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Promoting positive mental health: Theoretical frameworks for practice
Abstract
ABSTRACT
This paper reviews current conceptual frameworks for mental health promotion practice, covering both models of promoting positive mental health and those addressing the prevention of mental disorders.
The theoretical perspectives underpinning these frameworks are considered and key constructs and approaches are identified.
The risk reduction and competence enhancement approaches to promoting mental health are compared in terms of supporting research and sample programmes.
The theoretical implications of current findings concerning the effectiveness of
prevention and mental health promotion programmes are critically examined .
Based on the evidence, a compelling case is made for focusing on programmes that enhance protective factors with the explicit goal of developing positive mental health and well-being rather than prevention or risk reduction.
The current frameworks are modified in order to represent a competence enhancement perspective which locates the promotion of positive mental health within the broader spectrum of mental health intervention activities.
... Overall, the adolescents expressed positive attitudes toward mental health apps, even though few had experience with using them. A large proportion perceived such apps as useful tools that can help them cope with normal stresses of life, which is important in order to promote well-being and prevent mental health problems [43,44]. In the quantitative section of the study, availability was the most chosen benefit of using mental health apps. ...
Background
Adolescence is a critical time in which many psychological disorders develop. Mental health promotion is important, especially during this period. In recent years, an increasing number of mobile apps geared toward mental health promotion and preventing mental illness have been developed specifically for adolescents, with the goal of strengthening their mental health and well-being.
Objective
This study aims to explore adolescents’ attitudes toward mental health apps, as well as the perceived usefulness of mental health apps.
Methods
In this mixed methods study, a total of 183 adolescents (mean age 15.62, SD 3.21 years) answered a cross-sectional questionnaire, with 10 questions (eg, “What do you think about mental health apps in general?”). To complement the quantitative findings, individual interviews were conducted with 9 adolescents, during which they could elaborate on their opinions about mental health apps.
Results
A total of 30% (56/183) of the adolescents in the quantitative study had used a mental health app. Over half of the respondents (77/126, 61.1%) reported that they would use a mental health app if they had a mental health problem as well as that they thought mental health apps were somewhat or very useful (114/183, 62.3%). Availability was the most frequently reported advantage of mental health apps (107/183, 58.8%). Possible associated costs of mental health apps were the most frequently mentioned barrier to their use (87/183, 47.5%). Findings from the interviews also pointed to the importance of the availability of mental health apps as well as their credibility and potential to provide adolescents with autonomy when seeking mental health advice and help.
Conclusions
Overall, the results indicate that adolescents have a positive attitude toward and an interest in mental health apps. However, adolescents are also more or less unaware of such apps, which might be one reason why they are often not used. The findings of this study have important implications for future research on mental health apps and for developers of mental health apps that target young people. The insights gained from this study can inform the development of more effective mental health apps that better meet the needs and preferences of adolescents.
... Interventions that encourage trusting, sustainable and enrichening relationships between caregivers and children in their early years have shown to reduce drug use, child maltreatment and childhood aggression (WHO, 2009). Such family skills programmes combine knowledge transfer on parenting, in addition to skill building and further enhancing competencies, as well as providing reciprocal support (Barry, 2001). These primary prevention programmes have been recognised and recommended as evidence-based multioutcome programmes through a number of guidance documents and interinstitutional collaborations such as the UNODC WHO International Standards on Drug Use Prevention (UNODC & WHO., 2018), the INSPIRE initiative to end violence against children (WHO & Cdc, 2016), the Violence Prevention Alliance (Wessels et al., 2013;WHO, 2009) and the Helping Adolescents Thrive initiative (WHO & Unicef., 2021). ...
Strong Families is a programme developed for families living in challenged or stressful settings to prevent poor mental health and developmental outcomes, violence, and substance use. Facilitators are conventionally trained in person over two full days, by experienced international trainers. During the COVID-19 pandemic and due to travel restrictions, we developed an online course to deliver the content of the training manual electronically, with videos explaining the most difficult exercises, note taking functions and click and reveal activities to check their understanding. We further blended synchronous and asynchronous course formats to accommodate facilitators’ different time zones and work schedules. We tied two educational theories (Malcom Knowles theory of andragogy and Blooms taxonomy) into the Strong Families online course, to ensure learners are easily able to understand content, remember it and implement the gained skills within their communities. The aim of this paper is to discuss the process of the development of the Learning Management System and the Strong Families online course, as well as its benefits, key tools and essential considerations for replication through the UNODC multi-country and inter-disciplinary experience in digitalizing the Strong Family skills prevention tool to support other institutions interested in such a process, including in anticipation of future similar circumstances. To date, our online course has been made available in 10 languages, benefitting facilitators from 11 countries and the respective beneficiary families. Further impact evaluation, fidelity of implementation during national scale up and return on investment of integration of blended-learning concepts still need to be assessed.
