View source for Mental health

{{Short description|Level of human psychological well-being}}
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[[File:Psi mental health symbol.png|thumb|The Greek glyph "'''ψ'''" or "psi" when latinized, is a old symbol for mental health and well being]]
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Mental health is often mistakenly equated with the absence of mental illness. However, mental health refers to a person's overall emotional, psychological, and social well-being. It influences how individuals think, feel, and behave, and how they cope with stress, relate to others, and make choices. Mental illness, on the other hand, refers to diagnosable conditions—such as depression, anxiety disorders, or schizophrenia—that disrupt a person's thoughts, mood, behavior, or functioning. It is possible for individuals with mental illness to experience periods of good mental health, just as people without a mental illness may struggle with poor mental well-being at times.<sup>[1][2]</sup><ref>https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response</ref>
'''Mental health''' encompasses [[emotion]]al, [[Psychology|psychological]], and [[social]] [[well-being]], influencing [[cognition]], [[perception]], and [[behavior]]. Mental health plays a crucial role in an individuals daily life when managing stress, engaging with others, and contributing to life overall. According to the [[World Health Organization|World Health Organization (WHO)]], it is a "state of well-being in which the individual realizes his or her abilities, can [[Coping|cope]] with the normal [[Stress (biology)|stresses]] of life, can [[Work (human activity)|work]] productively and fruitfully, and can contribute to his or her community".<ref>{{cite web |url=https://www.who.int/data/gho/data/major-themes/health-and-well-being |title=Health and Well-Being |website=[[World Health Organization]] |access-date=2023-08-09}}</ref> It likewise determines how an individual handles [[Stress (biology)|stress]], [[interpersonal relationship]]s, and [[decision-making]].<ref>{{Cite web |date=2021-11-23 |title=About Mental Health |url=https://www.cdc.gov/mentalhealth/learn/index.htm |access-date=2022-04-11 | work = U.S. Centers for Disease Control and Prevention (CDC) |language=en-us}}</ref> Mental health includes subjective well-being, perceived [[self-efficacy]], [[autonomy]], competence, intergenerational dependence, and [[self-actualization]] of one's [[intellect]]ual and emotional potential, among others.<ref name="WHO">{{cite web|url=https://www.who.int/whr/2001/en/whr01_en.pdf?ua=1|title= The world health report 2001 – Mental Health: New Understanding, New Hope|publisher= WHO |access-date= 4 May 2014}}</ref>

From the perspectives of [[positive psychology]] or [[holism]], mental health may include an individual's [[ability]] to enjoy life and to create a balance between life activities and efforts to achieve [[psychological resilience]].<ref>{{cite book | vauthors = Snyder CR, Lopez SJ, Pedrotti JT |title=Positive psychology: the scientific and practical explorations of human strengths |date=2011 |publisher=SAGE |isbn=978-1-4129-8195-8 |oclc=639574840 }}{{page needed|date=November 2019}}</ref> [[Cultural diversity|Cultural differences]], personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health".<ref name="MedlinePlus">{{Cite web|url=https://medlineplus.gov/mentalhealth.html|title=Mental Health| work = MedlinePlus | publisher = U.S. National Library of Medicine |access-date=2019-11-20}}</ref> Some early [[Signs and symptoms|signs]] related to mental health difficulties are [[Sleep disorder|sleep irritation]], [[Lethargy|lack of energy]], [[lack of appetite]], thinking of [[Self-harm|harming oneself]] or others, [[self-isolating]] (though [[introversion]] and isolation are not necessarily unhealthy), and frequently zoning out.<ref name="MedlinePlus" />

== Mental disorders ==
{{See also|Mental disorder}}
Mental health, as defined by the [[Public Health Agency of Canada]],<ref>{{Cite web |date=2020-10-28|title=Public Health Agency of Canada|url=https://www.canada.ca/en/public-health.html|access-date=2021-10-02|website=www.canada.ca}}</ref> is an individual's capacity to feel, think, and act in ways to achieve a better [[quality of life]] while respecting personal, social, and cultural boundaries.<ref name="Manwell e007079">{{cite journal | vauthors = Manwell LA, Barbic SP, Roberts K, Durisko Z, Lee C, Ware E, McKenzie K | title = What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey | journal = BMJ Open | volume = 5 | issue = 6 | pages = e007079 | date = June 2015 | pmid = 26038353 | pmc = 4458606 | doi = 10.1136/bmjopen-2014-007079 }}</ref> Impairment of any of these are risk factor for [[mental disorder]]s, or mental illnesses,<ref>{{cite journal | vauthors = Galderisi S, Heinz A, Kastrup M, Beezhold J, Sartorius N | title = A proposed new definition of mental health | language = pl | journal = Psychiatria Polska | volume = 51 | issue = 3 | pages = 407–411 | date = June 2017 | pmid = 28866712 | doi = 10.12740/pp/74145 | doi-access = free }}</ref> which are a component of mental health. In 2019, about 970 million people worldwide suffered from a mental disorder, with [[Anxiety disorder|anxiety]] and [[Depression disorder|depression]] being the most common. The number of people suffering from mental disorders has risen significantly throughout the years.<ref>{{cite web | title = GBD Results | work = Global Health Data Exchange (GHDx) | publisher = Institute of Health Metrics and Evaluation. | url = https://vizhub.healthdata.org/gbd-results/ | access-date = 14 May 2022 }}</ref> Mental disorders are defined as health conditions that affect and alter cognitive functioning, emotional responses, and behavior associated with distress and/or impaired functioning.<ref>{{cite journal | vauthors = Manderscheid RW, Ryff CD, Freeman EJ, McKnight-Eily LR, Dhingra S, Strine TW | title = Evolving definitions of mental illness and wellness | journal = Preventing Chronic Disease | volume = 7 | issue = 1 | pages = A19 | date = January 2010 | pmid = 20040234 | pmc = 2811514 }}</ref><ref>{{cite journal | vauthors = Goldman HH, Grob GN | title = Defining 'mental illness' in mental health policy | journal = Health Affairs | volume = 25 | issue = 3 | pages = 737–49 | date = 2006-05-01 | pmid = 16684739 | doi = 10.1377/hlthaff.25.3.737 }}</ref> The [[ICD-11]] is the global standard used to [[diagnose]], treat, research, and report various mental disorders.<ref>{{Citation| vauthors = Evans SC, Roberts MC |title=''International Classification of Diseases'' ( <SCP> ''ICD'' </SCP> ), Mental and Behavioural Disorders Section |date=2015 |encyclopedia=The Encyclopedia of Clinical Psychology|pages=1–10|publisher=John Wiley & Sons, Ltd|language=en|doi=10.1002/9781118625392.wbecp257|isbn=978-1-118-62539-2 }}</ref><ref>{{Cite web|title=ICD-11|url=https://icd.who.int/en|access-date=2022-01-18| work = International Classification of Diseases | publisher = World Health Organization (WHO) }}</ref> In the United States, the [[DSM-5]] is used as the [[Classification of mental disorders|classification system of mental disorders]].<ref name="Regier 92–98">{{cite journal | vauthors = Regier DA, Kuhl EA, Kupfer DJ | title = The DSM-5: Classification and criteria changes | journal = World Psychiatry | volume = 12 | issue = 2 | pages = 92–8 | date = June 2013 | pmid = 23737408 | pmc = 3683251 | doi = 10.1002/wps.20050 }}</ref>

Mental health is associated with a number of lifestyle factors such as diet, exercise, stress, drug abuse, social connections and interactions.<ref name="Regier 92–98"/><ref>{{cite journal | vauthors = Manger S | title = Lifestyle interventions for mental health | journal = Australian Journal of General Practice | volume = 48 | issue = 10 | pages = 670–673 | date = October 2019 | pmid = 31569326 | doi = 10.31128/ajgp-06-19-4964 | doi-access = free }}</ref> Psychiatrists, psychologists, licensed professional clinical counselors, social workers, nurse practitioners, and family physicians can help manage mental illness with treatments such as therapy, counseling, and [[medication]].<ref>{{Cite web|title=What Is the Difference Between Psychologists, Psychiatrists and Social Workers?|url=https://www.apa.org/ptsd-guideline/patients-and-families/psychotherapy-professionals|access-date=2021-11-19| work = American Psychological Association (APA) }}</ref>

==History==
{{See also|Well-being|Eudaimonia|History of mental disorders}}

=== Early history ===
[[File:Csm 04 fidus-hygiene-kongress 01 ac668fa1b6.jpg|thumb|Highly stylized poster for the [[social hygiene|Hygiene]] Congress in Hamburg, 1912]]
In the mid-19th century, [[William Sweetser]] was the first to coin the term ''mental hygiene'', which can be seen as the precursor to contemporary approaches to work on promoting positive mental health.<ref>{{cite book | veditors = Shook JR |date=April 2012 |chapter=Sweetser, William |pages=1016–1020 |title=Dictionary of Early American Philosophers |publisher=Bloomsbury Publishing USA |isbn=978-1-4411-7140-5 |chapter-url=https://books.google.com/books?id=oOqoAwAAQBAJ&pg=PA1017 }}</ref><ref name=Mandell1995>{{cite web | vauthors = Mandell W |date=1995 |title=Origins of Mental Health, The Realization of an Idea | work = Johns Hopkins Bloomberg School of Public Health |publisher=Johns Hopkins University |location=Baltimore, MD |access-date=9 June 2015 |url=http://www.jhsph.edu/departments/mental-health/about-us/origins-of-mental-health.html }}</ref> [[Isaac Ray]], the fourth president<ref>{{cite web|title=Isaac Ray Award|url=https://www.psychiatry.org/psychiatrists/awards-leadership-opportunities/awards/isaac-ray-award|website=www.psychiatry.org|publisher=American Psychiatric Association|access-date=27 October 2017}}</ref> of the [[American Psychiatric Association]] and one of its founders, further defined mental hygiene as "the art of preserving the mind against all incidents and influences calculated to deteriorate its qualities, impair its energies, or derange its movements".<ref name=Mandell1995/>

In American history, mentally ill patients were thought to be religiously punished. This response persisted through the 1700s, along with the inhumane confinement and stigmatization of such individuals.<ref name="uniteforsight">{{Cite web|title=A Brief History of Mental Illness and the U.S. Mental Health Care System|url=http://www.uniteforsight.org/mental-health/module2|website=www.uniteforsight.org|access-date=2020-05-11|archive-date=2020-06-17|archive-url=https://web.archive.org/web/20200617230917/http://www.uniteforsight.org/mental-health/module2|url-status=dead}}</ref> [[Dorothea Dix]] (1802–1887) was an important figure in the development of the "mental hygiene" movement. Dix was a school teacher who endeavored to help people with mental disorders and to expose the sub-standard conditions into which they were put.<ref name="Barlow1">{{cite book | vauthors = Barlow DH, Durand VM, Steward SH | date = 2009 | title = Abnormal Psychology: An Integrative Approach | edition = Second Canadian | location = Toronto | publisher = Nelson Education | page = 16 | isbn = 978-0-17-644151-7 | url = https://archive.org/details/abnormalpsycholo0000barl/page/n23/mode/2up }}</ref> This became known as the "mental hygiene movement".<ref name=Barlow1/> Before this movement, it was not uncommon that people affected by mental illness would be considerably neglected, often left alone in deplorable conditions without sufficient clothing.<ref name=Barlow1/> From 1840 to 1880, she won the support of the federal government to set up over 30 state psychiatric hospitals; however, they were understaffed, under-resourced, and were accused of violating [[human rights]].<ref name="uniteforsight" />

[[Emil Kraepelin]] in 1896 developed the [[taxonomy (general)|taxonomy]] of mental disorders which has dominated the field for nearly 80 years. Later, the proposed disease model of abnormality was subjected to analysis and considered normality to be relative to the physical, geographical and cultural aspects of the defining group.<ref>{{cite journal | vauthors = Ebert A, Bär KJ | title = Emil Kraepelin: A pioneer of scientific understanding of psychiatry and psychopharmacology | journal = Indian Journal of Psychiatry | volume = 52 | issue = 2 | pages = 191–2 | date = April 2010 | pmid = 20838510 | pmc = 2927892 | doi = 10.4103/0019-5545.64591 | doi-access = free }}</ref>

At the beginning of the 20th century, [[Clifford Whittingham Beers|Clifford Beers]] founded "Mental Health America – National Committee for Mental Hygiene", after publication of his accounts as a patient in several [[lunatic asylums]], ''A Mind That Found Itself'', in 1908<ref>{{cite web | vauthors = Peck A | date = 2013 | title = Mental Health America – Origins | access-date = 9 June 2015 | url = http://www.socialwelfarehistory.com/organizations/mental-health-america-origins | work = The Social Welfare History Project }}</ref><ref name=CliffordBeersClinic>{{Cite web |url=http://www.cliffordbeers.org/aboutus.htm |title=About Us | work = Clifford Beers Clinic | location = New Haven, CT |access-date=2007-06-01 |archive-date=2007-04-09 |archive-url=https://web.archive.org/web/20070409125103/http://www.cliffordbeers.org/aboutus.htm |url-status=dead }}</ref><ref name="The roots of the concept of mental">{{cite journal | vauthors = Bertolote J | title = The roots of the concept of mental health | journal = World Psychiatry | volume = 7 | issue = 2 | pages = 113–6 | date = June 2008 | pmid = 18560478 | pmc = 2408392 | doi = 10.1002/j.2051-5545.2008.tb00172.x }}</ref> and opened the first outpatient mental health [[clinic]] in the United States.<ref name=CliffordBeersClinic/>

The mental hygiene movement, similar to the [[social hygiene movement]], had at times been associated with advocating [[eugenics]] and [[sterilisation (medicine)|sterilization]] of those considered too mentally deficient to be assisted into productive work and contented family life.<ref>{{cite book | vauthors = Jones G |title=Social Hygiene in Twentieth Century Britain |date=1986 |publisher=Croom Helm |location=London |isbn=978-0-7099-1481-5 | url = https://books.google.com/books?id=C9IOAAAAQAAJ&q=%27moral+hygiene%27+%27social+hygiene%27+%27mental+hygiene%27+movement | pages = 80–83 }}</ref><ref>{{cite encyclopedia | chapter-url = http://www.faqs.org/childhood/Gr-Im/Hygiene.html | encyclopedia = Encyclopedia of Children and Childhood in History and Society | chapter = Hygiene | vauthors = Wilkie JS | title = Hygiene - Evolving Ideas of Hygiene, Theories of Contagion, Public Hygiene - Encyclopedia of Children and Childhood in History and Society }}</ref> In the post-WWII years, references to mental hygiene were gradually replaced by the term 'mental health' due to its positive aspect that evolves from the treatment of illness to preventive and promotive areas of healthcare.<ref name="The roots of the concept of mental"/>

==== Institutionalization and Deinstitutionalization ====
When US government-run hospitals were accused of violating human rights, advocates pushed for [[deinstitutionalization]]: the replacement of federal mental hospitals for [[community mental health service]]s. The closure of state-provisioned psychiatric hospitals was enforced by the [[Community Mental Health Centers Act]] in 1963 that laid out terms in which only patients who posed an imminent danger to others or themselves could be admitted into state facilities.<ref>{{cite report | title=New York Times New York State Poll, June 2008 | publisher=Inter-university Consortium for Political and Social Research (ICPSR) | series=CBS News/New York Times Poll Series |id=ICPSR 26164 | date=3 December 2009 | doi=10.3886/icpsr26164.v1 |location=Ann Arbor, MI }}</ref> This was seen as an improvement from previous conditions. However, there remains a debate on the conditions of these community resources.

