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The Status of Mental Health Promotion


Mental health is a state of wellbeing in which a person can use his or her own abilities and cope with the normal stresses of life. Mental health has a central place in global public health and public health in all countries. Poor mental health is associated with social inequality and social disconnection. Good mental health contributes to human, social and economic development. There are strong interconnections between mental and physical health and behaviour. Concepts closely related to mental health include wellbeing, a broader concept, and resilience. Resilience is a dynamic concept referring to a person’s ability to maintain or regain health after exposure to adversity. Mental health and resilience both depend on interactions between personal characteristics and social factors such as safety and access to education and work.

Health promoting actions support people to adopt healthy ways of life and create living conditions and environments conducive to health. Improving the mental health of a population requires a comprehensive approach to promoting mental health alongside prevention and treatment of mental ill health. Actions that promote mental health and prevent mental illnesses may overlap.

The field of mental health promotion is evolving rapidly. Several countries are introducing evidence-based and cross-government policies and programs to promote wellbeing. Evidence is emerging on the cost-effectiveness of a number of these interventions; in parenting, schools, workplaces, older age, and other social support domains. Experience is growing on the development of partnerships and implementation in countries, the links between mental health and human rights, and the need for mental health promotion in low-income countries and in disaster situations and other emergencies. Continuing innovation, adaptation and evaluation of programs is now required, especially in low-income countries, to integrate mental health promotion in the public health agenda of countries worldwide.


  1. 1.

    World Health Organization. WHO MIND — Mental Health in development. WHO. Available from URL: (Accessed 15 July 2012).

    Google Scholar 

  2. 2.

    Samarasekera U. Jim Kim takes the helm at the World Bank. Lancet. 2012; 380:15–7.

    Article  PubMed  Google Scholar 

  3. 3.

    Wilkinson R, Pickett K. The Spirit Level: Why More Equal Societies Almost Always do Better. London: Allen Lane/Pengiin; 2009.

    Google Scholar 

  4. 4.

    Sachs JD. Health in the developing world: achieving the Millennium Development Goals. Bull World Health Organ. 2004;82:947–9; discussion 50-2.

    PubMed  Google Scholar 

  5. 5.

    Sachs JD, McArthur JW. The Millennium Project: a plan for meeting the Millennium Development Goals. Lancet. 2005;365:347–53.

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Miranda JJ, Patel V. Achieving the Millennium Development Goals: does mental health play a role? PLoS Med. 2005;2:e291.

    Article  Google Scholar 

  7. 7.

    Desjarlais R, Eisenberg L, Good B, Kleinman A. World Mental Health: Problems and Priorities in Low-Income Countries. New York, NY: Oxford University Press; 1995.

    Google Scholar 

  8. 8.

    Prince M, Patel V, Saxena S, Mario Maj, Maselko J, Phillips M, et al. No health without mental health: a slogan with substance. The Lancet Series on Global Mental Health. Lancet. 2007.

    Google Scholar 

  9. 9.

    Ludwig J, Duncan GJ, Gennetian LA, Katz LF, Kessler RC, et al. Neighborhood effects on the long-term well-being of low-income adults. Science. 2012;337: 1505–10.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    World Health Organization. Mental health and development: targeting people with mental health conditions as a vulnerable group. Geneva: WHO; 2010.

    Google Scholar 

  11. 11.

    Petersen I, Bhana A, Flisher AJ, Swartz L, Richter L, (editors). Promoting Mental Health in Scarce-Resource Contexts: Emerging Evidence and Practice. South Africa: HSRC Press; 2010.

    Google Scholar 

  12. 12.

    Vaillant GE. Positive mental health: is there a cross-cultural definition? World Psychiatry. 2012;11:93–9.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Fisher M, Baum F. The social determinants of mental health: implications for research and health promotion. Aust N Z J Psychiatry. 2010;44:1057–63.

    Article  PubMed  Google Scholar 

  14. 14.

    Sartorius N. Universal strategies for the prevention of mental illness and the promotion of mental health. In: Jenkins R, Ustun TB, (editors). Preventing Mental Illness: Mental Health Promotion in Primary Care. Chichester: John Wiley & Sons; 1998. p.61–7.