... Family skills programmes provide a range of parenting knowledge, skill building, competency enhancement and support [17]. They aim to strengthen family protective factors such as communication, trust, problem-solving skills and conflict resolution, and strengthen the bonding and attachment between caregivers and children. ...
Background
Family is one of the most influential social institutions and caregivers act as the main protective factors for children’s mental health and resilience skills. Family skills programmes support caregivers to be better parents and strengthen positive age-specific and age-appropriate family functioning and interactions. We developed a universal, brief and light programme for implementation in low-resource settings, the Family UNited (FU) programme, and conducted a pilot study to show feasibility of implementation, replicability and effectiveness in improving family functioning, child behaviour and resilience.
Methods
We recruited caregivers with children aged 8–14 years through schools in East Java, Indonesia and Dhaka, Bangladesh to the FU programme. Demographic data, emotional and behavioural difficulties of children, child resilience and parental skills and family adjustment measures were collected from children and caregivers before, 2 and 6 weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire), PAFAS (Parenting and Family Adjustment Scales) and CYRM-R (Child and Youth Resilience Measure).
Results
We enrolled 29 families in Bangladesh and allocated 37 families to the intervention and 33 to the control group in Indonesia. Overall, there was no effect over time in the control group on any of the PAFAS subscales, whereas significant reductions in scores were found on six of the seven subscales in either country in the intervention group, most prominently in caregivers with higher scores at baseline. We found highly significant reductions in total SDQ scores in the intervention group in both countries, whereas there was no effect over time in the control group in Indonesia. Boys in the intervention group in Indonesia and in Bangladesh seemed to have benefitted significantly on the SDQ as well as the total resilience scale. Overall, on the CYRM-R, particularly children below the 33rd percentile at pre-test benefitted substantially from the programme.
Conclusions
The implementation of a brief family skills programme was seemingly effective and feasible in resource-limited settings and positively improved child mental health, resilience and parenting practices and family adjustment skills. These results suggest the value of such a programme and call for further validation through other methods of impact assessment and outcome evaluation.
Trial registration: Clinical Trial Registration: ISRCTN99645405, retrospectively registered, 22 September, 2022.
... Family Skills Training offers a combination of parenting knowledge, skill building, competency enhancement, and support [1]. Family skills packages have been designed to reduce current family relationship problems and prevent future difficulties through training, support, or education [2]. ...
Homes in which families are experiencing stressful and challenging circumstances can foster a social space that engenders violent behaviours in parents, inadequate childcare, and the exposure of children to criminal and antisocial behaviours at an early age in addition to many other negative social and health consequences throughout their development. Family Skills Training offers a combination of parenting knowledge, skill building, competency enhancement, and support to strengthen family protective factors, such as communication, trust, problem-solving skills, and conflict resolution. Through over a decade-long experience piloting evidence-based family skills packages globally, we developed a universal open-source family skills package, “Family UNited” (FU), designed for families with children aged 8 to 15 years living in low- and middle-income countries (LMIC). The current study aims to explore the efficacy, fidelity, and acceptability of FU in Trentino and Parma, Italy. We plan to conduct a multi-site, non-blinded, two-armed, cluster-randomised controlled trial to assess efficacy in 160 families: the intervention group receiving FU and the waitlist/control group only receiving FU after the completion of all data collection points. We will prospectively collect outcome data, assessing changes in parenting skills and family adjustment in caregivers, children’s behaviour, resilience capacities, and attitudes towards peer violence. To assess programme delivery, fidelity, feasibility, and acceptability we will include an embedded process evaluation. This study aims to evaluate the improvement in parenting skills, child well-being, and family mental health after participation in FU, compared to no intervention. Even though this trial is to be conducted in a high-income country, such results complement the existing piloting experience in LMIC. with impact-related measures encouraging the adoption of such approaches globally and beyond the EU borders.
... Furthermore, most studies were not informed by a health promotion or mental health framework, theory, or model. Evidence suggests that mental health promotion should move toward theory-based research to facilitate theory-informed interventions [66]. Additionally, most included studies did not report on whether their data collection instruments were pretested, which introduced concerns regarding the validity and reliability of these instruments. ...
There have been increased calls to address the growing mental health concerns of post-secondary students in Canada. Health promotion focuses on prevention and is needed as part of a comprehensive approach to student mental health support, with an emphasis on not just the individual but also the sociocultural environment of postsecondary institutions. The aim was to conduct a scoping review of the literature pertaining to the associations between postsecondary institutional factors and student wellbeing. The review included a comprehensive search strategy, relevance screening and confirmation, and data charting. Overall, 33 relevant studies were identified. Major findings provide evidence that institutional attitudes, institutional (in)action, perceived campus safety, and campus climate are associated with mental wellbeing, suggesting that campus wide interventions can benefit from continued monitoring and targeting these measures among student populations. Due to the large variability in reporting and measurement of outcomes , the development of standardized measures for measuring institutional-level factors are needed. Furthermore, institutional participation and scaling up established population-level assessments in Canada that can help systematically collect, evaluate, and compare findings across institutions and detect changes in relevant mental health outcomes through time.