It has been proven that this transition was beneficial for many patients: there was an increase in overall satisfaction, a better quality of life, and more friendships between patients all at an affordable cost. This proved to be true only in the circumstance that treatment facilities had enough funding for staff and equipment as well as proper management.<ref>{{cite journal | vauthors = Knapp M, Beecham J, McDaid D, Matosevic T, Smith M | title = The economic consequences of deinstitutionalisation of mental health services: lessons from a systematic review of European experience | journal = Health & Social Care in the Community | volume = 19 | issue = 2 | pages = 113–25 | date = March 2011 | pmid = 21143545 | doi = 10.1111/j.1365-2524.2010.00969.x | doi-access = free }}</ref> However, this idea is a polarizing issue. Critics of deinstitutionalization argue that poor living conditions prevailed, patients were lonely, and they did not acquire proper medical care in these treatment homes.<ref name="Novella_2010">{{cite journal | vauthors = Novella EJ | title = Mental health care and the politics of inclusion: a social systems account of psychiatric deinstitutionalization | journal = Theoretical Medicine and Bioethics | volume = 31 | issue = 6 | pages = 411–27 | date = December 2010 | pmid = 20711755 | doi = 10.1007/s11017-010-9155-8 | s2cid = 23328647 }}</ref> Additionally, patients that were moved from state psychiatric care to nursing and residential homes had deficits in crucial aspects of their treatment. Some cases result in the shift of care from health workers to patients' families, where they do not have the proper funding or medical expertise to give proper care.<ref name="Novella_2010" /> On the other hand, patients that are treated in community mental health centers lack sufficient cancer testing, [[vaccination]]s, or otherwise regular medical check-ups.<ref name="Novella_2010" />

Other critics of state deinstitutionalization argue that this was simply a transition to "[[transinstitutionalization]]", or the idea that prisons and state-provisioned hospitals are interdependent. In other words, patients become inmates. This draws on the Penrose Hypothesis of 1939, which theorized that there was an inverse relationship between prisons' population size and the number of psychiatric hospital beds.<ref name="Schildbach_2018">{{cite journal | vauthors = Schildbach S, Schildbach C | title = Criminalization Through Transinstitutionalization: A Critical Review of the Penrose Hypothesis in the Context of Compensation Imprisonment | journal = Frontiers in Psychiatry | volume = 9 | pages = 534 | date = 25 October 2018 | pmid = 30410452 | pmc = 6209624 | doi = 10.3389/fpsyt.2018.00534 | doi-access = free }}</ref> This means that populations that require psychiatric mental care will transition between institutions, which in this case, includes state psychiatric hospitals and criminal justice systems. Thus, a decrease in available psychiatric hospital beds occurred at the same time as an increase in inmates.<ref name="Schildbach_2018" /> Although some are skeptical that this is due to other external factors, others will reason this conclusion to a lack of empathy for the mentally ill. There is no argument for the social stigmatization of those with mental illnesses, they have been widely marginalized and discriminated against in society.<ref name="uniteforsight" /> In this source, researchers analyze how most compensation prisoners (detainees who are unable or unwilling to pay a fine for petty crimes) are unemployed, homeless, and with an extraordinarily high degree of mental illnesses and [[substance use disorder]]s.<ref name="Schildbach_2018" /> Compensation prisoners then lose prospective job opportunities, face social marginalization, and lack access to resocialization programs, which ultimately facilitate reoffending.<ref name="Schildbach_2018" /> The research sheds light on how the mentally ill—and in this case, the poor—are further punished for certain circumstances that are beyond their control, and that this is a vicious cycle that repeats itself. Thus, prisons embody another state-provisioned mental hospital.

Families of patients, advocates, and mental health professionals still call for increase in more well-structured community facilities and treatment programs with a higher quality of long-term inpatient resources and care. With this more structured environment, the United States will continue with more access to mental health care and an increase in the overall treatment of the mentally ill.

However, there is still a lack of studies for mental health conditions (MHCs) to raise awareness, knowledge development, and attitudes toward seeking medical treatment for MHCs in Bangladesh. People in rural areas often seek treatment from the traditional healers and MHCs are sometimes considered a spiritual matter.<ref>{{cite journal | vauthors = Uddin MN, Bhar S, Islam FM | title = An assessment of awareness of mental health conditions and its association with socio-demographic characteristics: a cross-sectional study in a rural district in Bangladesh | journal = BMC Health Services Research | volume = 19 | issue = 1 | pages = 562 | date = August 2019 | pmid = 31409332 | pmc = 6692949 | doi = 10.1186/s12913-019-4385-6 | s2cid = 199547608 | doi-access = free }}</ref>

== Epidemiology ==
{{See also|Prevalence of mental disorders}}

[[Mental illnesses]] are more common than [[cancer]], [[Diabetes mellitus|diabetes]], or [[heart disease]]. As of 2021, over 22 percent of all Americans over the age of 18 meet the criteria for having a mental illness.<ref>{{Cite web |date=March 2023 |title=Mental Illness | work = National Institute of Mental Health (NIMH) |url=https://www.nimh.nih.gov/health/statistics/mental-illness |access-date=January 5, 2024 |language=en}}</ref> Evidence suggests that 970 million people worldwide have a mental disorder.<ref>{{Cite web |date=June 8, 2022 |title=Mental disorders |url=https://www.who.int/news-room/fact-sheets/detail/mental-disorders |access-date=January 5, 2024 |website=World Health Organization |language=en}}</ref> [[Major depressive disorder|Major depression]] ranks third among the top 10 leading causes of disease worldwide. By 2030, it is predicted to become the leading cause of [[disease]] worldwide.<ref>{{cite book | vauthors = Bains N, Abdijadid S | chapter = Major Depressive Disorder |date=2023 | chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK559078/ | title = StatPearls |access-date=2024-01-05 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32644504 }}</ref> Over 700 thousand people commit [[suicide]] every year and around 14 million attempt it.<ref>{{Cite web |title=Suicide prevention |url=https://www.who.int/health-topics/suicide |access-date=January 5, 2024 |website=World Health Organization |language=en}}</ref> A [[World Health Organization]] (WHO) report estimates the global cost of mental illness at nearly $2.5 trillion (two-thirds in indirect costs) in 2010, with a projected increase to over $6 trillion by 2030.<ref>{{cite web | title = The World Health Report 2001: Mental Disorders affect one in four people | date = 28 September 2001 | url = https://www.who.int/whr/2001/media_centre/press_release/en/ |publisher = World Health Organization (WHO) }}</ref>

Evidence from the WHO suggests that nearly half of the world's population is affected by mental illness with an impact on their [[self-esteem]], relationships and ability to function in everyday life.<ref>{{cite journal | vauthors = Storrie K, Ahern K, Tuckett A | title = A systematic review: Students with mental health problems--a growing problem | journal = International Journal of Nursing Practice | volume = 16 | issue = 1 | pages = 1–6 | date = February 2010 | pmid = 20158541 | doi = 10.1111/j.1440-172X.2009.01813.x }}</ref> An individual's emotional health can impact their physical health. Poor mental health can lead to problems such as the inability to make adequate decisions and [[substance use disorder]]s.<ref name="Richards 2010 247">
{{cite journal| vauthors = Richards K, Campenni C, Muse-Burke J |title=Self-care and Well-being in Mental Health Professionals: The Mediating Effects of Self-awareness and Mindfulnes|journal=Journal of Mental Health Counseling |date=July 2010 |volume=32 |issue=3 |pages=247–264 |doi=10.17744/mehc.32.3.0n31v88304423806}}</ref>

Good mental health can improve life quality whereas poor mental health can worsen it. According to Richards, Campania, & Muse-Burke, "There is growing evidence that is showing emotional abilities are associated with pro-social behaviors such as stress management and physical health."<ref name="Richards 2010 247"/> Their research also concluded that people who lack emotional expression are inclined to anti-social behaviors (e.g., substance use disorder and [[alcohol use disorder]], physical fights, [[vandalism]]), which reflects one's mental health and suppressed emotions.<ref name="Richards 2010 247"/> Adults and children who face mental illness may experience [[social stigma]], which can exacerbate the issues.<ref>{{cite journal | vauthors = Heary C, Hennessy E, Swords L, Corrigan P |title=Stigma towards Mental Health Problems during Childhood and Adolescence: Theory, Research and Intervention Approaches |journal=Journal of Child and Family Studies |date=6 July 2017 |volume=26 |issue=11 |pages=2949–2959 |doi=10.1007/s10826-017-0829-y |s2cid=148951912 }}</ref>

=== Global prevalence ===
{{See also|Global mental health|:Category:Mental health by country}}
[[File:Two Continua Model Large.png|thumb|The Two Continua Model of Mental Health and Mental Illness]]
Mental health can be seen as a [[continuum (theory)|continuum]], where an individual's mental health may have many different possible [[Value (ethics)|values]].<ref name=Keyes2002>{{cite journal | vauthors = Keyes CL | title = The mental health continuum: from languishing to flourishing in life | journal = Journal of Health and Social Behavior | volume = 43 | issue = 2 | pages = 207–22 | date = June 2002 | pmid = 12096700 | doi = 10.2307/3090197 | s2cid = 2961978 | jstor = 3090197 }}</ref> [[Well-being|Mental wellness]] is viewed as a positive attribute; this definition of mental health highlights [[emotional well-being]], the capacity to live a full and [[creativity|creative]] life, and the flexibility to deal with life's inevitable challenges. Some discussions are formulated in terms of contentment or happiness.<ref>{{cite book | vauthors = Graham MC |title=Facts of Life: ten issues of contentment |date=2014 |publisher=Outskirts Press |isbn=978-1-4787-2259-5 |pages=6–10}}</ref> Many therapeutic systems and self-help books offer methods and philosophies espousing strategies and techniques vaunted as effective for further improving the mental wellness. [[Positive psychology]] is increasingly prominent in mental health.

A [[holistic]] model of mental health generally includes concepts based upon [[anthropological]], [[education]]al, [[psychological]], [[religious]], and [[sociological]] perspectives. There are also models as theoretical perspectives from [[personality psychology|personality]], [[social psychology|social]], [[clinical psychology|clinical]], [[health psychology|health]] and [[developmental psychology]].<ref name=WitmerSweeney>{{cite journal | vauthors = Witmer JM, Sweeny TJ | title = A holistic model for wellness and prevention over the lifespan | journal = Journal of Counseling and Development | volume = 71 | pages = 140–148 | year = 1992 | doi = 10.1002/j.1556-6676.1992.tb02189.x | issue = 2 }}</ref><ref name=HattieMyersSweeney_p354364>{{cite journal | vauthors = Hattie JA, Myers JE, Sweeney TJ | title = A factor structure of wellness: Theory, assessment, analysis and practice | journal = Journal of Counseling and Development | volume = 82 | pages = 354–364 | year = 2004 | doi = 10.1002/j.1556-6678.2004.tb00321.x | issue = 3 }}</ref>

The tripartite model of mental well-being<ref name=Keyes2002/><ref name="ReferenceA">{{cite journal | vauthors = Joshanloo M |title=Revisiting the Empirical Distinction Between Hedonic and Eudaimonic Aspects of Well-Being Using Exploratory Structural Equation Modeling |journal=Journal of Happiness Studies |volume=17 |issue=5 |pages=2023–2036 |date=23 October 2015 |doi=10.1007/s10902-015-9683-z|s2cid=16022037 }}</ref> views mental well-being as encompassing three components of emotional well-being, social well-being, and [[psychological well-being]]. Emotional well-being is defined as having high levels of positive emotions, whereas social and psychological well-being are defined as the presence of psychological and social skills and abilities that contribute to optimal functioning in daily life. The model has received empirical support across cultures.<ref name="ReferenceA"/><ref>{{cite journal | vauthors = Bobowik M, Basabe N, Páez D | title = The bright side of migration: hedonic, psychological, and social well-being in immigrants in Spain | journal = Social Science Research | volume = 51 | pages = 189–204 | date = May 2015 | pmid = 25769861 | doi = 10.1016/j.ssresearch.2014.09.011 }}</ref><ref>{{cite journal | vauthors = Gallagher MW, Lopez SJ, Preacher KJ | title = The hierarchical structure of well-being | journal = Journal of Personality | volume = 77 | issue = 4 | pages = 1025–50 | date = August 2009 | pmid = 19558444 | pmc = 3865980 | doi = 10.1111/j.1467-6494.2009.00573.x }}</ref> The Mental Health Continuum-Short Form (MHC-SF) is the most widely used scale to measure the tripartite model of mental well-being.<ref>{{cite journal | vauthors = Keyes CL, Wissing M, Potgieter JP, Temane M, Kruger A, van Rooy S | title = Evaluation of the mental health continuum-short form (MHC-SF) in setswana-speaking South Africans | journal = Clinical Psychology & Psychotherapy | volume = 15 | issue = 3 | pages = 181–92 | date = May 2008 | pmid = 19115439 | doi = 10.1002/cpp.572 | s2cid = 20788777 }}</ref><ref>{{cite journal | vauthors = Joshanloo M, Lamers SM |title=Reinvestigation of the factor structure of the MHC-SF in the Netherlands: Contributions of exploratory structural equation modeling |journal=Personality and Individual Differences |date=July 2016 |volume=97 |pages=8–12 |doi=10.1016/j.paid.2016.02.089|url=https://ris.utwente.nl/ws/files/6945051/1-s2.0-S0191886916301258-main.pdf }}</ref><ref>{{cite journal | vauthors = Joshanloo M | title = A New Look at the Factor Structure of the MHC-SF in Iran and the United States Using Exploratory Structural Equation Modeling | journal = Journal of Clinical Psychology | volume = 72 | issue = 7 | pages = 701–13 | date = July 2016 | pmid = 26990960 | doi = 10.1002/jclp.22287 | hdl = 11343/291078 | hdl-access = free }}</ref>

===Demographics===
====Children and adolescents ====
{{Further| Infant mental health |Mental disorders diagnosed in childhood|Developmental psychopathology}}{{see also|Depression in childhood and adolescence|Adverse childhood experiences}}