    Google Scholar 

  15. 15.

    Kleinman A. Global mental health: a failure of humanity. Lancet. 2009;374: 603–4.

    Article  PubMed  Google Scholar 

  16. 16.

    Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005.

    Google Scholar 

  17. 17.

    Barry M, Jenkins R. Implementing Mental Health Promotion: Churchill Livingstone Elsevier; 2007.

    Google Scholar 

  18. 18.

    Friedli L. Mental health, resilience and inequalities. Copenhagen: World Health Organization Europe; 2009.

    Google Scholar 

  19. 19.

    Kellam SG. Developing and maintaining partnerships as the foundation of implementation and implementation science: reflections over a half century. Adm Policy Ment Health. 2012;39:317–20.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    World Health Organization. Mental health: strengthening mental health promotion. Fact Sheet 220. WHO; 2007.

    Google Scholar 

  21. 21.

    Sturgeon S, Orley J. Concepts of mental health across the world. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005. p.50–69.

    Google Scholar 

  22. 22.

    Anderson P, Cooper C, Layard R, Litchfield P, Jane-Llopis E. Well-being and global success: a report prepared by the World Economic Forum Global Agenda Council on Health & Well-being. Geneva: World Economic Forum; 2012.

    Google Scholar 

  23. 23.

    New Economics Foundation. Well-being evidence for policy: A review. London: NEF; 2012.

    Google Scholar 

  24. 24.

    Organization for Economic Co-operation and Development. Better Life Initiative: measuring well-being and progress. OECD. Available from UEL:,3746,en_2649_201185_47837376_1_1_1_1,00.html (Accessed 15 july 2012).

    Google Scholar 

  25. 25.

    United Nations. The world we want. Political Declaration Rio+20 Summit. UN; 2012.

    Google Scholar 

  26. 26.

    Holtz TH, Holmes SM, Stonington S, Eisenberg L. Health is still social: contemporary examples in the age of the genome. PLoS Med. 2006;3:e419.

    Article  Google Scholar 

  27. 27.

    Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet. 2011;378:1502–14.

    Article  PubMed  Google Scholar 

  28. 28.

    Patel V, Kleinman A. Poverty and common mental disorders in developing countries. Bull World Health Organ. 2003;81:609–15.

    PubMed  PubMed Central  Google Scholar 

  29. 29.

    Jane-Llopis E, Anderson P, Stewart-Brown S, Weare K, Wahlbeck K, et al. Reducing the silent burden of impaired mental health. J Health Commun. 2011;16 Suppl 2:59–74.

    Article  PubMed  Google Scholar 

  30. 30.

    Rogers A, Pilgrim D. Mental Health and Inequality. Basingstoke: Palgrave Macmillan; 2003.

    Google Scholar 

  31. 31.

    Rutz l W. Social psychiatry and public mental health: present situation and future objectives. Time for rethinking and renaissance? Acta Psychiatr Scand Suppl. 2006;429:95–100.

    Article  Google Scholar 

  32. 32.

    Commision on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the CSDH. Geneva: World Health Organization; 2008.

    Google Scholar 

  33. 33.

    Fisher J, Herrman H. Gender, social policy and implications for promoting women’s mental health. In: Chandra P, Herrman H, Fisher J, Kastrup M, Niaz U, et al., (editors). Contemporary Topics in Women’s Mental Health. Chichester: Wiley-Blackwell; 2009. p.499–506.

    Chapter  Google Scholar 

  34. 34.

    Patel V, Swartz L, Cohen A. The evidence for mental health promotion in developing countries. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005. p.189–202.

    Google Scholar 

  35. 35.

    World Health Organization. Mental health: new understanding, new Hope. The World Health Report. Geneva: WHO; 2001.

    Google Scholar 

  36. 36.

    Sartorius N. Stigma and mental health. Lancet. 2007;370:810–1.

    Article  PubMed  Google Scholar 

  37. 37.

    Stuart H. Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions. World Psychiatry. 2008;7:185–8.

    Article  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Henderson C, Thornicroft G. Stigma and discrimination in mental illness: time to change. Lancet. 2009;373:1928–30.

    Article  PubMed  Google Scholar 

  39. 39.

