Promotion

180 MENTAL HEALTH PROMOTION
held in high esteem because of the knowledge they had accumulated and consequently
as the custodians of community wisdom. As a result of transformations many older
people have withdrawn from society because they do not feel they belong, becoming
isolated and lonely. It has been suggested that the rising, and disproportionately high
incidence of suicide among older women in Japan and in rural China may be due to
societal transition, changes in traditional family values and family conflict (Dein and
Huline-Dickens 1997; Pritchard and Baldwin 2002).
Activity theory
On the other hand, activity theory suggests that older people have the same activity
and social contact needs as middle-aged individuals. A decrease in social interaction
and activities are therefore imposed rather than voluntarily sought. Well adjusted older
people aim to maintain their accepted lifestyle as long as possible and attempt to
replace lost roles and activities. For the ageing experience to be successful substantial
levels of social, physical and mental activities need to be maintained or developed.
In contrast to disengagement theory the level of engagement or disengagement is
not as a result of inevitable and intrinsic processes but influenced by past lifestyles,
socio-economic status and imposed social changes. The theory implies that the loss of
social function is an undesirable state that older people wish to avoid (Burbank 1986;
Havighurst et al. 1998). This perspective seems to be more in tune with observations
made in many ‘non-Western’ cultures. Many types of mental health problems are more
prevalent among older Inuits, Africans, Native Americans and some ethnic minority
groups in the UK than the equivalent white European (Nyangweso 1998; Abrahamson
et al. 2002; Bjerregaard and Curtis 2002; Sproston and Nazroo 2002), although the
causal link has been questioned.
Activity theory has been criticized for not acknowledging that personality may
play a part in determining relationships between life satisfaction and role activity or
recognizing that coping strategies built up over people’s lives are utilized to deal with
changes in social networks (Bengtson et al. 1997).
Social constructionist theories emphasize that social reality changes over time, and
focus on people’s social meaning, social relations, attitudes towards age and ageing,
and life events and timing. One such theory is Kuyper’s and Bengtson’s social breakdown
theory.
Kuyper’s and Bengtson’s social breakdown theory
This theory suggests that ageist attitudes label older people as incompetent in social
mechanisms, ultimately leading to a situation of learned helplessness where the older
person relinquishes personal control (Bengtson et al. 1997). This theoretical approach
provides different perspectives on mental health promotion interventions and older
people than are often implemented in practice. The approach has, however, been criticized
for giving limited attention to the impact of the wider social and cultural
environment.
Social exchange theories
These aim to explain the impact of emotional, social and financial resources on
exchanges of contact and social support, particularly between generations. According
to these an explanation for why there is less contact between the young and the old