Mental health problems among children and adolescents contributed to a global prevalence of 13%.<ref>{{Cite journal |last=Polanczyk |first=Guilherme V. |last2=Salum |first2=Giovanni A. |last3=Sugaya |first3=Luisa S. |last4=Caye |first4=Arthur |last5=Rohde |first5=Luis A. |date=March 2015 |title=Annual Research Review: A meta‐analysis of the worldwide prevalence of mental disorders in children and adolescents |url=https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12381 |journal=Journal of Child Psychology and Psychiatry |language=en |volume=56 |issue=3 |pages=345–365 |doi=10.1111/jcpp.12381 |issn=0021-9630}}</ref> As of 2019, about one in seven of the world's 10–19 year olds experienced a mental health disorder; about 165 million young people in total.<ref name="www.who.int">{{Cite web|title=Adolescent mental health|url=https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health|access-date=2021-07-08|website=www.who.int|language=en}}</ref><ref>{{Cite web|title=Mental health|url=https://data.unicef.org/topic/child-health/mental-health/|access-date=2024-05-25| work = The United Nations International Children's Emergency Fund (UNICEF) |language=en}}</ref> A person's teenage years are a unique period where much crucial psychological development occurs, and is also a time of increased vulnerability to the development of adverse mental health conditions. Children having mental health problems can have adverse outcomes, such as poor school performance, social difficulties, substance abuse, and poor physical health.<ref>{{Cite journal |last=Patel |first=Vikram |last2=Flisher |first2=Alan J |last3=Hetrick |first3=Sarah |last4=McGorry |first4=Patrick |date=April 2007 |title=Mental health of young people: a global public-health challenge |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673607603687 |journal=The Lancet |language=en |volume=369 |issue=9569 |pages=1302–1313 |doi=10.1016/S0140-6736(07)60368-7}}</ref> The adverse effects even extend beyond the children themselves - increased utilization of public sector services and healthcare services; loss [[productivity]] among parents or care-givers; and burden to the society as a whole.<ref>{{Cite journal |last=Beecham |first=Jennifer |date=June 2014 |title=Annual Research Review: Child and adolescent mental health interventions: a review of progress in economic studies across different disorders |url=https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12216 |journal=Journal of Child Psychology and Psychiatry |language=en |volume=55 |issue=6 |pages=714–732 |doi=10.1111/jcpp.12216 |issn=0021-9630 |pmc=4657502 |pmid=24580503}}</ref> More than half of mental health conditions start before a child reaches 20 years of age, with onset occurring in [[adolescence]] much more frequently than it does in early childhood or adulthood. However, pre-school children with early mental health problems are increasing in prevalence in recent years.<ref>{{Cite journal |last=Vasileva |first=Mira |last2=Graf |first2=Ramona K. |last3=Reinelt |first3=Tilman |last4=Petermann |first4=Ulrike |last5=Petermann |first5=Franz |date=April 2021 |title=Research review: A meta‐analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years |url=https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.13261 |journal=Journal of Child Psychology and Psychiatry |language=en |volume=62 |issue=4 |pages=372–381 |doi=10.1111/jcpp.13261 |issn=0021-9630}}</ref>  Many such cases go undetected and untreated.<ref>{{Cite web|date=2015-10-26|title=Mental health statistics: children and young people|url=https://www.mentalhealth.org.uk/statistics/mental-health-statistics-children-and-young-people|access-date=2021-10-05|website=Mental Health Foundation|language=en}}</ref><ref name="www.who.int" /><ref name = "2024Orben">{{cite journal | vauthors = Orben A, Meier A, Dalgleish T, Blakemore S | title = Mechanisms linking social media use to adolescent mental health vulnerability| journal = [[Nature Reviews Psychology]] | date = May 2024 | volume = 3| issue = 6| pages = 407–423| doi =10.1038/s44159-024-00307-y | doi-access = free }}</ref><ref>{{cite journal | vauthors = McGrath JJ, Al-Hamzawi A, Alonso J, Altwaijri Y, Andrade LH, Bromet EJ, Bruffaerts R, de Almeida JM, Chardoul S, Chiu WT, Degenhardt L, Demler OV, Ferry F, Gureje O, Haro JM, Karam EG, Karam G, Khaled SM, Kovess-Masfety V, Magno M, Medina-Mora ME, Moskalewicz J, Navarro-Mateu F, Nishi D, Plana-Ripoll O, Posada-Villa J, Rapsey C, Sampson NA, Stagnaro JC, Stein DJ, Ten Have M, Torres Y, Vladescu C, Woodruff PW, Zarkov Z, Kessler RC | collaboration = WHO World Mental Health Survey Collaborators | title = Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries | journal = The Lancet. Psychiatry | volume = 10 | issue = 9 | pages = 668–681 | date = September 2023 | pmid = 37531964 | doi = 10.1016/S2215-0366(23)00193-1 | pmc = 10529120 }}</ref>

In the United States alone, in 2021, at least roughly 17.5% of the population (ages 18 and older) were recorded as having a mental illness. The comparison between reports and statistics of mental health issues in newer generations (18–25 years old to 26–49 years old) and the older generation (50 years or older) signifies an increase in mental health issues as only 15% of the older generation reported a mental health issue whereas the newer generations reported 33.7% (18–25) and 28.1% (26–49).<ref>{{cite web |title=Mental Illness |url=https://www.nimh.nih.gov/health/statistics/mental-illness |website=National Institute of Mental Health |access-date=13 September 2023}}</ref>  The role of caregivers for youth with mental health needs is valuable, and caregivers benefit most when they have sufficient psychoeducation and peer support.<ref>{{cite journal | vauthors = Yoo A, Kim M, Ross MM, Vaughn-Lee A, Butler B, dosReis S | title = Engaging Caregivers in the Treatment of Youth with Complex Developmental and Mental Health Needs | journal = The Journal of Behavioral Health Services & Research | volume = 45 | issue = 3 | pages = 440–453 | date = July 2018 | pmid = 29520663 | doi = 10.1007/s11414-018-9604-0 | s2cid = 3801878 }}</ref> Depression is one of the leading causes of illness and disability among adolescents.<ref name="www.who.int" /> Suicide is the fourth leading cause of death in 15-19-year-olds.<ref name="www.who.int" /> Exposure to childhood trauma can cause mental health disorders and poor academic achievement.<ref>{{cite journal | vauthors = Larson S, Chapman S, Spetz J, Brindis CD | title = Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services | journal = The Journal of School Health | volume = 87 | issue = 9 | pages = 675–686 | date = September 2017 | pmid = 28766317 | doi = 10.1111/josh.12541 | s2cid = 13713247 | url = https://escholarship.org/uc/item/6th2r852 }}</ref> Ignoring mental health conditions in adolescents can impact adulthood.<ref name="Kato_2015">{{cite journal | vauthors = Kato N, Yanagawa T, Fujiwara T, Morawska A | title = Prevalence of Children's Mental Health Problems and the Effectiveness of Population-Level Family Interventions | journal = Journal of Epidemiology | volume = 25 | issue = 8 | pages = 507–16 | date = 2015 | pmid = 26250791 | pmc = 4517988 | doi = 10.2188/jea.JE20140198 }}</ref> 50% of preschool children show a natural reduction in behavioral problems. The remaining experience long-term consequences.<ref name="Kato_2015" /> It impairs physical and mental health and limits opportunities to live fulfilling lives.<ref name="Kato_2015" /> A result of depression during adolescence and adulthood may be substance abuse.<ref name="Kato_2015" /><ref name="Merikangas_2009">{{cite journal | vauthors = Merikangas KR, Nakamura EF, Kessler RC | title = Epidemiology of mental disorders in children and adolescents | journal = Dialogues in Clinical Neuroscience | volume = 11 | issue = 1 | pages = 7–20 | date = 2009 | doi = 10.31887/DCNS.2009.11.1/krmerikangas | pmid = 19432384 | pmc = 2807642 }}</ref> The average age of onset is between 11 and 14 years for depressive disorders.<ref name="Merikangas_2009" /> Only approximately 25% of children with behavioral problems refer to medical services.<ref name="Kato_2015" /> The majority of children go untreated.<ref name="Kato_2015" />

====Homeless population====
{{Further| Homelessness and mental health}}
Mental illness is thought to be highly prevalent among homeless populations, though access to proper diagnoses is limited. An article written by Lisa Goodman and her colleagues summarized Smith's research into PTSD in homeless single women and mothers in St. Louis, Missouri, which found that 53% of the respondents met diagnostic criteria, and which describes homelessness as a risk factor for mental illness.<ref name="Homelessness as psychological traum">{{cite journal|vauthors=Goodman L, Saxe L, Harvey M|date=November 1991|title=Homelessness as psychological trauma. Broadening perspectives|journal=The American Psychologist|volume=46|issue=11|pages=1219–25|doi=10.1037/0003-066x.46.11.1219|pmid=1772159}}</ref> At least two commonly reported symptoms of psychological trauma, social disaffiliation and learned helplessness are highly prevalent among homeless individuals and families.<ref name="Hwang">{{cite journal|vauthors=Hwang SW, Tolomiczenko G, Kouyoumdjian FG, Garner RE|date=November 2005|title=Interventions to improve the health of the homeless: a systematic review|journal=American Journal of Preventive Medicine|volume=29|issue=4|pages=311–9|doi=10.1016/j.amepre.2005.06.017|pmid=16242595}}</ref>

While mental illness is prevalent, people infrequently receive appropriate care.<ref name="Homelessness as psychological traum" /> Case management linked to other services is an effective care approach for improving symptoms in people experiencing homelessness.<ref name="Hwang" /> Case management reduced admission to hospitals, and it reduced substance use by those with substance abuse problems more than typical care.<ref name="Hwang" />

====Immigrants and refugees====
{{See also|Mental health of refugees}}
States that produce refugees are sites of social upheaval, civil war, even genocide.<ref name="Miller_2018">{{cite journal | vauthors = Miller A, Hess JM, Bybee D, Goodkind JR | title = Understanding the mental health consequences of family separation for refugees: Implications for policy and practice | journal = The American Journal of Orthopsychiatry | volume = 88 | issue = 1 | pages = 26–37 | date = 2018 | pmid = 28617002 | pmc = 5732089 | doi = 10.1037/ort0000272 }}</ref> Most refugees experience trauma. It can be in the form of torture, sexual assault, family fragmentation, and death of loved ones.<ref name="Miller_2018" /><ref name="Sangalang_2019">{{cite journal | vauthors = Sangalang CC, Becerra D, Mitchell FM, Lechuga-Peña S, Lopez K, Kim I | title = Trauma, Post-Migration Stress, and Mental Health: A Comparative Analysis of Refugees and Immigrants in the United States | journal = Journal of Immigrant and Minority Health | volume = 21 | issue = 5 | pages = 909–919 | date = October 2019 | pmid = 30244330 | doi = 10.1007/s10903-018-0826-2 | s2cid = 52334254 | url = https://escholarship.org/uc/item/51v45549 }}</ref>

Refugees and immigrants experience psycho[[social stress]]ors after resettlement.<ref name="Bustamante_2017">{{cite journal | vauthors = Bustamante LH, Cerqueira RO, Leclerc E, Brietzke E | title = Stress, trauma, and posttraumatic stress disorder in migrants: a comprehensive review | journal = Revista Brasileira de Psiquiatria | volume = 40 | issue = 2 | pages = 220–225 | date = 2017-10-19 | pmid = 29069252 | pmc = 6900760 | doi = 10.1590/1516-4446-2017-2290 }}</ref> These include discrimination, lack of economic stability, and social isolation causing emotional distress. For example, not far into the 1900s, campaigns targeting Japanese immigrants were being formed that inhibited their ability to participate in U.S. life, painting them as a threat to the American working-class. They were subject to prejudice and slandered by American media as well as anti-Japanese legislation being implemented.<ref>{{Cite web |title=The U.S. Mainland: Growth and Resistance {{!}} Japanese {{!}} Immigration and Relocation in U.S. History {{!}} Classroom Materials at the Library of Congress |url=https://www.loc.gov/classroom-materials/immigration/japanese/the-us-mainland-growth-and-resistance/ |access-date=2023-12-07 |website=Library of Congress | location = Washington, D.C. USA }}</ref><ref name="Miller_2018" /><ref name="Sangalang_2019" /> For refugees family reunification can be one of the primary needs to improve quality of life.<ref name="Miller_2018" /> Post-migration trauma is a cause of depressive disorders and psychological distress for immigrants.<ref name="Miller_2018" /><ref name="Sangalang_2019" /><ref name="Bustamante_2017" />

=== Mental Health in Social Work ===
{{See also|Mental health in aviation|Https://en.wikipedia.org/wiki/Mental health professional}}

===={{anchor|Psychiatric social work}}Mental health in social work====
{{Further| Social work}}{{see also|Clinical social work}}
[[Social work]] in mental health, also called psychiatric social work, is a process where an individual in a setting is helped to attain freedom from overlapping internal and external problems (social and economic situations, family and other relationships, the physical and organizational environment, psychiatric symptoms, etc.). It aims for harmony, [[quality of life]], self-actualization and personal adaptation across all systems. Psychiatric social workers are [[mental health professional]]s that can assist patients and their family members in coping with both mental health issues and various economic or social problems caused by mental illness or psychiatric dysfunctions and to attain improved mental health and well-being. They are vital members of the treatment teams in Departments of Psychiatry and Behavioral Sciences in hospitals. They are employed in both outpatient and inpatient settings of a hospital, nursing homes, state and local governments, substance use clinics, correctional facilities, health care services, private practice, etc.<ref>{{cite book | vauthors = Francis AP |title=Social Work in Mental Health: Contexts and Theories for Practice |date=2014 |publisher=SAGE Publications India |isbn=978-93-5150-116-9 }}{{page needed|date=November 2019}}</ref>

In the United States, social workers provide most of the mental health services. According to government sources, 60 percent of mental health professionals are [[Clinical social work|clinically trained social workers]], 10 percent are [[psychiatrist]]s, 23 percent are [[psychologist]]s, and 5 percent are [[psychiatric nurse]]s.<ref>National Association of Social Workers, 2011</ref>

Mental health social workers in Japan have professional knowledge of health and welfare and skills essential for person's well-being. Their social work training enables them as a professional to carry out Consultation assistance for mental disabilities and their social reintegration; Consultation regarding the rehabilitation of the victims; Advice and guidance for post-discharge residence and re-employment after hospitalized care, for major life events in regular life, money and self-management and other relevant matters to equip them to adapt in daily life. Social workers provide individual home visits for mentally ill and do welfare services available, with specialized training a range of procedural services are coordinated for home, workplace and school. In an administrative relationship, Psychiatric social workers provides consultation, leadership, conflict management and work direction. Psychiatric social workers who provides assessment and psychosocial interventions function as a clinician, counselor and municipal staff of the health centers.<ref>{{cite web |title=精神保健福祉士の受験資格を取得するための養成課程 |trans-title=Psychiatric Social Worker Training Course |website=Japan College of Social Work |url=http://www.jcsw.ac.jp/faculty/tsushin/seishin/index.html |language=ja |access-date=2016-02-10 |archive-date=2017-10-26 |archive-url=https://web.archive.org/web/20171026214336/http://www.jcsw.ac.jp/faculty/tsushin/seishin/index.html |url-status=dead }}</ref>