    Rutter M. Implications of resilience concepts for scientific understanding. Ann N Y Acad Sci. 2006;1094:1–12.

    Article  PubMed  Google Scholar 

  40. 40.

    Herrman H, Stewart DE, Diaz-Granados N, Berger EL, Jackson B, Yuen T. What is resilience? Can J Psychiatry. 2011;56:258–65.

    Article  PubMed  Google Scholar 

  41. 41.

    Cicchetti D. Resilience under conditions of extreme stress: a multilevel perspective. World Psychiatry. 2010;9:145–54.

    Article  PubMed  PubMed Central  Google Scholar 

  42. 42.

    Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA. 2009;301:2252–9.

    CAS  Article  PubMed  Google Scholar 

  43. 43.

    Gunnar MR, Fisher PA. Bringing basic research on early experience and stress neurobiology to bear on preventive interventions for neglected and maltreated children. Dev Psychopathol. 2006;18:651–77.

    Article  PubMed  Google Scholar 

  44. 44.

    Anderson P, Harrison O, Cooper C, Jané-Llopis E. Incentives for health. J Health Commun. 2011;16:107–33.

    Article  PubMed  Google Scholar 

  45. 45.

    Herrman H, Moodie R, Saxena S. Mental health promotion. In: Heggenhougen K, Stella Q, (editors). International Encyclopedia of Public Health. San Diego: Academic Press; 2008. p.406–18.

    Chapter  Google Scholar 

  46. 46.

    Mittelmark MB, Puska P, O’Byrne D, Tang KC. Health promotion: a sketch of the landscape. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization. p.18–34.

  47. 47.

    Lahtinen E, Joubert N, Raeburn J, Jenkins R. Strategies for promoting the mental health of populations. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005. p.226–42.

    Google Scholar 

  48. 48.

    Patel V, Flisher AJ, Nikapota A, Malhotra S. Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry. 2008;49:313–34.

    Article  PubMed  Google Scholar 

  49. 49.

    Jolly R. Early childhood development: the global challenge. Lancet. 2007;369: 8–9.

    Article  PubMed  Google Scholar 

  50. 50.

    Stewart-Brown SL, Schrader-McMillan A. Parenting for mental health: what does the evidence say we need to do? Report of Workpackage 2 of the DataPrev project. Health Promot Int. 2011;26 Suppl 1:i10–28.

    Article  Google Scholar 

  51. 51.

    Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012;8:CD003517.

  52. 52.

    Konner M. The Evolution of Childhood. Cambridge, MA: Harvard University Press; 2010.

    Google Scholar 

  53. 53.

    Richards M, Hardy R, Wadsworth ME. Long-term effects of breast-feeding in a national birth cohort: educational attainment and midlife cognitive function. Public Health Nutr. 2002;5:631–5.

    Article  PubMed  Google Scholar 

  54. 54.

    Read J, Bentall RP. Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications. Br J Psychiatry. 2012;200:89–91.

    Article  PubMed  Google Scholar 

  55. 55.

    Young and Well Cooperative Reseach Centre. Available from URL: (Accessed 16 July 2012).

  56. 56.

    Burns J, Morey C, Lagelee A, Mackenzie A, Nicholas J. Reach Out! Innovation in service delivery. Med J Aust. 2007;187:S31–4.

    Google Scholar 

  57. 57.

    Friedli L, Parsonage M. Mental Health Promotion: Building an Economic Case: Northern Ireland Association for Mental Health (NIAMH); 2007.

    Google Scholar 

  58. 58.

    Knapp M, McDaid D, (editors). Mental health promotion and mental illness prevention: the economic case. London: Personal Social Services Research Unit, London School of Economics and Political Science; 2011.

    Google Scholar 

  59. 59.

    Aos S, Lieb R, Mayfield J, Miller M, Pennucci A. Benefits and costs of prevention and early intervention programs for youth. Olympia, WA: Institute for Public Policy; 2004. Available from URL: (Accessed 7 December 2012).

    Google Scholar 

  60. 60.

    HM Government. No health without mental health: a cross-government mental health outcomes strategy for people of all ages. Supporting Document — The economic case for improving efficiency and quality in mental health. London: Department of Health, UK; 2011.

