Mental health explained

As a mental health professional, I am sometimes asked what mental health is. Well … mental disorders are clearly defined. You can look into one of the diagnostic systems, like DSM or ICD, and find precise diagnostic criteria for each of them.

But what about mental health? How do we diagnose that? This is our topic for today: What is mental health?

The WHO definition

Some time ago mental health was viewed as lack of a mental disorder. You were mentally healthy when you weren’t mentally ill. But this view has dramatically changed in this century.

According to the World Health Organization (2004) mental health is not merely a non-presence of a mental disorder, but it is a state of well-being, characterized by four specific conditions.

You can consider yourself a mentally healthy person, when you:

• (A) realize your own potential and abilities, 
• (B) can cope with the normal stresses of life, 
• (C) can work productively and fruitfully,
• (D) are able to make a contribution to your community.

This definition is apparently clear and precise, but it raises some important questions. So, let´s take a closer look at the criteria of mental health.

REALIZING OWN POTENTIAL AND ABILITIES (criterion A)

In order to realize our full potential and abilities, we must be given an opportunity to do that by others. You can never know what you’re able to, if you were never given a chance to discover it.

People who grow up being systematically discriminated, socially degraded or bullied tend to diminish their own abilities. So, they may believe that they are indeed realizing their full potential, even though it’s not true. As a matter of fact, they can do more and better if only given a chance.

According to our definition, they can’t be considered as mentally healthy although they themselves may not see that.

COPING WITH THE NORMAL STRESSES OF LIFE (criterion B)

The key word here is NORMAL. Normal stress of life is something that we can expect is going to happen to us, like being nervous when heading for a job interview or to a dentist. Yet, people often get mental help when they are distressed and disorganized by events that I would never call NORMAL.

Think about someone who is suddenly fired from job or bullied by the boss. Or someone who is evicted from their property. Or someone who has just discovered that their partner is cheating. And perhaps someone who has suddenly become physically disabled.

Are those stresses normal and expected life outcomes? Should we expect being degraded or bullied when we apply for a job? Should we expect being homeless when we apply for a loan? Or, perhaps, we should expect that our partners will sleep with everybody else when we marry them?

So, when you get distressed and disorganized by such setbacks, there’s nothing unhealthy about that. You respond normally to abnormal circumstances.

And if someone claims that anything that can be predicted is normal and you should cope with that stress, don’t buy into that. We all know that airplane crashes are possible and likely to happen in the future. But we do not expect them to happen during our flight. Otherwise, only the insane would board a plane.

When things go wrong in your life, you just need support, like every human being. You need treatment, when things go wrong in your mind.

WORKING PRODUCTIVELY AND FRUITFULLY (criterion C)

You can’t continue being productive when your life has suddenly been disrupted by a personal catastrophe, like a sudden death of someone you love. But your temporary loss of productiveness in such a situation doesn’t say anything about your mental health. Our attention and emotions are always mobilized around things that matter most to us at a given point of time – and there’s nothing unhealthy about that.

You can’t work productively and fruitfully either, when you don’t have a proper job. A proper job for anyone is the one that allows them to realize their full potential and that matches their abilities.

So, when you underdeliver because you are either overqualified or underqualified for the job you do, it says a lot about your employer and nothing about your mental health.

MAKING CONTRIBUTION TO YOUR COMMUNITY (criterion D)

You can make contributions to your community only when the community welcomes it and provides you with an opportunity. 

But when the community stigmatizes and marginalizes you, when you’re judged by double standards, when you are expected to be an underachiever – then pathology is located in your surroundings, not within you.

So, not meeting the contribution criterion may indicate either a mentally unhealthy person or a person living in an unhealthy social environment.

MENTAL HEALTH DEFINITION CALIBRATED

When we locate problems in a wrong place, for example inside individuals instead of their environment, our chances of finding solutions decrease dramatically. So, this is my proposal for a revised definition of mental health:

You can consider yourself a mentally healthy person, when you:

• (A) Realize your own potential and abilities – when offered the opportunity by your social environment,
• (B) Respond to stresses of life – in accordance with their severity and importance,
• (C) Are able to work productively and fruitfully – when having an appropriate job,
• (D) Are able to make a contribution to your community – when it is welcomed and appreciated.

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