== Risk factors and causes of mental health problems ==
{{main|Causes of mental disorders}}
There are many things that can contribute to mental health problems, including biological factors, genetic factors, life experiences (such as [[psychological trauma]] or [[Domestic violence|abuse]]), and a [[Family history (medicine)|family history]] of mental health problems.<ref>{{Cite web |title=What Is Mental Health? {{!}} MentalHealth.gov |url=https://www.mentalhealth.gov/basics/what-is-mental-health |access-date=2022-09-22 |website=www.mentalhealth.gov}}</ref>

=== Biological factors ===
According to [[National Institutes of Health|the National Institute of Health]] Curriculum Supplement Series book, most scientists believe that changes in neurotransmitters can cause mental illnesses. In the section "The Biology of Mental Illnesses" the issue is explained in detail, "...there may be disruptions in the neurotransmitters dopamine, glutamate, and norepinephrine in individuals who have schizophrenia".
<ref>{{cite book | url=https://www.ncbi.nlm.nih.gov/books/NBK20369/ | title=Information about Mental Illness and the Brain | year=2007 | publisher=National Institutes of Health (US) }}</ref>

=== Demographic factors ===
Gender, age, ethnicity, life expectancy, longevity, population density, and community diversity are all demographic characteristics that can increase the risk and severity of mental disorders.<ref name=Lancet1>{{cite journal | vauthors = Lund C, Brooke-Sumner C, Baingana F, Baron EC, Breuer E, Chandra P, Haushofer J, Herrman H, Jordans M, Kieling C, Medina-Mora ME, Morgan E, Omigbodun O, Tol W, Patel V, Saxena S | title = Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews | journal = The Lancet. Psychiatry | volume = 5 | issue = 4 | pages = 357–369 | date = April 2018 | pmid = 29580610 | doi = 10.1016/S2215-0366(18)30060-9 }}</ref>

===Disability===
[[File:The prevalence of mental illness is higher in more unequal rich countries.jpg|thumb|The prevalence of mental illness is higher in more [[economic inequality|economically unequal]] countries.|alt=|275x275px]]Emotional mental disorders are a leading cause of disabilities worldwide. Investigating the degree and severity of untreated emotional mental disorders throughout the world is a top priority of the [[World Mental Health survey initiative|World Mental Health]] (WMH) survey initiative,<ref>{{cite web |title=The World Mental Health Survey Initiative |url=http://www.hcp.med.harvard.edu/wmh/ |publisher=Harvard Medical School |access-date=23 January 2016 }}</ref> which was created in 1998 by the [[World Health Organization]] (WHO).<ref>{{cite journal | vauthors = Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, Bruffaerts R, de Girolamo G, de Graaf R, Gureje O, Haro JM, Karam EG, Kessler RC, Kovess V, Lane MC, Lee S, Levinson D, Ono Y, Petukhova M, Posada-Villa J, Seedat S, Wells JE | title = Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys | journal = Lancet | volume = 370 | issue = 9590 | pages = 841–50 | date = September 2007 | pmid = 17826169 | pmc = 2847360 | doi = 10.1016/S0140-6736(07)61414-7 }}</ref> "[[Neuropsychiatric]] disorders are the leading causes of disability worldwide, accounting for 37% of all healthy life years lost through disease. These disorders are most destructive to low and middle-income countries due to their inability to provide their citizens with proper aid. Despite modern treatment and rehabilitation for emotional mental health disorders, "even economically advantaged societies have competing priorities and budgetary constraints".

===Unhappy marriage and divorce ===
Unhappily married couples suffer 3–25 times the risk of developing clinical depression, leading to [[divorce]].<ref>{{Cite journal | vauthors = Gray TD, Hawrilenko M, Cordova JV |date=2019 |title=Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes |journal=Journal of Marital and Family Therapy |volume=46 |issue=3 |pages=507–522 |doi=10.1111/jmft.12411 |pmid=31584721 |url=https://arammu.com/assets/research/MC%20Depression%20Outcomes.pdf}}</ref><ref>{{cite journal | vauthors = Fink BC, Shapiro AF | title = Coping Mediates the Association Between Marital Instability and Depression, but Not Marital Satisfaction and Depression | journal = Couple & Family Psychology | volume = 2 | issue = 1 | pages = 1–13 | date = March 2013 | pmid = 25032063 | pmc = 4096140 | doi = 10.1037/a0031763 }}</ref><ref>{{Cite journal | vauthors = Goldfarb MR, Trudel G |date=2019 |title=Marital quality and depression: a review |journal=Marriage & Family Review |volume=55 |issue=8 |pages=737–763 |doi=10.1080/01494929.2019.1610136 |s2cid=165116052 }}</ref> Studies found that divorce and separation increases chances of an individual encountering depression, anxiety, substance abuse issues, insomnia, and financial hardship.<ref>{{Cite journal |last1=Richards |first1=M. |last2=Hardy |first2=R. |last3=Wadsworth |first3=M. |date=September 1997 |title=The effects of divorce and separation on mental health in a national UK birth cohort |url=https://pubmed.ncbi.nlm.nih.gov/9300516 |journal=Psychological Medicine |volume=27 |issue=5 |pages=1121–1128 |doi=10.1017/s003329179700559x |doi-broken-date=1 May 2025 |issn=0033-2917 |pmid=9300516}}</ref>  Divorce and unhappy married couples not only affect the mental health of both the parents, but particularly the children of a separated home. Children of divorced parents engage in early sexual behavior, academic difficulties, substance abuse, depressive moods, and an increased chance of living in poverty due to family instability.<ref>{{Cite journal |last1=D'Onofrio |first1=Brian |last2=Emery |first2=Robert |date=2019-01-02 |title=Parental divorce or separation and children's mental health |journal=World Psychiatry |volume=18 |issue=1 |pages=100–101 |doi=10.1002/wps.20590 |issn=1723-8617 |pmc=6313686 |pmid=30600636}}</ref>

=== Stress ===
[[File:Inspired by 'Dementia Friends' training at @mcrmuseum last week (14650851663).jpg|thumb|Dementia Friends training]]
The [[Centre for Addiction and Mental Health]] discusses how a certain amount of stress is a normal part of daily life. Small doses of stress help people meet deadlines, be prepared for presentations, be productive and arrive on time for important events. However, long-term stress can become harmful. When stress becomes overwhelming and prolonged, the risks for mental health problems and medical problems increase."<ref>{{Cite web|title=20131 Stress|url=https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/stress|access-date=2020-11-13|website=CAMH|language=en-CA}}</ref> Also on that note, some studies have found language to deteriorate mental health and even harm humans.<ref>{{Cite web| vauthors = Vey JS, Love H |date=2020-07-13|title=Recognizing that words have the power to harm, we commit to using more just language to describe places|url=https://www.brookings.edu/blog/the-avenue/2020/07/13/recognizing-that-words-have-the-power-to-harm-we-commit-to-using-more-just-language-to-describe-places/|access-date=2021-05-09|website=Brookings|language=en-US}}</ref>

The impact of a stressful environment has also been highlighted by different models. Mental health has often been understood from the lens of the [[Diathesis–stress model|vulnerability-stress model]].<ref>{{cite journal | vauthors = Monroe SM, Simons AD | title = Diathesis-stress theories in the context of life stress research: implications for the depressive disorders | journal = Psychological Bulletin | volume = 110 | issue = 3 | pages = 406–425 | date = November 1991 | pmid = 1758917 | doi = 10.1037/0033-2909.110.3.406 }}</ref> In that context, stressful situations may contribute to a preexisting vulnerability to negative mental health outcomes being realized. On the other hand, the [[Differential susceptibility|differential susceptibility hypothesis]] suggests that mental health outcomes are better explained by an increased sensitivity to the environment than by vulnerability.<ref>{{cite journal | vauthors = Belsky J, Pluess M | title = Beyond diathesis stress: differential susceptibility to environmental influences | journal = Psychological Bulletin | volume = 135 | issue = 6 | pages = 885–908 | date = November 2009 | pmid = 19883141 | doi = 10.1037/a0017376 }}</ref> For example, it was found that children scoring higher on observer-rated environmental sensitivity often derive more harm from low-quality parenting, but also more benefits from high-quality parenting than those children scoring lower on that measure.<ref>{{cite journal | vauthors = Lionetti F, Aron EN, Aron A, Klein DN, Pluess M | title = Observer-rated environmental sensitivity moderates children's response to parenting quality in early childhood | journal = Developmental Psychology | volume = 55 | issue = 11 | pages = 2389–2402 | date = November 2019 | pmid = 31414847 | pmc = 7565718 | doi = 10.1037/dev0000795 }}</ref>

===Unemployment===
[[Unemployment]] has been shown to hurt an individual's emotional well-being, [[self-esteem]], and more broadly their mental health. Increasing unemployment has been shown to have a significant impact on mental health, predominantly depressive disorders.<ref>{{cite journal | vauthors = Extremera N, Rey L | title = Attenuating the Negative Impact of Unemployment: The Interactive Effects of Perceived Emotional Intelligence and Well-Being on Suicide Risk | journal = PLOS ONE | volume = 11 | issue = 9 | pages = e0163656 | date = 29 September 2016 | pmid = 27685996 | pmc = 5042532 | doi = 10.1371/journal.pone.0163656 | bibcode = 2016PLoSO..1163656E | doi-access = free }}</ref> This is an important consideration when reviewing the triggers for mental health disorders in any population survey.<ref>{{Cite journal|title = Unemployment impairs mental health: Meta-analysis| vauthors = Paul KI, Moser K |date = 2009|journal = Journal of Vocational Behavior|doi = 10.1016/j.jvb.2009.01.001|volume=74|issue = 3|pages=264–282}}</ref> According to a 2009 meta-analysis by Paul and Moser, countries with high income inequality and poor unemployment protections experience worse mental health outcomes among the unemployed.<ref>{{Cite journal | vauthors = Pappas S | title = The toll of job loss. | journal = Monitor on Psychology | date = 2020 | volume = 51 | issue = 7 | pages = 51–61 |url= https://www.apa.org/monitor/2020/10/toll-job-loss |access-date=2023-11-26 }}</ref>

=== Poverty ===
{{excerpt|Poverty|Mental health|paragraphs=1|only=paragraphs}}

=== Environmental factors ===
{{excerpt|Effects of climate change on mental health|paragraphs=1|only=paragraphs}}

=== Diet and nutrition ===
Recent findings suggest that dietary patterns may play a role in the development of mental health conditions. [[Dieting|Diets]] low in nutrients and high in processed foods have been associated with increased risk of mood disorders. Research has also shown that disruptions in gut microbiota, which are influenced by diet, can impact inflammation, neurotransmitter function, and emotional regulation. These mechanisms may contribute to conditions such as depression and anxiety.<ref>{{Cite journal |last1=Barbosa |first1=Izabela G |last2=Miranda |first2=Aline S. |last3=Berk |first3=Michael |last4=Teixeira |first4=Antonio L |date=2025-01-02 |title=The involvement of the microbiota-gut-brain axis in the pathophysiology of mood disorders and therapeutic implications |url=https://www.tandfonline.com/doi/full/10.1080/14737175.2024.2438646 |journal=Expert Review of Neurotherapeutics |language=en |volume=25 |issue=1 |pages=85–99 |doi=10.1080/14737175.2024.2438646 |pmid=39630000 |issn=1473-7175|url-access=subscription }}</ref>

== Stigma of Mental Health ==

=== Disparities in Care ===
The [[Social stigma|stigma]] of mental health is perceived differently due to historical and cultural context. Attitudes regarding treatments and seeking services are influenced by the impact of society's stigma associated with mental health. Many communities with different ethnic backgrounds, socioeconomic statuses, and cultural beliefs experience poor treatment and fewer easily accessible, quality-care resources.

==== Race ====
Mental health impacts individuals of all ethnic and racial backgrounds across the world. Asian Americans often experience extreme levels of self-stigma, created from the intersection of cultural and societal factors.<ref>{{Cite journal |last1=Wong |first1=Eunice C. |last2=Collins |first2=Rebecca L. |last3=Cerully |first3=Jennifer |last4=Seelam |first4=Rachana |last5=Roth |first5=Beth |date=2017-01-13 |title=Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges |journal=Rand Health Quarterly |volume=6 |issue=2 |pages=6 |issn=2162-8254 |pmc=5568160 |pmid=28845344}}</ref> Cultural pressures lead to self-isolation and shame surrounding the inability to exceed expectations and maintain high achievement. Latino Americans face societal discrimination and report heightened levels of shame when speaking about mental health struggles. Latino communities face structural barriers such as documentation, low rates of English proficiency, and difficulties understanding the steps needed to navigate the healthcare system, ultimately limiting accessibility to mental health services.<ref>{{Cite journal |last1=Grieb |first1=Suzanne M. |last2=Platt |first2=Rheanna |last3=Vazquez |first3=Monica Guerrero |last4=Alvarez |first4=Kiara |last5=Polk |first5=Sarah |date=2023-04-22 |title=Mental Health Stigma Among Spanish-Speaking Latinos in Baltimore, Maryland |journal=Journal of Immigrant and Minority Health |volume=25 |issue=5 |pages=999–1007 |doi=10.1007/s10903-023-01488-z |issn=1557-1920 |pmc=10201042 |pmid=37213041}}</ref> Latino men often face deep-rooted shame regarding mental health issues due to the cultural expectation of leading communities or a household. Immigration status, language barriers, or cultural beliefs cause many Latino Americans to avoid seeking professional care. The stigma surrounding mental health results in delayed professional care, embarrassment, and social rejection.

