Promotion

CONCLUDING COMMENTS AND THE FUTURE 215
attributed to them. The selection of the specific phases has been made on the grounds
that there are some broadly similar experiences at the designated periods in the lifespan
which it can be useful to examine together. It was not our intention to adopt a
simple ages and stages model or to make any assumptions that what may be relevant
to some countries with broadly similar intellectual traditions and histories applies
universally.
Chapter 2 analysed the concept of mental health and brought out some of the
dilemmas and debates surrounding its definition. While leaving readers to consider their
preferred definition of mental health Glenn Macdonald argued against a fully eclectic
position. He made a strong case for mental health to be viewed as a positive attribute
rather than as a simple absence of ill health. Concern was expressed about the individualistic
emphasis of many definitions of mental health. The importance of identifying
and understanding concepts of mental health across cultures and developing valid
measures was introduced, issues that are now becoming more fully acknowledged as
key foundations for the development of mental health promotion programmes. Early
chapters commented in general on the determinants of mental health and these were
discussed in greater detail in the lifespan chapters. In accordance with dominant thinking
in health promotion and public health particular emphasis has been placed on
the underlying social determinants of mental health and the argument made that
these must be addressed if significant impacts are to be made on the mental health of
individuals and populations.
Prior to considering the nature of mental health promotion Chapter 3 outlined the
growth of the general discipline of health promotion and described its fundamental
principles and values. It has been argued that, ideally, mental health promotion should
be conceived and implemented in accordance with these principles. That is, it should
seek to promote the mental health of all, foster individual and community empowerment
and be committed to equity and the reduction of mental health inequalities.
Active participation of individuals and communities in the identification of needs and
the planning and implementation of programmes should also be encouraged. In the
earlier chapters efforts have been made to describe mental health promotion programmes
which adopted these principles and values although many reported studies
have had a more restricted focus and commitment to a preventive rather than an
empowerment approach.
While each of the lifespan chapters addressed similar issues there were also some
differences over and above the content specific to each life phase. There were the special
issues selected within each chapter, the extent of detail in discussion of some mental
health promotion concerns, the breadth of evidence included, and the individual
writers’ views on specific matters. Contributors have given differing levels of emphasis
to certain concepts discussed across chapters. Resilience is a particular example. This
has become a major concept in mental health promotion, arguably rather more so than
in other areas of health promotion. It fits in well with the group of individualistic
concepts widely associated with mental health. It is important that activities at the
individual level are in the context of community and societal actions that address the
causes of challenging circumstances. There is a risk that the balance between the individually
focused activities and those at meso and macro level may otherwise tip too
heavily towards the individual.