mental health promotion
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MENTAL HEALTH PROMOTION. Meeting of the EU Chief Medical Officers April 12, 2012 – Hotel Crowne Plaza Copenhagen Anna Paldam Folker , PhD , Senior Advisor National Board of Health, Denmark. THREE CHALLENGES. DANISH TRENDS IN PUBLIC MENTAL HEALTH. - PowerPoint PPT PresentationTRANSCRIPT
National Board of Health Denmark
MENTAL HEALTH PROMOTION
Meeting of the EU Chief Medical OfficersApril 12, 2012 – Hotel Crowne Plaza Copenhagen
Anna Paldam Folker, PhD, Senior AdvisorNational Board of Health, Denmark
National Board of Health Denmark
THREE CHALLENGES
CONCEPT MEASUREMENT CHANGE
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DANISH TRENDS IN PUBLIC MENTAL HEALTH
20% of children (11-15 yrs) report daily symptoms of emotional distress – doubled since 1991
10% of the adult population (+16) has poor mental health, i.e. they report low levels of well-being and poor daily function 15% among young women 16% among people without training and education
15% of seniors (+75) seldom or never see friends and family, 10% report loneliness
National Board of Health Denmark
DANISH TRENDS IN PUBLIC MENTAL HEALTH
Poor mental health is the most prevalent cause of disability pensions and absenteeism
The number of citizens treated for symptoms of depression and anxiety has doubled since 2002: 0.45 million receive anti-depressants
In the same period the number of children and adults on ADHD medication has increased 1000%
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HEALTH CONSEQUENCES
Poor mental health is associated with disease: Emotional distress in adolescence often precedes
depression and anxiety in adulthood (Weare 2012) Loneliness is significantly related to the development of
CHD, depression and Alzheimer’s (Masi 2012) Loneliness is as dangerous as smoking and alcohol in
terms of risk of death (Holt-Lunstad 2010)
Depression and anxiety are estimated to become the highest ranking disease problems in the developed world in 2020 (WHO 2008)
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WHAT EXPLAINS THE INCREASE IN MENTAL HEALTH PROBLEMS?
A reaction to features of modern society? Heavy burden on individual responsibility Many demands, high ideals – fast pace Less tolerance for vulnerable people
A result of less stigmatization of mental health issues? The problems have been there all the time, but have now
come into the open
Have we become less resilient against life challenges? Tendency to medicalize what used to be seen as part of a
normal life: disappointments, grief, melancholia
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CONCEPTUALIZING MENTAL HEALTH
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… MORE THAN THE ABSENCE OF MENTAL DISORDER
But how much more?
Positive psychology: Mental health is to flourish: to live within the optimal range of human capability as regards quality, creativity, growth and resilience (Keyes 2002)
Two problems: too elitist, seems to medicalize most of the population
WHO: Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life and is able to take part in social relations (WHO 2005, slightly modified)
National Board of Health Denmark
MEASURING MENTAL HEALTH
No established standard for the measurement of mental health in non-clinical populations
A tendency to measure the prevalence of mental disorders or clinical symptoms and ignore positive mental health
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National Health Profile
SF-12 scale4 question on well-being
8 questions on daily function
Municipality interventions
WHO-5 well-being index5 questions on well-being
Correlates with SF-12
TWO APPROACHES
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MENTAL HEALTH CUTS ACROSS DISEASE
The two-dimensional model
No disease Disease
Poor mental health no diseasepoor mental health
diseasepoor mental health
Good mental health
no diseasegood mental health
diseasegood mental health
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A PUBLIC HEALTH APPROACH Focus on the social determinants of mental
health – operate mainly outside the health sector Safe, supportive upbringing No bullying and discrimination Attainment of education and employment Unstressful working conditions Social connectedness
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A PUBLIC HEALTH APPROACH Dual focus on risk and protective factors
Strengthen the social, emotional and physical environment
e.g. in families, educational settings, work places and senior care
Reducing risk factorse.g. help and support for vulnerable families
National public health goals and prevention packages Evidence-based recommendations to the municipalities
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Development of methods
and interventions
Measuring mental health in
municipality interventions
Action plans, targets and policy
National public health goals and prevention
packages
Problem awareness
and information
Concept, measurement, public debate, health surveys
TASKS IN MENTAL HEALTH PROMOTION