Toward a new definition of mental health

According to the World Health Organization ( WHO ), mental health is “ a state of wellbeing in which the individual realizes his or her own abilities, can cope with the convention stresses of life, can work productively and productively, and is able to make a contribution to his or her community ” ( 1 ). This definition, while representing a solid progress with deference to moving away from the conceptualization of mental health as a state of absence of mental illness, raises several concerns and lends itself to potential misunderstandings when it identifies positivist feelings and positive function as key factors for mental health. In fact, regarding wellbeing as a samara aspect of mental health is unmanageable to reconcile with the many challenge life situations in which wellbeing may even be unhealthy : most people would consider as mentally insalubrious an individual experiencing a submit of wellbeing while killing respective persons during a war action, and would regard as healthy a person feeling desperate after being fired from his/her job in a situation in which occupational opportunities are barely.

People in estimable genial health are frequently deplorable, ailing, angry or dysphoric, and this is separate of a amply live animation for a human being. In malice of this, mental health has been much conceptualized as a strictly positive feign, marked by feelings of happiness and feel of domination over the environment ( 2 – 4 ). Concepts used in several papers on genial health include both key aspects of the WHO definition, i.e. positive emotions and positive functioning. Keyes ( 5, 6 ) identifies three components of genial health : aroused wellbeing, psychological wellbeing and social wellbeing. aroused wellbeing includes happiness, interest in life sentence, and atonement ; psychological wellbeing includes liking most parts of one ‘s own personality, being well at managing the responsibilities of day by day animation, having adept relationships with others, and being satisfied with one ‘s own life ; social wellbeing refers to positive operation and involves having something to contribute to society ( social contribution ), feeling part of a community ( social consolidation ), believing that society is becoming a better stead for all people ( social realization ), and that the way club works makes sense to them ( social coherence ). however, such a position of mental health, influenced by hedonic and eudaimonic traditions, which champion plus emotions and excellence in functioning, respectively ( 7 ), risks excluding most adolescents, many of whom are slightly shy, those who fight against perceived injustice and inequalities or are discouraged from doing indeed after years of useless efforts, arsenic well as migrants and minorities experiencing rejection and discrimination. The concept of positive officiate is besides translated by several definitions and theories about mental health into the ability to work productively ( 1, 8 ), and may lead to the wrong termination that an individual at an age or in a physical stipulate preventing her/him from working productively is not by definition in good mental health. Working productively and productively is much not possible for contextual reasons ( for example, for migrants or for discriminate people ), which may prevent people from contributing to their community. Jahoda ( 9 ) subdivided mental health into three domains : self-fulfillment, in that individuals are able to in full exploit their electric potential ; sense of mastery over the environment ; and sense of autonomy, i.e. ability to identify, confront, and solve problems. Murphy ( 10 ) argued that these ideas were laden with cultural values considered significant by north Americans. however, even for a north american english person, it is hard to imagine, for model, that a mentally healthy human being in the hands of terrorists, under the menace of decapitation, can experience a sense of happiness and domination over the environment. The definition of genial health is clearly influenced by the culture that defines it. however, as besides advocated by Vaillant ( 11 ), common sense should prevail and sealed elements that have a universal importance for mental health might be identified. For exemplar, in hurt of cultural differences in eating habits, the recognition of the importance of vitamins and the four basic food groups is universal .

Toward a new definition of mental health

Aware of the fact that differences across countries in values, cultures and social backdrop may hinder the accomplishment of a cosmopolitan consensus on the concept of mental health, we aimed at elaborating an inclusive definition, avoiding a much as possible restrictive and culture-bound statements. The concept that mental health is not merely the absence of mental illness ( 1, 8 ) was unanimously endorsed, while the comparison between mental health and well-being/functioning was not, and a definition leaving room for a variety show of emotional states and for “ imperfect functioning ” was drafted. The proposed definition is reported hereby :

mental health is a moral force state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of company. Basic cognitive and social skills ; ability to recognize, express and modulate one ‘s own emotions, a well as sympathize with others ; tractability and ability to cope with adverse life events and function in sociable roles ; and harmonious relationship between body and mind represent significant components of mental health which contribute, to varying degrees, to the state of home equilibrium .