... This has caused a rise in parenting and family skills interventions for humanitarian and low resource contexts (29). Family skills interventions offer a combination of parenting knowledge, skill building, competency enhancement and support (30). They aim to strengthen family protective factors such as communication, trust, problem-solving skills and conflict resolution, and strengthen the bonding and attachment between caregivers and children. ...
Religious beliefs and practices are fundamental to shaping family functioning in many countries and cultures around the world. They are often associated with a strong influence on parenting, and a potential resource for parents. While nurturing caregiving can act as a protective shield, buffering against the negative effects on children’s well-being, armed conflict and displacement often compromises parental well-being and positive parenting practices. Making interventions available to families affected by conflict and displacement that help to develop the quality of parenting is now seen as an important component in the care of war-affected children, causing a rise in family skills interventions for humanitarian contexts. Accordingly, there are certain considerations that need to be taken to achieve cultural sensitivity and acceptability, that account for the influence of religion. Here we share our United Nations Office on Drugs and Crime (UNODC) experience in the case of implementing “Strong Families,” a UNODC family skills programme implemented in over 30 countries, providing key recommendations. (1) Appreciate and account for common religious beliefs and practices in your target populations; (2) ensure programme material acceptability and sensitivity; (3) avoid initiation of direct discussions, on religious beliefs or practices; and (4) facilitator need to be trained and prepared to respond to questions about faith. Though these considerations are presented considering the implementation of family skills programmes, they are also relevant to a range of other programming in which direct social (or other) contact is made with families in challenged contexts, aiming to reduce any perceived gaps between trainers and the families they are working with, and give families a sense that their religious beliefs, values, and priorities are understood.
Epidemiological studies suggest that psychiatric disorders are as prevalent among high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sports organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sports performance ethos with a discourse on mental health. This narrative cornerstone review examines challenges related to definitions and classifications of athlete mental health in high-performance sports and how these influence assessments and the implementation of interventions. We discuss challenges with concept creep and psychiatrisation and outline their consequences for sports healthcare professionals. Based on this, we present a framework that aligns different categories of athlete mental health conditions (from the reduction of wellbeing to psychiatric disorders) with intervention types (from the provision of supporting environments to pharmacotherapy). We conclude that researchers and sports practitioners need to carefully consider conceptual creep and the risk of pathologising normal and healthy, albeit emotionally aversive, reactions to athlete lifeworld events when assessing athlete mental health. A clear separation of terminology denoting the athlete's resources to handle the lifeworld (including salutogenic factors) and terms describing psychiatric conditions and their management is necessary to avoid misguidance in intervention planning.
Around 20% of the world's adolescents have mental health problem (Vranda, 2015) and half of these start during adolescence (Kessler et al., 2005). School-based intervention programmes possess a great potential in reducing the risk factors and increasing the protective factors to promote mental health and well-being of children and adolescents (Vranda, 2015; Shoshani & Steinmetz, 2013). The present study aims to examine the effectiveness of positive psychology interventions on mental health and emotion regulation of at risk adolescents. 65 students were identified as at-risk by administering SDQ (students form) from a sample of 147 class 8th students. Other tools used were Mental Health Continuum-Short Form (Keyes et al., 2009) and Difficulties in Emotion Regulation Scale (Victor, & Klonsky, 2016). Positive Psychology Interventions (PPIs) (12 sessions) related to gratitude, hope and mindfulness were given for about three months. Findings are discussed in terms of implications for positive psychology interventions as a sustainable mental health promotional tool in the school context.
The perinatal period is crucial in women’s lives in their way toward
motherhood. Pregnant women and new mothers are at higher risk
for experiencing mental health issues due to a variety of physiological, psychological, cognitive, and social changes. According to current studies among pregnant women and new mothers, anxiety and depression are on the rise, especially in resource-constrained countries. Poor mental well-being during pregnancy is a significant public health issue and the greatest unaddressed health problem in the reproductive health arena. It leads to a range of adverse outcomes for both mothers and children. Apart from short-term morbidity, maternal mental illness has a negative effect on family functioning as well as on infants’ cognitive, physical, social, and behavioral growth. However, maternal mental health problems can be prevented to a large extent, and well-being can be promoted. But in resource-constrained countries, research on preventive and promotion intervention specific to the perinatal period is minimal. The present narrative review poses an agenda to strengthen mental
health promotion in pregnant women in resource-constrained
nations. The review explores the relevant literature about the significance of maternal mental health promotion, the effectiveness of promotion and prevention strategies, barriers to sustainable mental health, and the way forward.
ResearchGate has not been able to resolve any references for this publication.