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MENTAL HEALTH PROMOTION

MENTAL HEALTH PROMOTION. Meeting of the EU Chief Medical Officers April 12, 2012 – Hotel Crowne Plaza Copenhagen Anna Paldam Folker , PhD , Senior Advisor National Board of Health, Denmark. THREE CHALLENGES. DANISH TRENDS IN PUBLIC MENTAL HEALTH.

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MENTAL HEALTH PROMOTION

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  1. MENTAL HEALTH PROMOTION Meeting of the EU Chief Medical Officers April 12, 2012 – Hotel Crowne Plaza Copenhagen Anna Paldam Folker, PhD, Senior Advisor National Board of Health, Denmark

  2. THREE CHALLENGES

  3. DANISH TRENDS IN PUBLIC MENTAL HEALTH • 20% of children (11-15 yrs) reportdaily symptoms of emotionaldistress – doubledsince 1991 • 10% of the adult population (+16) has poor mental health, i.e. theyreportlowlevels of well-being and poordailyfunction • 15% amongyoungwomen • 16% amongpeoplewithouttraining and education • 15% of seniors (+75) seldom or never seefriends and family, 10% reportloneliness

  4. DANISH TRENDS IN PUBLIC MENTAL HEALTH Poor mental health is the most prevalentcause of disability pensions and absenteeism The number of citizenstreated for symptoms of depression and anxiety has doubledsince 2002: 0.45 million receiveanti-depressants In the same period the number of children and adults on ADHD medication has increased 1000%

  5. HEALTH CONSEQUENCES • Poor mental health is associatedwithdisease: • Emotionaldistress in adolescenceoftenprecedes depression and anxiety in adulthood (Weare 2012) • Loneliness is significantlyrelated to the development of CHD, depression and Alzheimer’s (Masi 2012) • Loneliness is as dangerous as smoking and alcohol in terms of risk of death (Holt-Lunstad 2010) • Depression and anxietyareestimated to become the highestrankingdisease problems in the developedworld in 2020 (WHO 2008)

  6. WHAT EXPLAINS THE INCREASE IN MENTAL HEALTH PROBLEMS? • A reaction to features of modern society? • Heavy burden on individualresponsibility • Manydemands, high ideals – fast pace • Lesstolerance for vulnerable people • A result of lessstigmatization of mental healthissues? • The problems have beenthere all the time, but have nowcomeinto the open • Have webecomelessresilientagainstlifechallenges? • Tendency to medicalizewhatused to beseen as part of a normal life:disappointments, grief, melancholia

  7. CONCEPTUALIZING MENTAL HEALTH

  8. … MORE THAN THE ABSENCE OF MENTAL DISORDER But howmuch more? Positive psychology: Mental health is to flourish: to live within the optimal range of human capability as regardsquality, creativity, growth and resilience (Keyes 2002)  Two problems: too elitist, seems to medicalize most of the population WHO: Mental health is a state of well-being in which the individualrealizes his or her ownabilities, cancopewith the normal stresses of life and is able to take part in social relations (WHO 2005, slightlymodified)

  9. MEASURING MENTAL HEALTH No established standard for the measurement of mental health in non-clinical populations A tendency to measure the prevalence of mental disorders or clinical symptoms and ignore positive mental health

  10. TWO APPROACHES

  11. MENTAL HEALTH CUTS ACROSS DISEASE

  12. A PUBLIC HEALTH APPROACH • Focuson the social determinants of mental health – operatemainlyoutside the healthsector • Safe, supportiveupbringing • Nobullying and discrimination • Attainment of education and employment • Unstressfulworkingconditions • Social connectedness

  13. A PUBLIC HEALTH APPROACH • Dualfocusonrisk and protective factors • Strengthen the social, emotional and physicalenvironment e.g. in families, educationalsettings, workplaces and senior care • Reducingrisk factors e.g. help and support for vulnerable families • National public healthgoals and preventionpackages Evidence-basedrecommendations to the municipalities

  14. TASKS IN MENTAL HEALTH PROMOTION

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