The addition of a note explaining what is meant in the definition by the formulation “ universal values ” is deemed necessary, in the light of the mislead function of this expression in certain political and social circumstances. The values we are referring to are : regard and care for oneself and early living beings ; recognition of connection between people ; obedience for the environment ; respect for one ‘s own and others ‘ freedom. The concept of “ dynamic state of home equilibrium ” is meant to reflect the fact that different life era ask changes in the achieve chemical equilibrium : adolescent crises, marriage, becoming a parent or retirement are good examples of life sentence era requiring an active search for a new genial chemical equilibrium. This concept besides incorporates and acknowledges the world that mentally healthy people may experience appropriate human emotions – including for example fear, wrath, sadness and grief – whilst at the same time possessing sufficient resilience to timeously restore the active country of internal equilibrium. All components proposed in the definition act significant but not mandatary aspects of genial health ; as a count of fact, they may contribute to a varying degree to the state of equilibrium, so that amply developed functions may offset an damage in another aspect of mental functioning. For case, a very empathic person, highly concern in common share, may compensate for a moderate degree of cognitive deterioration, and still find a satisfactory chemical equilibrium and pursue her/his life sentence goals. The main reasons underlying the choice of the components included in the definition are provided hereafter. basic cognitive and social skills are regarded as an crucial component of genial health in the light of their affect on all aspects of everyday animation ( 12 – 15 ). cognitive skills include the ability to pay attention, remember and organize information, resolve problems, and make decisions ; social skills involve the ability to use one ‘s own repertory of verbal/non-verbal abilities to communicate and interact with others. All these abilities are interdependent and allow people to function in their environment. address to the “ basic ” level of these abilities is meant to clarify that meek degrees of deterioration are compatible with mental health, while control to severe degrees of disability, specially if not balanced by other aspects, may require digest by other members of the society and a number of social incentives, such as facilitate occupation opportunities, fiscal benefits or ad hoc train programs. emotional regulation, i.e. the ability to recognize, express and modulate one ‘s own emotions, is besides regarded as an crucial component of mental health ( 16 ). It has been proposed as a mediator of try allowance ( 17, 18 ), and a connect between inappropriate or ineffective emotional rule and depressive disorder has been found in clinical and neuroimaging studies ( 19 – 22 ). A variety show of modulated emotional response options, that can be flexibly employed, contribute to an individual ‘s mental health, and alexithymia ( i.e., an inability to identify and express one ‘s own emotions ) is a hazard agent for mental and physical disorders ( 23, 24 ). Empathy, i, the ability to experience and understand what others feel without confusion between oneself and others, enables individuals to communicate and interact in effective ways and to predict actions, intentions, and feelings of others ( 25 ). The absence of empathy is not lone a hazard factor for violence and a feature of speech of antisocial personality disorderliness, but besides impairs sociable interactions at all levels. flexibility and ability to cope with adverse events are besides deemed crucial to mental health care. Flexibility refers to the ability to revise a course of military action in the side of unannounced difficulties or obstacles, change one ‘s own ideas in the unaccented of new evidence, and adapt to changes that different life era or contingent situations may require. Lack of flexibility may result in great distress for a person undergoing sudden and/or authoritative life changes, and is an authoritative aspect of respective psychiatric disorders, such as obsessional personality or delusional disorder ( 26 ). The basic ability to function in social roles and to participate in meaningful social interactions is an important aspect of mental health and peculiarly contributes to resilience against distress ; however, social exception and stigmatization much impair social participation, so any definition of mental health alluding to this aspect has to avoid “ blaming the victim ” and to carefully analyze social patterns of stigmatization, discrimination and exception that impair engagement ( 27 ). The inclusion body of a harmonious kinship between body and mind is based on the concept that beware, genius, organism and environment are heavily interconnected, and the overall experience of being in the earth can not be separated from the way in which one ‘s body feels in its environment ( 28 ). Disturbances of this interaction may result in psychotic experiences, eating disorders, self-harm, body dysmorphic disorder or poor physical health.

CONCLUSIONS

The definition of mental health drafted in this paper is aimed to overcome perspectives based on ideal norms or hedonic and eudaimonic theoretical traditions, in favor of an inclusive approach, vitamin a loose as possible of restrictive and culture-bound statements, and american samoa close as possible to human biography have, which is sometimes joyful, and at other times deplorable or disgusting or frightening ; sometimes satisfactory, and at other times challenging or unsatisfactory. The proposed definition is besides compatible with the recovery movement position, in which recovery after an illness is seen as a procedure aimed to attain a meet and valued life by building on the functions spared by the illness, in malice of the fact that other functions have been impaired ( 29 ) .

Acknowledgments

This wallpaper was drafted as separate of the activities of the Committee on Ethical Issues of the European Psychiatric Association .