Positive Mental Health

"Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with people, and the ability to adapt to change and cope with adversity".⁴

This definition affirms the view that mental health is not merely the absence of mental illness but also the presence of something positive. Additionally, mental health includes more than demonstrating the presence of 'good' behavior. It involves 'feeling good emotionally' and 'doing well' in everyday function'.⁵

What you can do. 
What does mental health look like to you?  As we interact with children and youth throughout the day, it's important to tune into their mental health. Make a point of looking at their faces and what they are doing. Look at the children in the picture. Do they look mentally healthy? If so, identify what factors led you to that conclusion. Next, read about positive mental health to see if your observations align with the characteristics associated with positive mental health.

These four characteristics are generally present when a person is mentally healthy.¹ We can strategically tune into these characteristics in ourselves and others.

1. Positive affect or emotional state. Positive affect can be observed in a person’s face (e.g. smiling, looking happy or content). Does the person smile during some parts of the day? How much positive affect should we aim for in a day? According to Barbara Frederickson, an emotion theorist, we should aim for a 3 to 1 ratio of positive to negative emotions.⁷ If we’ve had a particularly negative day, it’s important to build in some mental health promotion strategies into the rest of the day in order to feel better emotionally.

2. Positive psychological and social function. Does the person enjoy fulfilling relationships with other? Have friends? Feel good about him or herself? Is the person able to think clearly in order to complete tasks?

3. Participation in meaningful & needed activities. Does the person perform needed everyday tasks such as schoolwork and activities of daily living (e.g. getting dressed, eating meals, proper hygiene)? Does the person engage in a balance of school/work, play/leisure, and rest/sleep activities?

4. Coping with life stressors and demonstrating resilience when challenged. Does the person bounce back following a challenge and learn from the experience? Able to regulate emotions? Has the person learned strategies for maintaining mental health (e.g. engaging in enjoyable activities, relaxation strategies, exercise, healthy diet).

Our observations are powerful! Make a point to tune into all students’ emotions throughout the day. Look at their faces. Do you see smiling some of the day in response to interactions or what they’re doing? Do they look content? If a particular young person looks sad, make a point to check in with them. A simple question such as “how are you doing?” can open the door to checking in with them. Take time to listen. Also, tune into what students are doing. Are they able to participate successfully in activities they need or want to do in multiple contexts throughout the day (e.g. classroom, cafeteria, recess, hallways)? Tune into how students cope with challenges such as taking a test, transitioning between classes, and friendship challenges.

Mental Health ≠ Absence of Mental Illness
"...evidence indicates that the absence of mental illness does not imply the presence of mental health, and the absence of mental health does not imply the presence of mental illness." ⁹

How we think about ‘mental health’ has a powerful influence in how people take care of their mental health and how educational and healthcare services are perceived, talked about, and implemented. If, for example, the term mental health is perceived to mean services for people with mental illness, then the general public and service providers will only focus on treating mental illness. In contrast, if mental health is perceived as a positive state of functioning important for overall health, everyone will be committed to helping all people develop and maintain mental health.

In order to help create healthy schools, families and communities, it is important to consciously reframe ‘mental health’ – as a positive state of functioning – one that is different from mental illness.²

Every Moment Counts emphasizes reframing ‘mental health’ to focus on positive mental health, mental health promotion, and mental health literacy.

It’s important to keep in mind that positive mental health represents a dynamic state of functioning that can vary throughout life that can vary throughout a person’s life based on a number of biological (e.g. genetics), environmental (e.g. abuse/neglect), and situational (e.g. death of a family member) factors.² For this reason, all school personnel must tune into any marked changes in a child’s affect, social functioning, and ability to adapt to daily challenges in order to promote early intervention. Based on a large survey of U.S. adults between the ages of 25 and 74, findings support a continuum model of mental health and mental illness.¹⁰ The mental health continuum as described by Keyes⁹ can be viewed as a range of functioning from mental illness or "languishing in life" at one end to "moderately mentally healthy" to "complete mental health and flourishing" at the other end. An increase in illness and health problems have been found in adults without complete mental health and flourishing—even those without a mental illness. Completely mentally healthy adults had the fewest missed workdays, fewest chronic physical conditions, lowest health care utilization, and highest levels of psychosocial functioning.

What you can do?
Keep an eye out for children at-risk for developing mental health challenges. Tune into situational stressors that may negatively affect mental health. Children with and without physical or emotional disabilities are likely, at some point in their lives, to struggle with situational stressors such as parental divorce, the death of a family member, living in poverty, friendship issues, bullying, or academic challenges. During such times, character strengths, coping strategies, and environmental supports can serve as important 'buffers' in preventing mental ill-health.¹¹ While interacting with and observing children, make a habit of tuning in to possible stressors and advocating for services to counteract stressors and build competencies (e.g. bereavement support groups, participation in after-school clubs).¹² Check out the Calm Moments Cards for ideas on how to embed strategies to help reduce stress and enhance mental wellbeing.

Promoting positive mental health is everybody’s business!

