1. Embracing the Principles of Mental Health Promotion

 

The training programme embraces the idea of mental health promotion as distinct from mental illness prevention or curative care. Positive mental health is seen as a resource, as a value on its own and as a basic human right essential to social and economic development. Mental health promotion aims to impact on determinants of mental health so as to increase positive mental health and to reduce inequalities.

 

What this criterion means for care professionals

 

In most EU countries, each different care profession has legally prescribed roles and responsibilities. With regard to mental health, these generally have a major focus on the care and protection of people with mental health difficulties. This traditionally leaves little scope for a role in mental health promotion, which generally sits fairly low down in the list of mental health responsibilities. Care professionals need to integrate the idea that positive mental health is not synonymous with absence of disease. Taking into account the strengths of individuals and the positive aspects of life must be included in interventions addressing the needs of both individuals and groups. This involves integrating the concept of positive mental health, including well-being, salutogenic factors (such as optimism), resilience (the capacity to cope with adversity) and quality of life. Above all, health promotion is not just about changing attitudes and behaviours, but also about defending people’s right to health and changing living conditions. Inequalities in society can lead to poorer mental health for those with less mental health resources. Mental health promotion involves acting upon the determinants of mental health, including clients’ and communities’ social and ecological conditions, income, employment, housing, leisure, daily routines, transport, social and physical environment..

 

What this criterion means for initial training of care professionals

 

From the very beginning of initial training, present health and social care not in terms of treating disease or caring for the ill, but as promoting good health and well-being. Talk about people before talking about disease. Begin by defining health, mental health and health promotion, and only then begin talking about treating, resolving or preventing mental health problems. The study and development of concepts such as resilience (as opposed to vulnerability) will help students integrate the philosophy of mental health promotion. Remember that the concept of health and health promotion refers to different theoretical foundations than the concept of prevention or treatment: health education in the positive sense brings in whole areas of knowledge concerning the socio-economic and physical environment. It incorporates disciplines such as anthropology, sociology and ecology.

 

In initial training, use activities that help students understand that people have a right to positive mental health and that care professionals have a key role to play in helping individuals or communities to access this right by acting upon the determinants of mental health. This involves a form of social activism where professionals will need to identify aspects of legislation that might prevent people from accessing their Right to Health and Mental Health or that prevent them from exercising other rights which in turn affect their mental health.

 

Ideas for training modules/exercises

 

• A training module on the helping relationship must show that the first job of a care professional in the field of mental health is not to identify and treat a problem or an illness in a “patient” but to help and support a “person” in good mental health to maintain and/or optimise their mental health and well-being. To do this, professionals must have an understanding of the environmental, social and economic factors that will influence peoples’ mental health. Initial training should also include modules working on the determinants of care professionals’ mental health, or even of students’ mental health.

• Include modules on the determinants of students’ own mental health. Students should understand that each individual may have a different definition of well-being and of good mental health; compare definitions and discuss the implications for building collective mental health promotion programmes. Underline the principles that need to be respected to guarantee the Right to Health and, in this respect, distinguish between mental health promotion and traditional “prevention” activities.

• Use physical health promotion as an analogy (e.g. sleep, sexuality, healthy diet, exercise) to understand how mental health promotion themes targeting for example interpersonal and coping skills differ from the traditional approaches used in illness prevention (risk groups, risk factors etc.).

• Include role play exercises where students work in pairs, taking it in turns to identify determinants that might influence the other student’s mental health and well-being. Ask students to build eco-maps with and for each other, depicting resources in the local community that will impact on their mental health and well-being. Build strategies to act upon these determinants.

(see: http://www.genogramanalytics.com/examples_ecomaps.html)

 

Illustrate how this criterion could be respected for continuous training

 

Experienced professionals will generally have had training and/or experience in mental health prevention programmes. Understanding the difference between promotion and prevention has major implications for traditional mental health prevention topics. The health promotion paradigm fundamentally changes the dynamic. Take into account the possibility that participants with years of professional practice may find it more difficult to change their professional posture.

Furthermore, care professionals have often spent so much time trying to resolve clients’ or patients’ serious problems that a health promotion approach is often seen as a luxury that is scarcely relevant to the harsh realities of everyday life and everyday professional activity. Professionals need to understand that promoting mental health can also result in reducing people’s problems. Examine the implications of this in the different fields that participants are working in (children, youth, women/men, socially excluded, etc.).

 

Continuous training for care professionals, whatever the field they are working in, should include training on actively defending peoples’ rights and acting on the determinants of mental health.

 

Ideas for training modules/exercises

 

• Training on mental health promotion and healthy living at school involves building programmes on how to live together, manage conflict, exercise, be clean, sleep well, play together, find the right balance between work and play, understand emotions, etc. Begin directly with modules on the promotion of good mental health. Remember that care professionals with years of experience may find it more difficult to rethink their professional role, especially if their role has traditionally been prevention of illness, bullying or violence, screening and care for children who are already ill or resolving the social problems of families whose children attend the school.

• Students need to understand that mental health is a right. Include discussion on how the right to good health can be compared to other basic human rights, such as cultural, social, economical and political rights. Devise plans for participants’ current organizations on how to implement the right to mental health. What might be the implications of the plan for the way the organisation currently works? Ask participants to identify possible tensions between “curative” or “prevention” approaches and health promotion approaches.

• Take in to account the fact that some of the professionals being trained may themselves have unhealthy working conditions creating work/life balance problems, burnout, etc. Use personal experiences to help participants to understand not only weak points, gaps and obstacles but also to devise plans for overcoming these problems. Discuss in small groups how their own organisations respect the principles of good mental health.

• Use case studies highlighting social factors and social support as protective elements when faced with difficult life events and highlighting how the role of a good lifestyle building positive mental health.

• Role play in small groups (3 or 4 people) where each group member writes and delivers a public speech to the other group members concerning the need for policy or legislation change with regard to the needs and desires of a particular population. Decide on a target population, investigate the knowledge base concerning the needs of this population, identify legislation and policy texts that might hamper well-being for this population, prepare the public speech arguing for the need for change. Listeners play the role of evaluators, who assess the quality of the prepared speech on the following criteria: clarity, readability of written version, relevance of policy or legislative constraints affecting the needs of the target population, pertinence of the proposals for revision of policy.

 

Consult the following Resource Kit for further information, relevant legal and policy texts, and examples of posters, slides and training programmes that respect this criterion:

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