Alicia Nortje, Ph.D. 28-02-2022
Definition of mental health
The terms ‘mental wellbeing’ and ‘mental health’ are important concepts that are difficult to define.
The World Health Organization (2004) defines mental health in the following way:
- It is a state of wellbeing,
- in which the individual realizes their abilities,
- can cope with the normal stresses of life,
- can work productively and fruitfully, and
- can contribute to their community.
Other terms that might be used in the literature include positive mental health, mental capital, and wellbeing, which can be psychological, mental, or subjective (de Cates, Stranges, Blake, & Weich, 2015).
Challenges to the definition of mental health
There are some challenges to the definition of mental health and what it means to be mentally healthy (de Cates et al., 2015; Fusar-Poli et al., 2020).
Mental health is framed as part of a larger set of behaviors that result in a healthy, happy, and meaningful existence (World Health Organization, 2004). Together with physiological health, mental health is considered part of the broader concept of health. However, the determinants of physical health and psychological health are different.
Specifically, to be physically healthy typically implies the absence of illness (Fusar-Poli et al., 2020). The World Health Organization (2004) states that mental health is not limited to the absence of mental illnesses or diseases. For example, just because an MRI scan shows that there are no abscesses or tumors present, it doesn’t imply that someone is mentally healthy.
These two concepts – mental wellbeing and mental illness – are not dependent on each other (de Cates et al., 2015). This implies that patients can present with mental illness and also have high levels of mental wellbeing.
At one point, mental health was considered a collection of symptoms of positive feelings and positive functioning (Keyes, 2002). Keyes (2002) argued that mental health could be measured on a continuum: one end anchored with the presence of mental disorders, and the other, with mental wellbeing.
However, subsequent research now considers mental wellbeing as a separate concept from mental illness and mental distress (see the discussion in de Cates et al., 2015).
For example, patients may experience mental distress in response to stressful events. However, their distress can be considered a normal reaction and a healthy coping mechanism. An example of this is a patient who is grieving. Feelings of grief and possibly depression are normal responses to loss.
Definitions of mental health are also influenced by social, cultural, and historical variables (de Cates et al., 2015). Here are two examples:
- Cultures that value independence and autonomy may have different concepts of mental health compared to cultures that favor behavior that benefits the community.
- The understanding of mental health and the factors that affect it is influenced by time and societal changes. For example, burnout has been recognized as an occupational phenomenon that arises from poorly managed work stress.
However, ‘occupational stress’ didn’t exist as a psychological construct before the 40-hour workweek was introduced. In this instance, the concept of occupational stress came into existence when work hours became more structured, and the concept of an ‘occupation’ was born (Weber & Jaekel-Reinhard, 2000).