Public Mental Health: A Positive Approach
By Gillian Hilscher

In this series we’ve talked about the nuances of mental health/illness and the long way we have to go in understanding it, but this doesn’t mean there aren’t already a number of promising avenues through which to treat the mental health problems that plague our society. An increasingly popular approach is something called “public mental health,” which researcher Kristian Wahlbeck champions in his 2015 paper, “Public mental health: the time is ripe for translation of evidence into practice”; keep reading to learn all about it.

“Public mental health” refers to addressing mental health issues through a broad, sweeping, population-level lens rather than a narrow and more targeted approach. Wahlbeck explains that this concept is becoming increasingly accepted due to a buildup of evidence that early life experiences and social relationships (i.e., societal factors that lie beyond the walls of a hospital) play a large role in one’s risk of developing a mental illness. This evidence, he argues, suggests the need for an approach to mental health that reaches all corners and facets of society—not just those that are strictly health-related.

Wahlbeck supports mental health promotion: improving a population’s mental health by actively strengthening its wellbeing, not just reducing its mental disorders. He argues that positive (read proactive) measures can be taken in schools, the workplace, and social activities to bolster the mental health of children/adolescents, adults, and older adults, respectively. These measures can include learning about mental health and emotional intelligence, implementing policies that raise awareness for mental health and aim to reduce stress, or simply increasing the size of one’s social network, all of which have been shown—through decades of research and observation—to reduce levels of stress, depression, and aggression, improve productivity, and promote mental wellbeing.

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In a conversation about the number of mental disorder preventive measures that have proven to be effective, Wahlbeck describes three general strategies of primary prevention: universal, selective, and indicated prevention. Universal prevention is in line with the public mental health measures already described—wide-reaching programs that influence all members of society. Selective prevention is aimed at individuals with a higher risk for developing a disorder, while indicated prevention targets individuals with actual biomarkers or symptoms (however subtle) that foreshadow a future mental disorder. 

Wahlbeck explains that indicated preventive measures seem to be the most effective strategy in regards to psychoses (including conditions like schizophrenia), but universal preventive measures have been shown to be highly effective in nearly everything else: reducing the instance of mental disorders in young people, strengthening communities, and reducing suicide rates and substance abuse disorders, all of which affect (and are affected by) mental health issues. 

To close out his argument, Wahlbeck stresses the importance of empowering the “service user” (the person with the mental health problem) in their journey toward recovery. He argues that this kind of individual empowerment did not receive the level of significance it deserves in the previous views that confined mental health conversations to hospital settings rather than community- and society-wide initiatives. He claims that this shift toward empowerment is a key step in combating the stigma that continues to surround mental disorders. According to Wahlbeck, public mental health programs have the unique ability to foster widespread awareness, acceptance, and growth, ultimately leading to a more satisfied and mentally healthy society.