‘at risk’. This resulted in a focus on ameliorating these