===== Gender =====
{{Further|Mental disorders and gender|Sex differences in psychology}}

Existing evidence demonstrates that [[Mental disorders and gender|mental disorders are connected with gender]]. For example, an elevated risk of depression for women was observed at different phases of life, commencing in adolescence in different contexts.<ref>{{cite book |title=AM:STARs Adolescent Medicine |vauthors=Dopp RR, Lipson SK, Eisenberg D |date=2013-12-31 |publisher=American Academy of Pediatrics |isbn=978-1-58110-873-6 |pages=573–596 |chapter=Mental Health Among Late Adolescents and Young Adults from a Population-Level and Clinical Perspective |doi=10.1542/9781581108736-mental_health |s2cid=1101013}}</ref><ref>{{cite journal |vauthors=Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, Weyerer S, König HH, Riedel-Heller SG |date=February 2012 |title=Age- and gender-specific prevalence of depression in latest-life--systematic review and meta-analysis |journal=Journal of Affective Disorders |volume=136 |issue=3 |pages=212–221 |doi=10.1016/j.jad.2010.11.033 |pmid=21194754}}</ref> Females have a higher risk of anxiety<ref>{{cite journal |vauthors=Baxter AJ, Scott KM, Vos T, Whiteford HA |date=May 2013 |title=Global prevalence of anxiety disorders: a systematic review and meta-regression |journal=Psychological Medicine |volume=43 |issue=5 |pages=897–910 |doi=10.1017/s003329171200147x |pmid=22781489}}</ref> and eating disorders,<ref>{{cite journal |vauthors=Qian J, Wu Y, Liu F, Zhu Y, Jin H, Zhang H, Wan Y, Li C, Yu D |date=March 2022 |title=An update on the prevalence of eating disorders in the general population: a systematic review and meta-analysis |journal=Eating and Weight Disorders |volume=27 |issue=2 |pages=415–428 |doi=10.1007/s40519-021-01162-z |pmc=8933366 |pmid=33834377}}</ref> whereas males have a higher chance of substance abuse and behavioral and developmental issues.<ref>{{cite journal |vauthors=Cheng HG, Deng F, Xiong W, Phillips MR |date=May 2015 |title=Prevalence of alcohol use disorders in mainland China: a systematic review |journal=Addiction |volume=110 |issue=5 |pages=761–774 |doi=10.1111/add.12876 |pmc=6680273 |pmid=25678403}}</ref> This does not imply that women are less likely to suffer from developmental disorders such [[autism spectrum disorder]], attention deficit hyperactivity disorder, Tourette syndrome, or early-onset schizophrenia. Ethnicity and ethnic heterogeneity have also been identified as risk factors for the prevalence of mental disorders, with minority groups being at a higher risk due to discrimination and exclusion.<ref name="Lancet1" /> Approximately 8 in 10 people with autism suffer from a mental health problem in their lifetime, in comparison to 1 in 4 of the general population that suffers from a mental health problem in their lifetimes.<ref>{{cite web |date=14 March 2024 |title=Depression and autism |url=https://www.autistica.org.uk/what-is-autism/depression-and-autism |access-date=23 January 2025 |website=Autistica}}</ref><ref>{{cite web |date=7 March 2024 |title=Suicide and autism |url=https://www.autistica.org.uk/what-is-autism/suicide-and-autism |access-date=23 January 2025 |website=Autistica}}</ref><ref>{{cite journal |last1=Lever |first1=Anne |last2=Hilde |first2=Geurts |date=2016 |title=Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder |journal=Journal of Autism and Developmental Disorders |volume=46 |issue=6 |pages=1916–1930 |doi=10.1007/s10803-016-2722-8 |pmc=4860203 |pmid=26861713}}</ref>

Traditional gender roles and societal pressures influence an individual's perception regarding personal mental health issues and the importance of seeking professional help. For men, society implements strong-headed characteristics such as emotional resilience, hard-headedness, motivation, and stoicism. The stigma placed on mental health makes many men believe showing signs of vulnerability could be considered weak. Men experience immense amounts of internalized stigma from societal expectations, causing symptoms such as isolation, depression, anxiety, and resistance to treatment.<ref>{{Cite journal |last1=Wirth |first1=James H. |last2=Bodenhausen |first2=Galen V. |date=February 2009 |title=The role of gender in mental-illness stigma: a national experiment |url=https://pubmed.ncbi.nlm.nih.gov/19175755 |journal=Psychological Science |volume=20 |issue=2 |pages=169–173 |doi=10.1111/j.1467-9280.2009.02282.x |issn=1467-9280 |pmid=19175755}}</ref> Women experience more emotional regulation due to connective relationships with other women or family members. Although women encounter less judgment when accessing professional treatment, the labeling of being overly emotional and unstable causes concern for many women hesitant to seek help.

===== Financial Status =====
Poverty and an individual's financial status play a critical role in the challenges of mental health. Low-income individuals and families often experience physical barriers to accessing mental health treatments, significantly increasing the chances of mental health struggles. Job insecurity, shame surrounding financial resources, and inability to seek professional help stimulate external and internal stigma. Societal norms may lead to an expectation that if financially unsuccessful, unemployment results in personal failure and negative stereotypes. Unemployed individuals may be perceived as irresponsible, unmotivated, and lazy. Psychological stress surrounding financial stability causes internalized discrimination and societal judgment. A study emphasized that using interventions and professional treatments will reduce psychological stress, normalize needing accessible health care, and decrease stigma around mental health regardless of economic background.<ref>{{Cite journal |last1=Ryu |first1=Soomin |last2=Fan |first2=Lu |date=2023 |title=The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults |journal=Journal of Family and Economic Issues |volume=44 |issue=1 |pages=16–33 |doi=10.1007/s10834-022-09820-9 |issn=1058-0476 |pmc=8806009 |pmid=35125855}}</ref>

====== Geography ======
Rural areas and urban communities encounter differences surrounding the stigma of mental health due to the geography of the location. Urban areas offer far more mental health services and a variety of diverse professional resources. Dense urban populations naturally experience more exposure to mental health advocacy, exhibiting lower levels of stigma towards mental health. Although urban communities may offer access to mental health services, individuals still struggle with negative opinions regarding psychological distress. Residents in rural areas project a higher percentage of stigma towards mental health, promoting emotional stoicism, societal rejection, and judgment.<ref>{{Cite journal |last1=Schroeder |first1=Shawnda |last2=Tan |first2=Chih Ming |last3=Urlacher |first3=Brian |last4=Heitkamp |first4=Thomasine |date=February 2021 |title=The Role of Rural and Urban Geography and Gender in Community Stigma Around Mental Illness |url=https://pubmed.ncbi.nlm.nih.gov/33218261 |journal=Health Education & Behavior |volume=48 |issue=1 |pages=63–73 |doi=10.1177/1090198120974963 |issn=1552-6127 |pmid=33218261}}</ref> Rural areas lack availability and offer far more limited treatments to the community.

====Cultural and religious considerations====
Mental health is a socially constructed concept; different societies, groups, [[culture]]s (both ethnic and national/regional), institutions, and professions have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions, if any, are appropriate.<ref name="Weare2000_p12">{{cite book |title=Promoting Mental, Emotional and Social Health: A Whole School Approach |vauthors=Weare K |publisher=RoutledgeFalmer |year=2000 |isbn=978-0-415-16875-5 |location=London |page=12}}</ref> Thus, different professionals will have different cultural, class, political and religious backgrounds, which will impact the [[methodology]] applied during treatment. In the context of [[deaf mental health care]], it is necessary for professionals to have cultural competency of deaf and hard of hearing people and to understand how to properly rely on trained, qualified, and certified interpreters when working with [[Deaf culture|culturally Deaf]] clients.

Research has shown that there is stigma attached to mental illness.<ref>{{cite web |author=Office of the Deputy Prime Minister – Social Exclusion Unit |date=2004 |title=Factsheet 1: Stigma and Discrimination on Mental Health Grounds |url=http://www.cabinetoffice.gov.uk/media/cabinetoffice/social_exclusion_task_force/assets/publications_1997_to_2006/factsheet_stigma.pdf |archive-url=https://web.archive.org/web/20081229152129/http://www.cabinetoffice.gov.uk/media/cabinetoffice/social_exclusion_task_force/assets/publications_1997_to_2006/factsheet_stigma.pdf |archive-date=2008-12-29}}</ref> Due to such stigma, individuals may resist labeling and may be driven to respond to mental health diagnoses with [[denialism]].<ref>{{cite book |title=Mental Health Ethics: The Human Context |vauthors=Barker P |date=2010 |publisher=Routledge |isbn=978-1-136-88193-0 |page=146}}</ref> Family caregivers of individuals with mental disorders may also suffer discrimination or face stigma.<ref>{{cite journal |vauthors=Yin Y, Zhang W, Hu Z, Jia F, Li Y, Xu H, Zhao S, Guo J, Tian D, Qu Z |date=26 September 2014 |title=Experiences of stigma and discrimination among caregivers of persons with schizophrenia in China: a field survey |journal=PLOS ONE |volume=9 |issue=9 |pages=e108527 |bibcode=2014PLoSO...9j8527Y |doi=10.1371/journal.pone.0108527 |pmc=4178170 |pmid=25259732 |doi-access=free}}</ref>

Addressing and eliminating the social stigma and [[Treatment of mental disorders|perceived stigma]] attached to mental illness has been recognized as crucial to education and awareness surrounding mental health issues. In the [[United Kingdom]], the [[Royal College of Psychiatrists]] organized the campaign ''Changing Minds'' (1998–2003) to help reduce stigma,<ref>Royal College of Psychiatrists: [http://www.rcpsych.ac.uk/campaigns/previouscampaigns/changingminds.aspx Changing Minds].</ref> while in the [[United States]], efforts by entities such as the [[Born This Way Foundation]] and ''[[The Manic Monologues]]'' specifically focus on removing the stigma surrounding mental illness.<ref name="WaPo-stigma">{{cite news |date=29 April 2019 |title=A play that hopes to smash the stigma surrounding mental illness. |url=https://www.washingtonpost.com/national/health-science/a-play-that-hopes-to-smash-the-stigma-surrounding-mental-illness/2019/04/26/dcd13a46-65ee-11e9-a1b6-b29b90efa879_story.html |access-date=23 June 2020 |newspaper=The Washington Post |vauthors=Blakemore E}}</ref><ref name="KQED-stigma">{{cite web |date=2 May 2019 |title='Manic Monologues' Seeks to Disrupt the Stigma Around Mental Illness. |url=https://www.kqed.org/arts/13856397/manic-monologues-seeks-to-disrupt-the-stigma-around-mental-illness |access-date=23 June 2020 |work=KQED |vauthors=Myrow R}}</ref> The [[National Alliance on Mental Illness]] (NAMI) is a U.S. institution founded in 1979 to represent and advocate for those struggling with mental health issues. NAMI helps to educate about mental illnesses and health issues, while also working to eliminate stigma<ref>{{Cite web |title=NAMI Presents: Cure Stigma |url=https://www.curestigma.org/ |url-status=dead |archive-url=https://web.archive.org/web/20190703160739/https://www.curestigma.org/ |archive-date=2019-07-03 |access-date=2018-09-15 |website=NAMI Presents: Cure Stigma |language=en}}</ref> attached to these disorders.

Many [[mental health professional]]s are beginning to, or already understand, the importance of competency in religious diversity and [[spirituality]], or the [[atheism|lack thereof]]. They are also partaking in cultural training to better understand which interventions work best for these different groups of people. The [[American Psychological Association]] explicitly states that [[religion]] must be respected. Education in [[spirituality|spiritual]] and religious matters is also required by the [[American Psychiatric Association]],<ref name="HandbookofPsychotherapyandReligousDiversity_p4">{{cite book |title=Handbook of Psychotherapy and Religious Diversity |vauthors=Richards PS, Bergin AE |publisher=[[American Psychological Association]] |year=2000 |isbn=978-1-55798-624-5 |location=Washington, DC |page=4}}</ref> however, far less attention is paid to the damage that more rigid, fundamentalist faiths commonly practiced in the United States can cause.<ref>{{Cite web |title=Religious Trauma Syndrome |url=https://www.recoveringfromreligion.org/hotline-project-support/hotline-project-training/religious-trauma-syndrome/ |access-date=2018-12-08 |website=Recovering from Religion |language=en-US}}</ref>{{Unreliable source?|reason=Using this for this statement is akin to using an anti-vax site to claim that not enough attention is paid to "vaccination injury"|date=June 2022}} This theme has been widely politicized in 2018 such as with the creation of the Religious Liberty Task Force in July of that year.<ref>{{Cite web |date=August 2018 |title=Jeff Sessions' new task force puts freedom of religion first |url=https://qz.com/1335106/the-department-of-justices-religious-liberty-task-force-will-enforce-these-20-principles/ |access-date=2018-12-08 |website=Quartz |language=en |vauthors=Merelli A}}</ref> Also, many providers and practitioners in the United States are only beginning to realize that the institution of mental healthcare lacks knowledge and competence of many non-Western cultures, leaving providers in the United States ill-equipped to treat patients from different cultures.<ref>{{Cite web |title=How culture shapes your mind—and your mental illness - The Boston Globe |url=https://www.bostonglobe.com/ideas/2018/11/28/how-culture-shapes-your-mind-and-your-mental-illness/sMlhWP5LGSOvQAFd83I3qN/story.html |access-date=2018-12-08 |website=BostonGlobe.com}}</ref>

== Prevention and promotion ==
{{See also | Prevention of mental disorders}}
"The terms mental health promotion and prevention have often been confused. Promotion is defined as intervening to ''optimize'' positive mental health by addressing determinants of positive mental health (i.e. [[protective factor]]s) before a specific mental health problem has been identified, with the ultimate goal of improving the positive mental health of the population. Mental health prevention is defined as intervening to ''minimize'' mental health problems (i.e. [[risk factors]]) by addressing determinants of mental health problems before a specific mental health problem has been identified in the individual, group, or population of focus with the ultimate goal of reducing the number of future mental health problems in the population."<ref name= "MHPPYouth">{{Cite web|title=Promotion & Prevention|url=https://youth.gov/youth-topics/youth-mental-health/mental-health-promotion-prevention|access-date=2020-11-17|website=youth.gov}} {{PD-notice}}</ref><ref>{{cite book | vauthors = Miles J, Espiritu RC, Horen N, Sebian J, Waetzig E | title = A public health approach to children's mental health: A conceptual framework. | location = Washington, DC | publisher = Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health | date = 2010 | oclc = 918763518 }}</ref>

In order to improve mental health, the root of the issue has to be resolved. "Prevention emphasizes the avoidance of risk factors; promotion aims to enhance an individual's ability to achieve a positive sense of [[self-esteem]], mastery, well-being, and social inclusion."<ref>{{cite journal | vauthors = Power AK | title = Transforming the Nation's Health: next steps in mental health promotion | journal = American Journal of Public Health | volume = 100 | issue = 12 | pages = 2343–6 | date = December 2010 | pmid = 20966366 | pmc = 2978180 | doi = 10.2105/AJPH.2010.192138 }}</ref> Mental health promotion attempts to increase protective factors and healthy behaviors that can help prevent the onset of a diagnosable mental disorder and reduce risk factors that can lead to the development of a mental disorder.<ref name = "MHPPYouth" /> [[Yoga]] is an example of an activity that calms one's entire body and nerves.<ref>{{Cite web |title=The Benefits of Yoga |url=https://osteopathic.org/what-is-osteopathic-medicine/benefits-of-yoga/ |access-date=2022-05-02 |website=American Osteopathic Association |language=en-US}}</ref> According to a study on well-being by Richards, Campania, and Muse-Burke, "[[mindfulness (psychology)|mindfulness]] is considered to be a purposeful state, it may be that those who practice it belief in its importance and value being mindful, so that valuing of self-care activities may influence the intentional component of mindfulness."<ref name="Richards 2010 247"/> Akin to surgery, sometimes the body must be further damaged, before it can properly heal <ref name= "MHPPYouth2">{{Cite web|title=Mental Health Support|url=https://www.healthhelpchat.com/all-health-chat-rooms/|access-date=2023-12-23|website=healthhelpchat.com}}</ref>

