Promotion

ADOLESCENCE AND EMERGING ADULTHOOD 121
promoting mental health were family, friends, personal achievements, feeling good
about yourself, having people to talk to, pets, presents and having fun. Factors which
caused people to feel mentally unhealthy were identified as death of a family member,
friends or pets, break up of relationships, peer pressure, falling out with friends, divorce
or parents fighting, and boredom. More activities were seen as a way of attaining positive
mental health and adult interventions of various types were seen as important in
helping young people feel physically and emotionally safe. Young people’s knowledge
about mental health and illness came from the media, especially the TV. School and
parents did not seem to have played a formal role in developing the attitudes of the
young people.
Evidence of effective mental health promotion
with adolescents and young adults
Much of the research base for health promotion arises from US prevention science and
a risk and problem orientation. Prevention science has made significant advances in
understanding the malleable risk and protective factors for the onset of mental health
problems (WHO 2004b). But the mental health prevention activity has focused on
reducing risk factors in individuals and families especially those affecting young people
– home-based, individually focused intervention programmes being complemented by
school focused interventions that most frequently target individuals ‘at risk’. There is
now a growing emphasis on strengths, social and emotional learning and positive
youth development.
Wells et al. (2002, 2003) reported on a systematic review of mental health promotion
interventions in schools conducted in 1999. Most of the 17 studies were American,
but the conclusion about elements of programmes that create a positive impact was
clear:
• they adopt a whole-school approach;
• they are implemented continuously for more than a year;
• they involve changes to the school climate; and
• they are aimed at the promotion of mental health compared to the prevention of
mental illness.
(Wells et al. 2002: 197)
There was evidence that programmes which promote emotional and social competence
can contribute substantially to emotional well-being.
There are efforts in place to strengthen the evaluation of health promoting schools
in countries which, to date, have reported few, if any studies. Mũkoma and Flisher
(2004) reported from a systematic review of health promoting schools that they were
unable to find any evaluations from Africa. Their review arose from the need to develop
a framework for evaluating health promoting schools in South Africa. The criteria
used for inclusion in the review overlapped those of Lister-Sharp et al. (1999) but also
differed in some respects. Nine studies were included in the review from European
countries, Australia and the US. They reported positive developments from process