Promotion

Moving beyond definitions there have been various attempts to provide models
of mental health promotion practice. Chapter 2 used Albee and Ryan Finn’s (1993)
formula for mental illness – we can turn this around to describe mental health promotion
as increasing the factors above the line and reducing those below:
Coping skills + Self-esteem + Social support
Organic factors + stress + exploitation
As previously noted these particular factors were drawn from a review of literature and
identified as key factors. Social support is defined by Albee and Ryan Finn as support at
the individual level so we gain no strong impression from the top line of the influence
of factors at the macro or even, perhaps, at the meso level which promote mental
health.
Macdonald and O’Hara (1998) drew on this model in developing the Ten Element
Map, discussed in detail in Chapter 2, dividing factors into those which, if increased,
enhance mental health and those which need to be diminished. The model takes into
account the differing levels at which mental health is promoted; micro, meso and
macro level. Macdonald and O’Hara recognize that the individual elements of the
model can be queried although they do make clear their definitions and the source
of the meanings given. Barry (2001), on the other hand, has extended Mrazek and
Haggerty’s (1994) half circle risk reduction model which sets prevention within a spectrum
of mental treatment and rehabilitation and produced a whole circle where mental
health promotion activities of competence, resilience, supportive environment and
empowerment constitute the bottom circle. A succinct categorization of mental health
promotion which makes explicit its levels of action is that offered by Mentality (2005).
See Box 3.2. A mental health programme, even if its activities focus predominantly on
one of these levels, should recognize the others and the interactions between and influences
on action at a specific level, as Macdonald emphasized in the previous chapter.
Programmes which integrate levels of action, the healthy settings initiatives being a
good example, are the kinds of programmes that will be looked for in consideration of
evidence in the lifespan chapters.
Box 3.2 How does mental health promotion work?
MENTAL HEALTH PROMOTION 43
• Strengthening individuals: increasing emotional resilience through interventions
designed to promote self-esteem, life and coping skills, such as communicating, negotiating,
relationship and parenting skills.
• Strengthening communities: this involves increasing social inclusion and participation,
improving neighbourhood environments, developing health and social services which
support mental health, anti-bullying strategies in schools, workplace health, community
safety, childcare and self-help networks.
• Reducing structural barriers to health: through initiatives to reduce discrimination and
inequalities and to promote access to education, meaningful employment, housing
services and support for those who are vulnerable.