Mental health is conventionally defined as a hybrid of the absence of a [[Mental disorders|mental disorder]] and the presence of well-being. Focus is increasing on [[Mental disorders#Prevention|preventing mental disorders]].
Prevention is beginning to appear in mental health strategies, including the 2004 WHO report "''Prevention of Mental Disorders''", the 2008 EU "Pact for Mental Health" and the 2011 US National Prevention Strategy.<ref name="National_Prevention Council_2011" /><ref>{{cite book |author1=National Research Council |author2=Institute of Medicine | veditors = England MJ, Sim LJ |date=2009 |title=Depression in parents, parenting, and children: Opportunities to improve identification, treatment, and prevention |location=Washington, DC |publisher=National Academies Press |isbn=978-0-309-12178-1 |doi=10.17226/12565 |pmid=25009931 }}</ref>{{page needed |date=January 2016}} Some commentators have argued that a pragmatic and practical approach to mental disorder prevention at work would be to treat it the same way as physical injury prevention.<ref>{{Cite news|url=http://www.humanengineers.com/hr_library/staffs-mental-health-workplace-safety-issue/|title=Your Staff's Mental Health Is a Workplace Safety Issue - Humanengineers|date=2017-06-20|work=Humanengineers|access-date=2018-01-11|language=en-US|archive-date=2018-01-12|archive-url=https://web.archive.org/web/20180112042451/http://www.humanengineers.com/hr_library/staffs-mental-health-workplace-safety-issue/|url-status=dead}}</ref>

Prevention of a disorder at a young age may significantly decrease the chances that a child will have a disorder later in life, and shall be the most efficient and effective measure from a public health perspective.<ref>{{cite journal | vauthors = Jeronimus BF, Kotov R, Riese H, Ormel J | title = Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants | journal = Psychological Medicine | volume = 46 | issue = 14 | pages = 2883–2906 | date = October 2016 | pmid = 27523506 | doi = 10.1017/S0033291716001653 | s2cid = 23548727 | url = https://zenodo.org/record/895885 }}</ref> Prevention may require the regular consultation of a [[physician]] for at least twice a year to detect any signs that reveal any mental health concerns.

Additionally, social media is becoming a resource for prevention. In 2004, the Mental Health Services Act<ref>{{cite journal | vauthors = Clark W, Welch SN, Berry SH, Collentine AM, Collins R, Lebron D, Shearer AL | title = California's historic effort to reduce the stigma of mental illness: the Mental Health Services Act | journal = American Journal of Public Health | volume = 103 | issue = 5 | pages = 786–94 | date = May 2013 | pmid = 23488486 | pmc = 3698820 | doi = 10.2105/AJPH.2013.301225 }}</ref> began to fund marketing initiatives to educate the public on mental health. This California-based project is working to combat the negative perception with mental health and reduce the stigma associated with it. While social media can benefit mental health, it can also lead to deterioration if not managed properly.<ref>{{Cite news | vauthors = Barr S | date = 19 January 2022 | work = The Independent |url= https://www.independent.co.uk/life-style/health-and-families/social-media-mental-health-negative-effects-depression-anxiety-addiction-memory-a8307196.html |archive-url=https://ghostarchive.org/archive/20220512/https://www.independent.co.uk/life-style/health-and-families/social-media-mental-health-negative-effects-depression-anxiety-addiction-memory-a8307196.html |archive-date=2022-05-12 |url-access=subscription |url-status=live|title=Six Ways Social Media Negatively Affects Your Mental Health|orig-date=2020-10-10|access-date=2020-04-20|language=en-UK}}</ref> Limiting social media intake is beneficial.<ref>{{Cite news|url=https://www.unihomes.co.uk/blog/how-to-look-after-your-mental-health-coronavirus|title=Here's How to Look After Your Mental Health | work = UniHomes |date=2020-04-20|access-date=2020-04-20|language=en-UK}}</ref>

Studies report that patients in mental health care who can access and read their [[Electronic health record|Electronic Health Records]] (EHR) or [[OpenNotes|Open Notes]] online experience increased understanding of their mental health, feeling in control of their care, and enhanced trust in their clinicians. Patients' also reported feelings of greater validation, engagement, remembering their care plan, and acquiring a better awareness of potential [[side effect]]s of their [[medication]]s, when reading their mental health notes. Other common experiences were that shared mental health notes enhance [[patient empowerment]] and augment [[Autonomy|patient autonomy]].<ref>{{cite journal | vauthors = Schwarz J, Bärkås A, Blease C, Collins L, Hägglund M, Markham S, Hochwarter S | title = Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review | journal = JMIR Mental Health | volume = 8 | issue = 12 | pages = e34170 | date = December 2021 | pmid = 34904956 | pmc = 8715358 | doi = 10.2196/34170 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Blease C, Dong Z, Torous J, Walker J, Hägglund M, DesRoches CM | title = Association of Patients Reading Clinical Notes With Perception of Medication Adherence Among Persons With Serious Mental Illness | journal = JAMA Network Open | volume = 4 | issue = 3 | pages = e212823 | date = March 2021 | pmid = 33760088 | pmc = 7991965 | doi = 10.1001/jamanetworkopen.2021.2823 }}</ref><ref>{{cite journal | vauthors = O'Neill S, Chimowitz H, Leveille S, Walker J | title = Embracing the new age of transparency: mental health patients reading their psychotherapy notes online | journal = Journal of Mental Health | volume = 28 | issue = 5 | pages = 527–535 | date = October 2019 | pmid = 31364902 | doi = 10.1080/09638237.2019.1644490 | s2cid = 199000133 }}</ref><ref>{{cite journal | vauthors = Blease CR, O'Neill S, Walker J, Hägglund M, Torous J | title = Sharing notes with mental health patients: balancing risks with respect | language = English | journal = The Lancet. Psychiatry | volume = 7 | issue = 11 | pages = 924–925 | date = November 2020 | pmid = 32059796 | doi = 10.1016/S2215-0366(20)30032-8 | s2cid = 211121648 }}</ref><ref>{{cite journal | vauthors = Blease CR, O'Neill SF, Torous J, DesRoches CM, Hagglund M | title = Patient Access to Mental Health Notes: Motivating Evidence-Informed Ethical Guidelines | journal = The Journal of Nervous and Mental Disease | volume = 209 | issue = 4 | pages = 265–269 | date = April 2021 | pmid = 33764954 | doi = 10.1097/NMD.0000000000001303 | s2cid = 232367133 }}</ref><ref>{{cite journal | vauthors = Blease C, Salmi L, Rexhepi H, Hägglund M, DesRoches CM | title = Patients, clinicians and open notes: information blocking as a case of epistemic injustice | journal = Journal of Medical Ethics | pages = medethics–2021–107275 | date = May 2021 | volume = 48 | issue = 10 | pmid = 33990427 | doi = 10.1136/medethics-2021-107275 | pmc = 9554023 | s2cid = 234499337 }}</ref>

Furthermore, recent studies have shown that [[social media]] is an effective way to draw attention to mental health issues. By collecting data from [[Twitter]], researchers found that social media presence is heightened after an event relating to behavioral health occurs.<ref>{{cite journal | vauthors = McClellan C, Ali MM, Mutter R, Kroutil L, Landwehr J | title = Using social media to monitor mental health discussions - evidence from Twitter | journal = Journal of the American Medical Informatics Association | volume = 24 | issue = 3 | pages = 496–502 | date = May 2017 | pmid = 27707822 | pmc = 7651954 | doi = 10.1093/jamia/ocw133 }}</ref> Researchers continue to find effective ways to use social media to bring more awareness to mental health issues through online campaigns in other sites such as [[Facebook]] and [[Instagram]].<ref>{{cite journal | vauthors = Latha K, Meena KS, Pravitha MR, Dasgupta M, Chaturvedi SK | title = Effective use of social media platforms for promotion of mental health awareness | journal = Journal of Education and Health Promotion | volume = 9 | issue = 1 | pages = 124 | date = 2020 | pmid = 32642480 | pmc = 7325786 | doi = 10.4103/jehp.jehp_90_20 | doi-access = free }}</ref>

===Care navigation===
{{main|Mental health care navigator}}
Mental health care navigation helps to guide patients and families through the fragmented, often confusing mental health industries. Care navigators work closely with patients and families through discussion and collaboration to provide information on best therapies as well as referrals to practitioners and facilities specializing in particular forms of emotional improvement. The difference between therapy and care navigation is that the care navigation process provides information and directs patients to therapy rather than providing therapy. Still, care navigators may offer diagnosis and treatment planning. Though many care navigators are also trained therapists and doctors. Care navigation is the link between the patient and the below therapies. A clear recognition that mental health requires medical intervention was demonstrated in a study by Kessler et al. of the prevalence and treatment of mental disorders from 1990 to 2003 in the United States. Despite the prevalence of mental health disorders remaining unchanged during this period, the number of patients seeking treatment for mental disorders increased threefold.<ref>{{cite journal | vauthors = Kessler RC, Demler O, Frank RG, Olfson M, Pincus HA, Walters EE, Wang P, Wells KB, Zaslavsky AM | title = Prevalence and treatment of mental disorders, 1990 to 2003 | journal = The New England Journal of Medicine | volume = 352 | issue = 24 | pages = 2515–23 | date = June 2005 | pmid = 15958807 | pmc = 2847367 | doi = 10.1056/nejmsa043266 }}</ref>

===Methods===
==== Pharmacotherapy ====
[[Pharmacotherapy]] is a [[therapy]] that uses pharmaceutical drugs. Pharmacotherapy is used in the treatment of mental illness through the use of [[antidepressant]]s, [[benzodiazepine]]s, and the use of elements such as [[Lithium (medication)|lithium]]. It can only be prescribed by a medical professional trained in the field of [[Psychiatry]].

==== Physical activity ====
[[Exercise|Physical exercise]] can improve mental and physical health. Playing sports, walking, cycling, or doing any form of physical activity trigger the production of various hormones, sometimes including endorphins, which can elevate a person's mood.<ref>{{cite journal | vauthors = Avila-Palencia I, Int Panis L, Dons E, Gaupp-Berghausen M, Raser E, Götschi T, Gerike R, Brand C, de Nazelle A, Orjuela JP, Anaya-Boig E, Stigell E, Kahlmeier S, Iacorossi F, Nieuwenhuijsen MJ | title = The effects of transport mode use on self-perceived health, mental health, and social contact measures: A cross-sectional and longitudinal study | journal = Environment International | volume = 120 | pages = 199–206 | date = November 2018 | pmid = 30098553 | doi = 10.1016/j.envint.2018.08.002 | bibcode = 2018EnInt.120..199A | hdl-access = free | hdl = 10044/1/62973 | s2cid = 51965322 }}</ref>

Studies have shown that in some cases, physical activity can have the same impact as antidepressants when treating depression and anxiety.<ref>{{cite journal | vauthors = Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C | title = A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations | journal = Health Psychology Review | volume = 9 | issue = 3 | pages = 366–78 | date = 3 July 2015 | pmid = 25739893 | doi = 10.1080/17437199.2015.1022901 | s2cid = 24320503 }}</ref>

Moreover, cessation of physical exercise may have adverse effects on some mental health conditions, such as depression and anxiety. This could lead to different negative outcomes such as obesity, skewed body image and many health risks associated with mental illnesses.<ref>{{cite journal | vauthors = Weinstein AA, Koehmstedt C, Kop WJ | title = Mental health consequences of exercise withdrawal: A systematic review | journal = General Hospital Psychiatry | volume = 49 | pages = 11–18 | date = November 2017 | pmid = 28625704 | doi = 10.1016/j.genhosppsych.2017.06.001 }}</ref> Exercise can improve mental health but it should not be used as an alternative to therapy.<ref>{{Cite book | vauthors = Hales D |title=An Invitation to Health: Taking Charge of Your Health |publisher=Cengage Learning |date=January 31, 2020 |isbn=978-0-357-13679-9 |edition=19th |location=Boston, Massachusetts |pages=3–7a |language=en}}</ref>

====Activity therapies====
Activity therapies also called recreation therapy and occupational therapy, promote healing through active engagement. An example of occupational therapy would be promoting an activity that improves daily life, such as self-care or improving hobbies.<ref>{{Cite web|title=Occupational Therapy - Adults|url=https://interprofessionalclinic.com/client-services/occupational-therapy-adults/|access-date=2021-03-16|website=The Interprofessional Clinic|language=en-US|archive-date=2021-04-16|archive-url=https://web.archive.org/web/20210416072110/https://interprofessionalclinic.com/client-services/occupational-therapy-adults/|url-status=dead}}</ref>

Each of these therapies have proven to improve mental health and have resulted in healthier, happier individuals. In recent years, for example, coloring has been recognized as an activity that has been proven to significantly lower the levels of depressive symptoms and anxiety in many studies.<ref>{{cite journal | vauthors = Flett JA, Lie C, Riordan BC, Thompson LM, Conner TS, Hayne H | year = 2017 | title = Sharpen Your Pencils: Preliminary Evidence that Adult Coloring Reduces Depressive Symptoms and Anxiety | journal = Creativity Research Journal | volume = 29 | issue = 4| pages = 409–416 | doi=10.1080/10400419.2017.1376505| s2cid = 149346431 }}</ref>

====Expressive therapies====
[[Expressive therapies]] or [[creative arts therapies]] are a form of [[psychotherapy]] that involves the arts or artmaking. These therapies include [[art therapy]], [[music therapy]], [[drama therapy]], [[dance therapy]], and poetry therapy. It has been proven that music therapy is an effective way of helping people with a mental health disorder.<ref>{{Cite journal| vauthors = McCafferey T, Edwards J, Fannon D |date=2009|title=Is there a role for music therapy in the recovery approach in mental health?|journal=The Arts in Psychotherapy|volume=38|issue=3|pages=185–189|doi=10.1016/j.aip.2011.04.006|hdl=10344/3362|hdl-access=free}}</ref> Drama therapy is approved by NICE for the treatment of psychosis.<ref>{{cite web | work = The National Institute for Health and Care Excellence (NICE) | title = Dramatherapy in Early Intervention in Psychosis | date = March 2019 | url = https://www.nice.org.uk/sharedlearning/dramatherapy-in-early-intervention-in-psychosis }}</ref>

====Psychotherapy====
[[File:Conflict Model in Positive Psychotherapy.png|thumb|The three main conflicts of Positive Psychotherapy.]]
{{main|Psychotherapy}}
[[Psychotherapy]] is the general term for the scientific based treatment of mental health issues based on modern medicine. It includes a number of schools, such as [[gestalt therapy]], [[psychoanalysis]], [[cognitive behavioral therapy]], [[psychedelic therapy]], [[transpersonal psychology]]/psychotherapy, and [[Dialectical behavior therapy|dialectical behavioral therapy]].
[[Group therapy]] involves any type of therapy that takes place in a setting involving multiple people. It can include [[Psychodynamic psychotherapy|psychodynamic]] groups, [[expressive therapy]] groups, [[support groups]] (including the [[Twelve-step program]]), problem-solving and [[psychoeducation]] groups.

