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Mental health promotion – a natural fit for health promoters

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I. Introduction

"There is no health without mental health." - World Health Organization (WHO, 2001)
By the very nature of health promotion work we should be responsible
for a mental health promotion component in all our health promotion
efforts and endeavors. Mental health promotion could be integrated into
every program and activity we undertake.

It is also consistent with the health promotion tradition, best defined
by the Ottawa Charter for Health Promotion as "the process of enabling
individuals and communities to increase control over the determinants
of health and thereby improve their health" (WHO, 1986). Mental health
promotion (MPH) has been defined in an international workshop sponsored
by Health Canada as
"the process of enhancing the capacity of individuals and communities
to take control over their lives and improve their mental health.
Mental health promotion uses strategies that foster supportive
environments and individual resilience, while showing respect for
equity, social justice, interconnections and personal dignity"
(Centre for Health Promotion, 1997).

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II. Linking Mental Health and Capacities

Mental health promotion becomes a natural fit for the work of health
promoters. It is congruent with health promotion strategies and
commitment to increase individual, organizational and community
capacity and inclusion. In addition, research has shown that poor
mental health is linked to cardiovascular disease and other chronic
illnesses (Heart & Stroke Foundation Canada).

Today mental health is often confused with mental illness. Whereas
mental illness focuses on individual deficits, is relatively arbitrary
and based on prejudice and discrimination; mental health focuses on
individual strengths, a state of overall well-being and an individual
who is empowered to realize his or her abilities and is valued for the
contribution that is made. Mental health promotion in turn builds on
individual strengths and capacities, and works to enhance social
conditions and processes, i.e., the broader determinants of health that
permeates all health promotion work.

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III Opportunities for MHP on Provincial and Federal Agendas

Recently the province of Ontario created a new Ministry of Health
Promotion. Its strategic directions include work in the areas of
healthy living, tobacco, healthy weights and injury prevention. As
well, it has prioritized mental health and addictions, including
problem gambling as part of this mandate. We know that needs in the
area of mental health promotion exist right across the province and at
a very grass-roots level. A recent evaluation of the Ontario Health
Promotion Resource System (OPHRS) identified mental health as a major
area where health intermediaries felt they needed more support and
training. When the Local Health Integration Networks (LHIN's) conducted
their 14 provincial dialogues last year, mental health issues were
identified as one of the top priority areas for action.  

This is an excellent time for health promoters to undertake and include
mental health promotion activities, thus becoming more comprehensive,
strategic, and inclusive. Mental health promotion ideas should find
purchase in both the federal and provincial agendas given the nature of
the work that is being undertaken in these two jurisdictions. For
example we might find exciting new opportunities through the Chronic
Disease Prevention Alliances (Canadian, and Ontario); and the Primary
Care Reforms; the National Strategy on Cancer, Mental Health, and Heart
Disease; the Michael Kirby Commission; the National and Provincial
Public Health Agencies, who are including mental health promotion in
their mandates; the Global Economic Roundtable on Mental Health and
Addictions (Michael Wilson); and other National Strategies - including
problematic use of alcohol, drugs and other substances, i.e., tobacco
and physical health and many others.

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IV Strategies for Mental Health Promotion

In order to develop a strategy for mental health promotion, an organization needs to discuss the following:
·    What exactly do you want to do in terms of mental
health promotion work?  An environmental scan may help clarify
where gaps may exist and which gaps your organization is best
positioned to fill.
·    Who is your target audience?
·    What capacity do you have to carry out mental
health promotion work?  Do you have a history with mental health
work, or networks and connections that might help?
·    Short-term planning: what could you achieve within
a year?  Making contact and developing partnerships with other
organizations doing mental health and mental health promotion work
could be a valuable first phase.
·    Longer-term planning:  how could you build on your first year's achievements in a sustainable way?

As health promoters, we are all aware that health care professionals,
planners and policy/decision makers are often too preoccupied with the
immediate problems of those who have an illness to be able to pay
attention to the needs of those who are well.  They also find it
difficult to ensure that the rapidly changing social and environmental
conditions support rather than threaten mental health.  This
situation is only partly based on the lack of adequate evidence for the
effectiveness of health promoting interventions.  It also relates
to how health professionals, planners and policy/decision makers are
trained, and what the public expects of them.  In the case of
mental health, this also has to do with the discrimination and
prejudice surrounding mental health issues, and our reluctance to
discuss these issues openly.

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V. Mental Health is Everyone's Business - Communities, Decision-Makers, You!

Mental health is everybody's business, including individuals, families,
communities, commercial organizations, health promoters and other
health professionals either to promote mental health or gain from it.

At a community level useful guides and tools are key to help people
promote mental health in their own communities,. The Mental Health
Promotion Tool Kit (Willinsky, 1999) provides practical information and
resources for developing, implementing and evaluating mental health
promotion projects, using examples from three projects plus strategies,
tips and tools.

Policy/decision makers in government at the local, provincial and
national levels are also important. Their actions often affect mental
health in ways that they may not realize, and they need to assess the
possibilities and evidence for improving the mental health of the
population. The Canadian Mental Health Association (CMHA) public policy
work at national and provincial levels depends upon collaboration and
support to make a difference

The time has come for mental health promotion, within the broader field
of health promotion, to help tip the scales in the ongoing ounce of
prevention is worth a pound of cure debate in our health system.

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VI References

Centre for Health Promotion. 1997. "Proceedings from the International
Workshop on Mental Health Promotion, University of Toronto." In Mental
health promotion. Edited by C. Willinsky and B. Pape. Social Action
Series. Toronto: Canadian Mental Health
Association National Office.

Heart & Stroke Foundation Canada. "Is depression a heart breaker?"
Toronto: Heart & Stroke Foundation Canada. Retrieved May 3, 2006
or from Ontario CMHA Network e-journal  Spring 2006

Willinsky, C. 1999. Mental health promotion toolkit. Canadian Mental
Health Association National Office, and Mental Health Promotion Unit of
Health Canada. Retrieved May 3, 2006 from

World Health Organization (WHO). 1986. The Ottawa charter for health
promotion. International conference on health promotion (1986, Nov
17-21). Geneva: World Health Organization. Retrieved May 3, 2006

World Health Organization (WHO). 2001. The world health report 2001 -
Mental Health: New Understanding, New Hope. Retrieved May 3, 2006 from