Everyone should care about mental health because people who are mentally healthy and feel happy demonstrate greater degrees of everyday functioning¹³, healthy behaviors¹⁴, and perceived good health¹⁵. Completely mentally healthy individuals function better in everyday life reporting fewer sick days and chronic physical conditions, lower health care use, and higher levels of psychosocial functioning.¹³ Children and youth who experience positive mental health and well-being function better during academic and non-academic times of the school day.

Mental health literacy focuses on helping people develop a working knowledge of mental health – what it is and how to take care of it.¹⁶ The term mental health literacy was introduced in Australia by Anthony Jorm and represents a relatively new area of study.¹⁷ It specifically refers to one’s knowledge and beliefs about mental health and mental illness, which effects how people maintain mental health, recognize signs of mental health problems, and seek services for mental illness.¹⁸ Check out the mental health awareness posters available for download in the left side panel. Download and print them on 8.5X11" paper or as a poster.

So, let's talk about mental health! Embedded strategies that help children learn and talk about mental health, mental illness, and interventions may help reduce the negative stigma associated with mental illness by helping bring the topic into everyday conversations and framing mental health as a positive state of functioning. Programs focusing on mental health promotion (e.g. stress management, mental health literacy, and mindfulness) have shown a range of positive outcomes including improved social and/or physical functioning, and reduced symptoms.

Developing and implementing whole-school strategies to teach children and youth about positive mental health might be fostered in a number of creative ways. The use of posters, bookmarks, coloring sheets and even handwriting sheets that communicate strategies for taking care of one’s mental health can be embedded in everyday practice to promote mental health literacy.

"The aim of positive psychology is to begin to catalyze a change in the focus of psychology from preoccupation only with repairing the worst things in life to also building positive qualities".²²

Positive psychology is the study of positive mental health and the conditions that promote optimal functioning, such as enjoyable experiences and the use of character strengths.^20.21

Research findings from the field of positive psychology are used to inform practice in the area of mental health promotion and have provided the foundation for Every Moment Counts initiatives (model programs and embedded strategies).

For more information about positive psychology, visit the Positive Psychology Center and the International Positive Psychology Association.

For deeper learning, check out Coursera to take free online courses on positive psychology. There are numerous courses developed by leaders in positive psychology to choose from.

1 WHO (World Health Organization). (2001). Mental health: new understanding, new hope. The world health report. WHO, Geneva.
2 Barry, M. M., & Jenkins, R. (2007). Implementing mental health promotion. Edinburgh, Scotland: Churchill Livingstone/Elsevier.
3 Jane-Llopis, E., Barry, M., Hosman, C., & Patel, V. (2005). Mental health promotion works: A review. Promotion and Education Supplement, 2, 9-25.
4 U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD.
5 Miles, J., Espiritu, R.C., Horen, N., Sebian, J., Waetzig, E. (2010). A Public Health Approach to Children's Mental Health: A Conceptual Framework. Washington, DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health.
6 Mittlemark, M. B. (2007). Forward. In M. Barry & R. Jenkins. Implementing mental health promotion. (pp. ix-xi). Edinburgh: Churchill, Livingstone, Elsevier.
7 Fredrickson, B. L. (2009). Positivity: Groundbreaking research reveals how to embrace the hidden strength of positive emotions, overcome negativity, and thrive. New York: Crown Publishing Group.
8 Lochner, A. & Bales, S. N. (2006). Framing youth issues for public support. New Directions for Youth Development, 112,11-23.
9 Keyes, C. L. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62, 95-108.
10 Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73, 539–548.
11 Catalano, R. F., Hawkins, D., Berglund, M. L., Pollard, J. A., & Arthur, M. W. (2002). Prevention science and positive youth development: Competitive or cooperative frameworks? Journal of Adolescent Health, 31, 230-239.
12 Bazyk, S. (Ed.). (2011). Mental health promotion, prevention, and intervention with children and youth: A guiding framework for occupational therapy. Bethesda, MD: AOTA Press.
13 Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207-222.
14 Rasciute, S., Downward, P. (2010). Health or Happiness? What Is the Impact of Physical Activity on the Individual? Kyklos 63 (2), 256–270.
15 Sabatini, F. (2011). The relationship between happiness and health: evidence from Italy. MPRA: Munich Personal RePEc Archive, 1-23.
16 Barry, M.M. (2009). Addressing the determinants of positive mental health: concepts, evidence and practice International Journal of Mental Health Promotion, 11(3), 4-17.
17 Jorm, A. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67, 231-243.
18 Griffiths, K. M., Christensen, H., & Jorm, A. F. (2009). Mental health literacy as a function of remoteness of residence: An Australian national study. BMC Public Health, 9, 1–20.
19 Bazyk, S., & Arbesman, M. (2013). Occupational Therapy’s Practice Guidelines for Mental Health Promotion, Prevention, & Intervention. Bethesda, MD: AOTA Press.
20 Gable, S. L., & Haidt, J. (2005). What (and why) is positive psychology? Review of General Psychology, 9, 103-110.
21 Seligman, M. E. P. (2002). Authentic happiness. New York: Free Press.
22 Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5-14.