===== Occupational Therapy =====
[[File:Occupational therapy psychiatric hospital.jpg|thumb|Toy making activity used during occupational therapy during World War 1 psychiatric hospital.]]
[[Occupational therapy]] practitioners aim to improve and enable a client or group's participation in meaningful, everyday occupations.<ref name="American Occupational Therapy Association 2020">American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2). doi.org/10.5014/ajot.2020.74S2001</ref> In this sense, occupation is defined as any activity that "occupies one's time". Examples of those activities include daily tasks (dressing, bathing, eating, house chores, driving, etc.), sleep and rest, education, work, play, leisure (hobbies), and social interactions. The OT profession offers a vast range of services for all stages of life in a myriad of practice settings, though the foundations of OT come from mental health.

OT services focused on mental health can be provided to persons, groups, and populations <ref name="American Occupational Therapy Association 2020" /> across the lifespan and experiencing varying levels of mental health performance. For example, occupational therapy practitioners provide mental health services in school systems, military environments, hospitals, outpatient clinics, and inpatient mental health rehabilitation settings. Interventions or support can be provided directly through specific treatment interventions or indirectly by providing consultation to businesses, schools, or other larger groups to incorporate mental health strategies on a programmatic level. Even people who are mentally healthy can benefit from the health promotion and additional prevention strategies to reduce the impact of difficult situations.

The interventions focus on positive functioning, sensory strategies, managing emotions, interpersonal relationships, sleep, community engagement, and other cognitive skills (i.e. visual-perceptual skills, attention, memory, arousal/energy management, etc.).

====Self-compassion====
{{main|Self-compassion}}
According to Neff, self-compassion consists of three main positive components and their negative counterparts: Self-Kindness versus Self-Judgment, Common Humanity versus Isolation and Mindfulness versus Over-Identification.<ref>{{cite journal | vauthors = Pommier E, Neff KD, Tóth-Király I | title = The Development and Validation of the Compassion Scale | journal = Assessment | volume = 27 | issue = 1 | pages = 21–39 | date = January 2020 | pmid = 31516024 | doi = 10.1177/1073191119874108 | s2cid = 202569236 }}</ref> Furthermore, there is evidence from a study by Shin & Lin suggesting specific components of self-compassion can predict specific dimensions of positive mental health (emotional, social, and psychological well-being).<ref>{{cite journal | vauthors = Shin NY, Lim YJ | title = Contribution of self-compassion to positive mental health among Korean university students | journal = International Journal of Psychology | volume = 54 | issue = 6 | pages = 800–806 | date = December 2019 | pmid = 30206928 | doi = 10.1002/ijop.12527 | s2cid = 52191018 }}</ref>

====Social-emotional learning====
{{Further| Social emotional development#Social emotional learning & development in schools}}
The Collaborative for academic, social, emotional learning (CASEL) addresses five broad and interrelated areas of competence and highlights examples for each: self-awareness, self-management, social awareness, relationship skills,'' and ''responsible decision-making.<ref>{{Cite web|title=SEL: What Are the Core Competence Areas and Where are they Promoted?|url=https://casel.org/sel-framework/|access-date=2020-11-14 | work = Collaborative for Academic, Social, and Emotional Learning (CASEL) | location = Chicago, IL }}</ref> A meta-analysis was done by Alexendru Boncu, Iuliana Costeau, & Mihaela Minulescu (2017) looking at [[social-emotional learning]] (SEL) studies and the effects on emotional and behavior outcomes. They found a small but significant effect size (across the studies looked into) for externalized problems and social-emotional skills.<ref>{{Cite journal| vauthors = Boncu A, Costea I, Minulescu M | date=2017-12-31|title=A meta-analytic study investigating the efficiency of socio-emotional learning programs on the development of children and adolescents|url=http://www.rjap.psihologietm.ro/Download/rjap192_2.pdf|journal=Romanian Journal of Applied Psychology|pages=35–41|doi=10.24913/rjap.19.2.02|doi-access=free}}</ref> Holistic approaches to education also emphasize social-emotional development as a key pillar of personal growth.<ref>{{Cite web|title=What is Holistic SEL Growth?|url=https://bloomster.com/blog/what-is-holistic-growth|website=Bloomster|access-date=2025-05-23}}</ref>

====Meditation====
{{main|Meditation|Mindfulness-based cognitive therapy}}

The practice of mindfulness meditation has several potential mental health benefits, such as bringing about reductions in [[depression (mood)|depression]], [[anxiety]] and [[Psychological stress|stress]].<ref name=Goyal>{{cite journal | vauthors = Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA | title = Meditation programs for psychological stress and well-being: a systematic review and meta-analysis | journal = JAMA Internal Medicine | volume = 174 | issue = 3 | pages = 357–68 | date = March 2014 | pmid = 24395196 | pmc = 4142584 | doi = 10.1001/jamainternmed.2013.13018 }}</ref><ref name=Galla>{{cite journal | vauthors = Galla BM, O'Reilly GA, Kitil MJ, Smalley SL, Black DS | title = Community-Based Mindfulness Program for Disease Prevention and Health Promotion: Targeting Stress Reduction | journal = American Journal of Health Promotion | volume = 30 | issue = 1 | pages = 36–41 | date = September 2014 | pmid = 25162319 | doi = 10.4278/ajhp.131107-QUAN-567 | s2cid = 503591 }}</ref><ref name=Sharma>{{cite journal | vauthors = Sharma M, Rush SE | title = Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review | journal = Journal of Evidence-Based Complementary & Alternative Medicine | volume = 19 | issue = 4 | pages = 271–86 | date = October 2014 | pmid = 25053754 | doi = 10.1177/2156587214543143 | doi-access = free }}</ref><ref name= Khoury>{{cite journal | vauthors = Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, Chapleau MA, Paquin K, Hofmann SG | title = Mindfulness-based therapy: a comprehensive meta-analysis | journal = Clinical Psychology Review | volume = 33 | issue = 6 | pages = 763–71 | date = August 2013 | pmid = 23796855 | doi = 10.1016/j.cpr.2013.05.005 }}</ref> Mindfulness [[meditation]] may also be effective in treating substance use disorders.<ref name=Chiesa>{{cite journal | vauthors = Chiesa A, Serretti A | title = Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence | journal = Substance Use & Misuse | volume = 49 | issue = 5 | pages = 492–512 | date = April 2014 | pmid = 23461667 | doi = 10.3109/10826084.2013.770027 | s2cid = 34990668 }}</ref>

====Lucid dreaming====

[[Lucid dreaming]] has been found to be associated with greater mental well-being. It also was not associated with poorer sleep quality nor with cognitive dissociation.<ref>{{cite journal | vauthors = Schadow C, Schredl M, Rieger J, Göritz AS | date = 2018 | title = The relationship between lucid dream frequency and sleep quality: Two cross-sectional studies. | journal = International Journal of Dream Research | volume = 11 | pages = 154–159 | doi = 10.11588/ijodr.2018.2.48341 }}</ref> There is also some evidence lucid dreaming therapy can help with nightmare reduction.<ref name="Spoormaker_2006">{{cite journal | vauthors = Spoormaker VI, van den Bout J | title = Lucid dreaming treatment for nightmares: a pilot study | journal = Psychotherapy and Psychosomatics | volume = 75 | issue = 6 | pages = 389–94 | date = 2006 | pmid = 17053341 | doi = 10.1159/000095446 }}</ref>

==== Mental fitness ====
Mental fitness is a mental health movement that encourages people to intentionally regulate and maintain their emotional wellbeing through friendship, regular human contact, and activities that include meditation, calming exercises, aerobic exercise, mindfulness, having a routine and maintaining adequate sleep. Mental fitness is intended to build resilience against every-day mental and potentially physical health challenges to prevent an escalation of anxiety, depression, and suicidal ideation.<ref>{{cite journal | vauthors = Neuman MD, etal | collaboration = The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators | title = Preoperative psychological resilience and recovery after hip fracture: Secondary analysis of the REGAIN randomized trial | journal = Journal of the American Geriatrics Society | volume = 71 | issue = 12 | pages = 3792–3801 | date = December 2023 | pmid = 37698304 | doi = 10.1111/jgs.18552 | s2cid = 261694577 | doi-access = free }}</ref> This can help people, including older adults with health challenges, to more effectively cope with the escalation of those feelings if they occur.<ref>{{cite web |vauthors=Walkadean C |date=22 June 2020 |title=Mental fitness - a gamechanger |url=https://www.gotcha4life.org/blog/2020/5/14/mental-fitness-gamechanger |website=Gotcha4Life mental health and suicide prevention |access-date=3 July 2020 |archive-date=4 July 2020 |archive-url=https://web.archive.org/web/20200704094706/https://www.gotcha4life.org/blog/2020/5/14/mental-fitness-gamechanger |url-status=dead }}</ref>

====Spiritual counseling====
Spiritual counsellors meet with people in need to offer comfort and support and to help them gain a better understanding of their issues and develop a problem-solving relation with [[spirituality]]. These types of counselors deliver care based on spiritual, psychological and theological principles.<ref>{{cite journal | vauthors = Rosmarin DH, Pirutinsky S, Auerbach RP, Björgvinsson T, Bigda-Peyton J, Andersson G, Pargament KI, Krumrei EJ | title = Incorporating spiritual beliefs into a cognitive model of worry | journal = Journal of Clinical Psychology | volume = 67 | issue = 7 | pages = 691–700 | date = July 2011 | pmid = 21480226 | doi = 10.1002/jclp.20798 | url = https://digitalcommons.pepperdine.edu/cgi/viewcontent.cgi?article=1164&context=faculty_pubs | url-access = subscription }}</ref>

====Surveys====
The World Mental Health survey initiative has suggested a plan for countries to redesign their mental health care systems to best allocate resources.
"A first step is documentation of services being used and the extent and nature of unmet treatment needs. A second step could be to do a cross-national comparison of service use and unmet needs in countries with different mental health care systems. Such comparisons can help to uncover optimum financing, national policies, and delivery systems for mental health care."{{quote without source|date=October 2020}}

Knowledge of how to provide effective emotional mental health care has become imperative worldwide. Unfortunately, most countries have insufficient data to guide decisions, absent or competing visions for resources, and near-constant pressures to cut insurance and entitlements. WMH surveys were done in Africa ([[Nigeria]], South Africa), the Americas (Colombia, Mexico, United States), Asia and the Pacific ([[Japan]], [[New Zealand]], [[Beijing]] and [[Shanghai]] in the [[China|People's Republic of China]]), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), and the Middle East (Israel, Lebanon). Countries were classified with [[World Bank]] criteria as [[Low income|low-income]] ([[Nigeria]]), lower-middle-income ([[China]], [[Colombia]], [[South Africa]], [[Ukraine]]), higher middle-income ([[Lebanon]], [[Mexico]]), and high-income.

The coordinated surveys on emotional mental health disorders, their severity, and treatments were implemented in the aforementioned countries. These surveys assessed the frequency, types, and adequacy of mental health service use in 17 countries in which WMH surveys are complete. The WMH also examined unmet needs for treatment in strata defined by the seriousness of mental disorders. Their research showed that "the number of respondents using any 12-month mental health service was generally lower in developing than in developed countries, and the proportion receiving services tended to correspond to countries' percentages of [[gross domestic product]] spent on health care".
"High levels of unmet need worldwide are not surprising, since WHO Project [[ATLAS experiment|ATLAS]]' findings of much lower mental health expenditures than was suggested by the magnitude of burdens from mental illnesses. Generally, unmet needs in [[low-income]] and [[middle-income]] countries might be attributable to these nations spending reduced amounts (usually <1%) of already diminished health budgets on mental health care, and they rely heavily on out-of-pocket spending by citizens who are ill-equipped for it".

==Laws and public health policies==
{{Globalize|section|date=April 2025}}
{{See also| Mental health law|Public health}}
There are many factors that influence mental health including:
* [[Mental illness]], [[disability]], and [[suicide]] are ultimately the result of a combination of biology, environment, and access to and utilization of mental health treatment.
* Public health policies can influence access and utilization, which subsequently may improve mental health and help to progress the negative consequences of depression and its associated disability.

=== United States ===
Emotional mental illnesses is a particular concern in the United States since the U.S. has the highest annual prevalence rates (26 percent) for mental illnesses among a comparison of 14 developing and developed countries.<ref>{{cite journal | vauthors = Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, Haro JM, Vilagut G, Bromet EJ, Gluzman S, Webb C, Kessler RC, Merikangas KR, Anthony JC, Von Korff MR, Wang PS, Brugha TS, Aguilar-Gaxiola S, Lee S, Heeringa S, Pennell BE, Zaslavsky AM, Ustun TB, Chatterji S | title = Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys | journal = JAMA | volume = 291 | issue = 21 | pages = 2581–90 | date = June 2004 | pmid = 15173149 | doi = 10.1001/jama.291.21.2581 | doi-access = free }}</ref> While approximately 80 percent of all people in the United States with a mental disorder eventually receive some form of treatment, on average persons do not access care until nearly a decade following the development of their illness, and less than one-third of people who seek help receive minimally adequate care.<ref>{{cite journal | vauthors = Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC | title = Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication | journal = Archives of General Psychiatry | volume = 62 | issue = 6 | pages = 603–13 | date = June 2005 | pmid = 15939838 | doi = 10.1001/archpsyc.62.6.603 | doi-access = free }}</ref> The government offers everyone programs and services, but veterans receive the most help, there is certain eligibility criteria that has to be met.<ref>{{cite journal | vauthors = Tanielian T, Hansen ML, Martin LT, Grimm G, Ogletree C | journal = Rand Health Quarterly | title = Supporting the Mental Health Needs of Veterans in the Metro Detroit Area | volume = 6 | issue = 1 | pages = 15 | date = June 2016 | pmid = 28083443 | pmc = 5158279 | doi = 10.7249/RR1346 | isbn = 978-0-8330-9257-1 }}</ref>

==== {{anchor|Mental health policies in the United States}}Policies ====
Mental health policies in the United States have experienced four major reforms: the American asylum movement led by [[Dorothea Dix]] in 1843; the mental hygiene movement inspired by [[Clifford Whittingham Beers|Clifford Beers]] in 1908; the [[deinstitutionalization]] started by Action for Mental Health in 1961; and the community support movement called for by The CMCH Act Amendments of 1975.<ref name="U.S. Public Health Service">{{cite book |author=U.S. Public Health Service |date=1999 |title=Mental Health: A Report of the Surgeon General |chapter=Overview of Mental Health Services |access-date=19 February 2012 |chapter-url=http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec7.html |archive-url=https://web.archive.org/web/20120211145002/http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec7.html |archive-date=11 February 2012 }}</ref>