    Google Scholar 

  61. 61.

    Beddington J, Cooper CL, Field J, Goswami U, Huppert FA, et al. The mental wealth of nations. Nature. 2008;455:1057–60.

    CAS  Article  PubMed  Google Scholar 

  62. 62.

    Saxena S, Jane-Llopis E, Hosman C. Prevention of mental and behavioural disorders: implications for policy and practice. World Psychiatry. 2006;5:5–14.

    PubMed  PubMed Central  Google Scholar 

  63. 63.

    Jané-Llopis E, Katschnig H, McDaid D, Wahlbeck K. Evidence in decision making for mental health. Health Promot Int. 2011;26:140–6.

    Article  Google Scholar 

  64. 64.

    Walker L, Verins I, Moodie R, Webster K. Responding to the social and economic determinants of mental health: a conceptual framework for action. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice Geneva: World Health Organization; 2005. p.89–105.

    Google Scholar 

  65. 65.

    Eckenrode J, Campa M, Luckey DW, Henderson CR, Jr., Cole R, et al. Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial. Arch Pediatr Adolesc Med. 2010;164:9–15.

    Article  PubMed  Google Scholar 

  66. 66.

    Donelan-McCall N, Eckenrode J, Olds DL. Home visiting for the prevention of child maltreatment: lessons learned during the past 20 years. Pediatr Clin North Am. 2009;56:389–403.

    Article  PubMed  Google Scholar 

  67. 67.

    Zubrick SR, Kovess-Masfety V. Indicators of mental health. Geneva: WHO. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005. p.148–68.

    Google Scholar 

  68. 68.

    Wiseman J, McLeod J, Zubrick SR. Promoting mental health and well-being: integrating individual, organisational and community-level indicators. Health Promot J Austr. 2007;18:198–207.

    PubMed  Google Scholar 

  69. 69.

    Hawe P, Riley T. Developing sustainable programs: theory and practice. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World health Organization; 2005. p.252–63.

    Google Scholar 

  70. 70.

    Rowling L, Taylor A. Intersectoral approaches to promoting mental health. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005. p.264–83.

    Google Scholar 

  71. 71.

    Swartz L. Contextual issues. In: Petersen I, Bhana A, Flisher AJ, Swartz L, Richter L, (editors). Promoting Mental Health in Scarce-Resource Contexts: Emerging Evidence and Practice. South Africa: HRCS Press; 2010. p.49–59.

    Google Scholar 

  72. 72.

    Drew N, Funk M, Pathare S, Swartz L. Mental health and human rights. In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization; 2005.

    Google Scholar 

  73. 73.

    Inter-Agency Standing Committee. IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings Geneva: IASC; 2007.

    Google Scholar 

  74. 74.

    Herrman H. Promoting mental health and resilience after a disaster. J Exp Clin Med. 2012;4:82–7.

    Article  Google Scholar 

  75. 75.

    van Ommeren M, Saxena S, Saraceno B. Aid after disasters. BMJ. 2005;330: 1160–1.

    Article  PubMed  PubMed Central  Google Scholar 

  76. 76.

    Silove D, Bryant R. Rapid assessments of mental health needs after disasters. JAMA. 2006;296:576–8.

    CAS  Article  PubMed  Google Scholar 

  77. 77.

    Tol WA, Patel V, Tomlinson M, Baingana F, Galappatti A, et al. Research priorities for mental health and psychosocial support in humanitarian settings. PLoS Med. 2011;8:e1001096.

  78. 78.

    Herrman H, Swartz L. Promotion of mental health in poorly resourced countries. Lancet. 2007;370:1195–7.

    Article  PubMed  Google Scholar 

  79. 79.

    Saxena S, Herrman H, Moodie R, Saraceno B. Conclusions: the way forward In: Herrman H, Saxena S, Moodie R, (editors). Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health O; 2005.

    Google Scholar 

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Correspondence to Helen Herrman MD.

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Herrman, H., Jané-Llopis, E. The Status of Mental Health Promotion. Public Health Rev 34, 6 (2012).

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Key Words

  • Mental health promotion
  • wellbeing
  • resilience
  • psychosocial programs
  • prevention
  • human rights