January 2009 - Our Voice in Action

Mental Health Promotion: A Call to Action

OPHA is part of a co-ordinated movement towards engaging citizens and promoting mental health across Ontario…

by Jan Lancaster, Manager, Mental Health Promotion at Toronto Public Health

There is no health without Mental Health. The World Health Organization defines positive mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community" (WHO, 2001). Mental health promotion (MHP) is holistic and encompasses the entire individual — physical, mental, emotional, social and spiritual. It focuses on enhancing ones ability to cope, experience a positive quality to life and contribute socially and economically through enhancing the social, psychological, structural and spiritual aspects of our society. It also involves families, communities, and the broader environment.

Strategies to promote mental health are relevant to all members of society, across cultures and throughout the life cycle from infancy to seniors. Even those who have already been diagnosed with a serious mental illness can benefit from strategies that improve mental health and well-being.

The field of Public Health is increasingly realizing that health promotion strategies are just as useful in mental health as they are in the prevention of infectious or cardio-vascular diseases. Advocates of mental health promotion internationally and nationally now have evidence on what leads to positive mental health. The three most significant determinants of mental health are social inclusion, freedom from discrimination and violence, and access to economic resources to prevent poverty (Keleher & Armstrong, 2006).

Social connectedness is protective of mental health. Feelings of attachment and companionship improve one’s sense of purpose and self-esteem. A social network can provide support and enhance coping during times of stress.

Discrimination and violence are risk factors for poor mental health. Violence is often the vehicle through which discrimination is acted out. It can take the form of child and intimate partner abuse, neglect, bullying, youth violence, elder abuse and collective violence (Krug et al., 2002). Being a victim of violence is strongly associated with substance abuse and mental health problems.

Access to economic resources, such as housing, education, work and income, is strongly correlated with mental health because it impacts social connectedness and personal sense of competence and control, as well as socio-economic status. These factors are known to both protect and promote mental health (Mulvihill, Mailous & Atkin, 2001).

So where do we go from here in Ontario?

In early 2008, individuals from five organizations that included the Center for Addiction in Mental Health (CAMH), Health Nexus, Canadian Mental Health Association (Ontario), Centre for Health Promotion (University of Toronto), and the Ontario Public Health Association met to strategize and develop a paper to present to the Ministry of Health Promotion and the Ministry of Health. The result was a paper entitled "Mental Health Promotion in Ontario: A Call to Action" (2008) [PDF]. The two primary recommendations were:

  1. that the Government of Ontario begin engaging and consulting with citizens and a broad range of stakeholders on priorities for promoting mental health in Ontario; and,
  2. that the Government should be developing and implementing a coordinated strategy to promote mental health in the province.
Options for moving forward were also outlined in detail. The paper was presented to both Ministries in late 2008 with positive feedback and assurances that discussions would continue.

In addition, and most timely, was a national Mental Health Promotion think tank that was held in Calgary in November 2008 to discuss moving the mental health promotion agenda forward for Canada. It was attended by representatives from all provinces along with individuals from the Public Health Agency of Canada (PHAC) and the Mental Health Commission of Canada.

So for 2009 and beyond, those of us who work in this field have our work cut out for us. We have to continue to focus on strategies that promote connections in our society and that reduce discrimination and violence, and advocate for poverty reduction. We need to keep mental health promotion high on the provincial health agendas and move it into the reality of peoples lives here in Ontario.