Mental illness and well-being: The central importance of positive psychology and recovery approaches

Health Service and Population Research Department (Box P029), Institute of Psychiatry, King's College London, Denmark Hill, London SE58AF, UK.
BMC Health Services Research (Impact Factor: 1.71). 01/2010; 10(1):26. DOI: 10.1186/1472-6963-10-26
Source: PubMed


A new evidence base is emerging, which focuses on well-being. This makes it possible for health services to orientate around promoting well-being as well as treating illness, and so to make a reality of the long-standing rhetoric that health is more than the absence of illness. The aim of this paper is to support the re-orientation of health services around promoting well-being. Mental health services are used as an example to illustrate the new knowledge skills which will be needed by health professionals.
New forms of evidence give a triangulated understanding about the promotion of well-being in mental health services. The academic discipline of positive psychology is developing evidence-based interventions to improve well-being. This complements the results emerging from synthesising narratives about recovery from mental illness, which provide ecologically valid insights into the processes by which people experiencing mental illness can develop a purposeful and meaningful life. The implications for health professionals are explored. In relation to working with individuals, more emphasis on the person's own goals and strengths will be needed, with integration of interventions which promote well-being into routine clinical practice. In addition, a more societally-focussed role for professionals is envisaged, in which a central part of the job is to influence local and national policies and practices that impact on well-being.
If health services are to give primacy to increasing well-being, rather than to treating illness, then health workers need new approaches to working with individuals. For mental health services, this will involve the incorporation of emerging knowledge from recovery and from positive psychology into education and training for all mental health professionals, and changes to some long-established working practices.

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    • "This focus on the positive elements of mental health and functioning is superseding a previous emphasis on deficits, problems and symptoms. This is evident within psychiatric research, mental health policy and clinical practice (Slade, 2010), where the concepts of recovery and the use of well-being measures are increasing (Warner, 2009). Within the broader context of public health and policy, the current focus on positive elements relates to an acknowledgment that promoting well-being and independence is essential to prevent ill health, which is of particular relevance in light of the growing burden of long-term conditions (Nolte & McKee, 2008). "
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    ABSTRACT: Background. There is growing awareness of the public health importance of mental well-being both in the general population and in specific groups. The well-being of health professionals is likely to influence the quality of the care they deliver. This study was carried out to examine the well-being of Pakistani healthcare professionals, and to evaluate the psychometric performance of the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) in this population. Methods. A cross-sectional survey was carried out from June, 2013 to December, 2014 among 1,271 Pakistani health care providers (HCPs) working in seven different cities in Punjab province, Pakistan, to examine the acceptability, internal consistency, test-retest reliability and content and construct validity of the English version of the WEMWBS in a Pakistani population sample. All data were analyzed in SPSS v. 21. Results. Our analysis demonstrated unidimensional construct validity, high internal consistency (0.89) and test-retest reliability, good validity and easy readability of WEMWBS in our sample of Pakistani HCPs. The mean WEMWBS score was 48.1 (SD 9.4), which is lower than in the general population in other countries. Male HCPs scored significantly higher on the WEMWBS than their female counterparts (P < 0.05), and older respondents had higher scores.
    PeerJ 10/2015; 3(1):e1264. DOI:10.7717/peerj.1264 · 2.11 Impact Factor
    • "Well-being research has not been widely integrated within traditional treatment protocols for people with more severe mental health problems (Slade, 2010), and so a further area that may benefit from modification is psychosis. The National Institute for Health and Care Excellence (NICE) guidelines for psychosis and schizophrenia in adults [CG178, published February 2014] recommends cognitive– behavioral therapy (CBT) and family therapy, and emphasizes the importance of carers, friends, and family for recovery. "
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    ABSTRACT: Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline that has developed somewhat separately from psychotherapy and focuses on amplifying well-being rather than ameliorating deficit. The processes targeted in PPT (e.g., strengths, forgiveness, gratitude, savoring) are not emphasized in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualized intervention, called WELLFOCUS PPT, which aims to improve well-being for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in 4 stages: qualitative study, expert consultation, manualization, and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualized group therapy. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Psychotherapy Theory Research Practice Training 05/2015; DOI:10.1037/pst0000013 · 3.01 Impact Factor
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    • "Policymakers of different countries have also started to promote the concept of mental well-being (Department of Health, 2009; Health Promotion Board, 2010; Mental Health Commission of Canada, 2009; European Union, 2011). A recent article (Slade, 2010) has even encouraged the promotion of well-being as a new focus of health services alongside treating illness. Thus, the findings of this study will be of interest to fellow researchers and policymakers. "
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    ABSTRACT: The association between stress and health has been well researched in the past; however, comparatively few mediators have been tested to understand the underlying mechanism. With increasing awareness on mental well-being, this study evaluated the relationship between perceived stress and perceived health and examined mental well-being as a mediator. Two-hundred undergraduates aged 21 to 26 years completed the English Perceived Stress Scale, Health Status Questionnaire and Asian Mental Well-Being Scale that assess perceived stress, perceived health and mental well-being, respectively. Factor analysis and structural equation modelling on the Perceived Stress Scale replicated the reported two-factor structure after excluding an insignificant item. Linear multiple regression analyses indicated that perceived stress was negatively associated with perceived health. Results showed that mental well-being partially mediated the relationship between perceived stress and perceived health, although it is acknowledged that this association could be bidirectional. Findings from the present study suggest that future research could focus on reducing stress and improving mental well-being to alleviate the effect of stress on health. Copyright © 2013 John Wiley & Sons, Ltd.
    Stress and Health 02/2015; 31(1). DOI:10.1002/smi.2510 · 1.81 Impact Factor
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