In 1843, [[Dorothea Dix]] submitted a Memorial to the Legislature of Massachusetts, describing the abusive treatment and horrible conditions received by the mentally ill patients in jails, cages, and almshouses. She revealed in her Memorial: "I proceed, gentlemen, briefly to call your attention to the present state of insane persons confined within this Commonwealth, in cages, closets, cellars, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience...."<ref>{{cite journal | vauthors = Dix D | title = "I tell what I have seen"--the reports of asylum reformer Dorothea Dix. 1843 | journal = American Journal of Public Health | volume = 96 | issue = 4 | pages = 622–5 | date = April 2006 | pmid = 16551962 | pmc = 1470564 | doi = 10.2105/ajph.96.4.622 }}</ref> Many asylums were built in that period, with high fences or walls separating the patients from other community members and strict rules regarding the entrance and exit. In 1866, a recommendation came to the New York State Legislature to establish a separate asylum for chronic mentally ill patients. Some hospitals placed the chronic patients into separate wings or wards, or different buildings.<ref>{{cite journal | vauthors = Luchins AS | title = Moral treatment in asylums and general hospitals in 19th-century America | journal = The Journal of Psychology | volume = 123 | issue = 6 | pages = 585–607 | date = November 1989 | pmid = 2691669 | doi = 10.1080/00223980.1989.10543013 }}</ref>

In ''A Mind That Found Itself'' (1908) [[Clifford Whittingham Beers]] described the humiliating treatment he received and the deplorable conditions in the mental hospital.<ref>{{cite book | vauthors = Beers CW |author-link=Clifford Whittingham Beers |date=8 April 2004 |orig-year=1908 |title=A Mind That Found Itself: An Autobiography |url=https://www.gutenberg.org/files/11962/11962-h/11962-h.htm |publisher=Project Gutenberg }}</ref> One year later, the National Committee for Mental Hygiene (NCMH) was founded by a small group of reform-minded scholars and scientists—including Beers himself—which marked the beginning of the "mental hygiene" movement. The movement emphasized the importance of childhood prevention. [[World War I]] catalyzed this idea with an additional emphasis on the impact of maladjustment, which convinced the hygienists that prevention was the only practical approach to handle mental health issues.<ref>{{cite journal | vauthors = Cohen S | title = The mental hygiene movement, the development of personality and the school: the medicalization of American education | journal = History of Education Quarterly | volume = 23 | issue = 2 | pages = 123–49 | date = 1983 | pmid = 11614585 | doi = 10.2307/368156 | jstor = 368156 | s2cid = 44384151 }}</ref> However, prevention was not successful, especially for chronic illness; the condemnable conditions in the hospitals were even more prevalent, especially under the pressure of the increasing number of chronically ill and the influence of the depression.<ref name="U.S. Public Health Service"/>

In 1961, the Joint Commission on Mental Health published a report called Action for Mental Health, whose goal was for community clinic care to take on the burden of prevention and early intervention of the mental illness, therefore to leave space in the hospitals for severe and chronic patients. The court started to rule in favor of the patients' will on whether they should be forced to treatment. By 1977, 650 community mental health centers were built to cover 43 percent of the population and serve 1.9 million individuals a year, and the lengths of treatment decreased from 6 months to only 23 days.<ref name="Koyanagi_1991">{{cite journal | vauthors = Koyanagi C, Goldman HH | title = The quiet success of the national plan for the chronically mentally ill | journal = Hospital & Community Psychiatry | volume = 42 | issue = 9 | pages = 899–905 | date = September 1991 | pmid = 1743659 | doi = 10.1176/ps.42.9.899 }}</ref> However, issues still existed. Due to inflation, especially in the 1970s, the community nursing homes received less money to support the care and treatment provided. Fewer than half of the planned centers were created, and new methods did not fully replace the old approaches to carry out its full capacity of treating power.<ref name="Koyanagi_1991"/> Besides, the community helping system was not fully established to support the patients' housing, vocational opportunities, income supports, and other benefits.<ref name="U.S. Public Health Service"/> Many patients returned to [[welfare spending|welfare]] and criminal justice institutions, and more became [[homeless]]. The movement of deinstitutionalization was facing great challenges.<ref name=Torrey_Book>{{cite web | vauthors = Torrey EF |author-link1=E. Fuller Torrey |date=10 May 2005 |title=Deinstitutionalization: A Psychiatric "Titanic" |website=Frontline |publisher=WGBH Educational Foundation |url=https://www.pbs.org/wgbh/pages/frontline/shows/asylums/special/excerpt.html |archive-url=https://web.archive.org/web/20050525223230/http://www.pbs.org/wgbh/pages/frontline/shows/asylums/special/excerpt.html |archive-date=25 May 2005 }} Excerpts from {{cite book | vauthors = Torrey EF | author-link1=E. Fuller Torrey |title=Out of the Shadows: Confronting America's Mental Illness Crisis |date=1997 |publisher=John Wiley & Sons |location=New York |isbn=978-0-471-16161-5 |url-access=registration |url=https://archive.org/details/isbn_9780471161615 }}</ref>

After realizing that simply changing the location of mental health care from the state hospitals to nursing houses was insufficient to implement the idea of [[deinstitutionalization]], the [[National Institute of Mental Health]] (NIMH) in 1975 created the Community Support Program (CSP) to provide funds for communities to set up a comprehensive mental health service and supports to help the mentally ill patients integrate successfully in the society. The program stressed the importance of other supports in addition to medical care, including housing, living expenses, employment, transportation, and education; and set up new national priority for people with serious mental disorders. In addition, the Congress enacted the [[Mental Health Systems Act of 1980]] to prioritize the service to the mentally ill and emphasize the expansion of services beyond just clinical care alone.<ref name="Koyanagi_2007">{{citation |vauthors=Koyanagi C |date=August 2007 |title=Learning From History: Deinstitutionalization of People with Mental Illness As Precursor to Long-Term Care Reform |publisher=[[Kaiser Family Foundation]] |location=Menlo Park, CA |pages=1–22 |url=https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7684.pdf |access-date=2016-01-24 |archive-date=2018-11-29 |archive-url=https://web.archive.org/web/20181129132652/https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7684.pdf |url-status=dead }}</ref> Later in the 1980s, under the influence from the Congress and the Supreme Court, many programs started to help the patients regain their benefits. A new Medicaid service was also established to serve people who were diagnosed with a "chronic mental illness". People who were temporally hospitalized were also provided aid and care and a pre-release program was created to enable people to apply for reinstatement prior to discharge.<ref name="Koyanagi_1991"/> Not until 1990, around 35 years after the start of the deinstitutionalization, did the first state hospital begin to close. The number of hospitals dropped from around 300 by over 40 in the 1990s, and finally a Report on Mental Health showed the efficacy of mental health treatment, giving a range of treatments available for patients to choose.<ref name="Koyanagi_2007"/>

However, several critics maintain that deinstitutionalization has, from a mental health point of view, been a thoroughgoing failure. The seriously mentally ill are either homeless, or in prison; in either case (especially the latter), they are getting little or no mental health care. This failure is attributed to a number of reasons over which there is some degree of contention, although there is general agreement that community support programs have been ineffective at best, due to a lack of funding.<ref name=Torrey_Book/>

The 2011 National Prevention Strategy included mental and emotional well-being, with recommendations including better parenting and early intervention programs, which increase the likelihood of prevention programs being included in future US mental health policies.<ref name="National_Prevention Council_2011">{{citation |author=National Prevention Council |date=16 June 2011 |title=National Prevention Strategy |publisher=U.S. Department of Health and Human Services, Office of the Surgeon General |location=Washington, DC |url=http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf |archive-url=https://web.archive.org/web/20111004043040/http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf |archive-date=4 October 2011 }}</ref>{{page needed |date=January 2016}} The NIMH is researching only suicide and [[HIV/AIDS]] prevention, but the National Prevention Strategy could lead to it focusing more broadly on longitudinal prevention studies.<ref>{{cite web|title=Prevention of Mental Disorders|url=http://www.nimh.nih.gov/health/topics/prevention-of-mental-disorders/index.shtml|website=National Institute of Mental Health|access-date=7 August 2015 |archive-url=https://web.archive.org/web/20150705041918/https://www.nimh.nih.gov/health/topics/prevention-of-mental-disorders/index.shtml |archive-date=5 July 2015 }}</ref>{{Failed verification |reason=Source contains a list of publications. Suicide prevention appears only in sidebar links; HIV/AIDS is not mentioned. |date=January 2016}}

In 2013, United States Representative [[Timothy F. Murphy|Tim Murphy]] introduced the [[National Helping Families in Mental Health Crisis Day|Helping Families in Mental Health Crisis Act, HR2646]]. The bipartisan bill went through substantial revision and was reintroduced in 2015 by Murphy and Congresswoman [[Eddie Bernice Johnson]]. In November 2015, it passed the Health Subcommittee by an 18–12 vote.<ref>{{Cite web| vauthors = Murphy T |date=2016-07-14|title=Actions - H.R.2646 - 114th Congress (2015-2016): Helping Families in Mental Health Crisis Act of 2016|url=https://www.congress.gov/bill/114th-congress/house-bill/2646/all-actions|access-date=2021-05-06|website=www.congress.gov}}</ref>

=== Global Perspective ===
Historically, mental health challenges were criticized, underprioritized, and limited to the public due to lack of recognition. However, recent developments evolved over time to include quality care settings and accessible resources for individuals needing mental health support. Interventions reduced treatment gaps by catering to many diverse cultures and implementing health services across the globe. International organizations, such as the World Health Organization, increased funding towards mental health services that specialize in disorders.<ref>{{Cite journal |last1=Moitra |first1=Modhurima |last2=Owens |first2=Shanise |last3=Hailemariam |first3=Maji |last4=Wilson |first4=Katherine S. |last5=Mensa-Kwao |first5=Augustina |last6=Gonese |first6=Gloria |last7=Kamamia |first7=Christine K. |last8=White |first8=Belinda |last9=Young |first9=Dorraine M. |last10=Collins |first10=Pamela Y. |date=2023-05-31 |title=Global Mental Health: Where We Are and Where We Are Going |journal=Current Psychiatry Reports |volume=25 |issue=7 |pages=301–311 |doi=10.1007/s11920-023-01426-8 |issn=1535-1645 |pmc=10230139 |pmid=37256471}}</ref>

==== Countries and cultures ====
Systematic differences affected the perception of mental health across countries. East Asian countries are heavily influenced by cultural beliefs, associating mental health issues with weakness. Confucian values, practiced in South Korea, express values of self-control and maintaining "face."<ref name=":0">{{Cite journal |last1=Zhang |first1=Zhisong |last2=Sun |first2=Kaising |last3=Jatchavala |first3=Chonnakarn |last4=Koh |first4=John |last5=Chia |first5=Yimian |last6=Bose |first6=Jessica |last7=Li |first7=Zhimeng |last8=Tan |first8=Wanqiu |last9=Wang |first9=Sizhe |last10=Chu |first10=Wenjing |last11=Wang |first11=Jiayun |last12=Tran |first12=Bach |last13=Ho |first13=Roger |date=2019-12-31 |title=Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies |journal=International Journal of Environmental Research and Public Health |volume=17 |issue=1 |pages=280 |doi=10.3390/ijerph17010280 |doi-access=free |issn=1660-4601 |pmc=6981757 |pmid=31906068}}</ref> This value discourages East Asian individuals from seeking help when experiencing psychological distress out of fear of shaming one's family. Being heavily underfunded, East Asia has increased mental health awareness by implementing public educational programs and introducing mental health services to children in schools. Varying across the country, Japan lacks proper hospitalization and limited local community services, while Singapore promotes general healthcare, reducing the stigma across cultures.<ref name=":0" />

In African nations, the stigmatization of mental health viewed through a cultural lens and the prioritization of physical health issues cause neglect of health services. Insufficient financial resources and an extensive shortage of specialized caretakers cause concern for individuals with mental health conditions. Diseases such as AIDS, malaria, and Ebola attract health services attention due to the population impact.<ref>{{Cite journal |last=Okasha |first=Ahmed |date=February 2002 |title=Mental health in Africa: the role of the WPA |journal=World Psychiatry |volume=1 |issue=1 |pages=32–35 |issn=1723-8617 |pmc=1489826 |pmid=16946819}}</ref> In hopes of reducing the spread of diseases, psychological disorders remain unaddressed. African nations undergo systematic challenges such as policy gaps and inadequate resources with trained professionals. International organizations collaborate with African governments to implement public programs created by local communities.

Due to economic challenges, Latin American area's face disparities regarding income causing high percentage of poverty across the nation. Poverty and socioeconomic status increases mental health issues. Over 90% of Latin American population consist of Catholic and Protestant worshipping churches.<ref>{{Cite journal |last=Alarcón |first=Renato D. |date=February 2003 |title=Mental health and mental health care in Latin America |journal=World Psychiatry |volume=2 |issue=1 |pages=54–56 |issn=1723-8617 |pmc=1525063 |pmid=16946892}}</ref> The religious and cultural beliefs lead to negative perceptions of mental health which contribute to the stigma of illnesses.

== See also ==
{{Portal|Psychology}}

* [[988 (telephone number)]]
* [[Abnormal psychology]]
* [[Emotional resilience]]
* [[Ethnopsychopharmacology]]
* [[History of mental disorders]]
* [[Mental environment]]
* [[Mental health day]]
* [[Mental health during the COVID-19 pandemic]]
* [[Mental health first aid]]
* [[Mental health in education]]
* [[Mental health in the workplace]]
* [[Mental health of Asian Americans]]
* [[Self-help groups for mental health]]
* [[Social determinants of mental health]]
* [[Social stigma]]
* [[Suicide awareness]]
* [[Telepsychiatry|Telemental health]]
* [[World Mental Health Day]]
* [[Well-being]]

== References ==
{{Reflist}}

== Further reading ==
* [http://onlinebooks.library.upenn.edu/webbin/book/lookupname?key=Sweetser%2C%20William%2C%201797-1875 Online Books by William Sweetser]

== External links ==
{{Library resources box}}
* {{wikiquote-inline}}
* {{Commons category-inline}}
* [https://www.who.int/health-topics/mental-health Mental Health by WHO]
* [https://www.canada.ca/en/public-health.html The Public Health Agency of Canada]
* {{cite web |title=Mental health and substance abuse |website=WHO Regional Office for the Eastern Mediterranean |url=http://www.emro.who.int/entity/mental-health/ }}
* [http://www.nimh.nih.gov/ National Institute of Mental Health (United States)]
* [https://ec.europa.eu/health/non_communicable_diseases/mental_health_en Health-EU Portal] Mental Health in the EU
* [http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/Mentalhealth/index.htm Mental Health Department of Health (United Kingdom)]

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