Mental health was once defined as the psychological state that exists in the absence of mental illness. Contemporary social scientific thought, however, has abandoned the view that mental health and mental illness are antithetical to one another. Now, lack of mental illness no longer simply implies the presence of mental health, just as lack of mental health no longer suggests the presence of mental illness. Thus, the term mental health refers to a social psychological state greater than the mere absence of mental illness. Moreover, some scholars suggest that mental health can be present in individuals diagnosed with mental illness, a position that lends greater support to the view that mental health and mental illness ought not to be treated as oppositional categories.
Social scientists believe that mental health exists on a continuum, with optimal mental health occupying one pole of the continuum, poor mental health occupying the other. According to this model, an individual’s location on the continuum is subject to change over time and is influenced by some combination of social, psychological, and biological factors. In advocating this model, many practitioners of social work, sociology, and psychology reject definitions of mental health that posit it as a discrete state of being. The continuous model of mental health, however, is at times inconsistent with the definitions articulated within the medical community.
In the field of diagnostic psychiatry, in particular, many experts understand mental health as existing in a dichotomous relationship with mental illness. According to this view, the relationship between mental illness and mental health is not fluid, but discrete—one finds oneself in possession of either one or the other. The dichotomization of the concepts of mental health and mental illness occurs through the application of standardized diagnostic criteria intended to positively identify the presence of mental illness. In this sense, by demarcating cut-off points, mental health becomes bounded from mental illness and, perhaps as an unintended consequence, regarded as falling outside the purview of the research programs of psychiatry.
A systematic study of mental health has yet to emerge within the social sciences. However, even if a movement were to form around the concept, mental health most likely would continue to elude precise definition. Two interrelated factors contribute to the inherent vagueness of the term. First, the concept as such represents a subjective state of being, varying across individuals and groups. Second, the realization of mental health rests upon culturally and temporally specific definitions of what exactly constitutes normal emotions and behaviors. In other words, the meaning attached to interpretations of mental health, and indeed to the very definition of the term normal, is necessarily rooted in cultural value judgments. As a result, even well-intended efforts to develop a universal definition of mental health are unlikely to meet with success.
Despite these issues, efforts to lend definitional clarity to the term have been made. The psychologist and philosopher Williams James, for instance, understood mental health as the achievement of happiness, a state of being largely informed by the possession of a positive outlook on life. Abraham Maslow foregrounded the concept of self-actualization in his understanding of mental well-being, arguing that once individuals meet their basic needs they may ascend to a state of self-actualization—or a state in which one is capable of making the most of his or her unique abilities. Existential psychologists have suggested that mental health rests upon discovery of the meaning of life. Positive psychologists have emphasized the relationship between human happiness and the presence of an optimistic outlook on life. In conceptualizing human happiness, positive psychology underscores a number of virtues and strengths, including wisdom and knowledge, courage, humanity, justice, temperance, and transcendence. Access to these characteristics influences one’s capacity to achieve happiness, which in turn affects his or her level of mental health.
Contemporary social scientific research uses the concept of mental health to represent a broad inventory of positive attributes. The relationship between mental health and each implicated attribute is open-ended in the sense that the attribute is treated as a continuous variable (i.e., measured on a scale), and the presence of each attribute within an individual is subject to change over time. In other words, the relationship between these attributes, mental health, and the individual is not fixed. Within the social scientific community, a general consensus exists that mental health involves the presence of five general attributes, all of which correspond to an individual’s ability to capably function in society. Included among the list of attributes are (a) living up to one’s intellectual and emotional potential; (b) the ability to forge and maintain healthy and satisfying relationships; (c) the ability to cope with normal levels of stress; (d) a sense of self-efficacy; and (e) the ability to adapt to unfamiliar situations and environments. Sometimes a sixth attribute—perceiving things the way they are, or “being in touch with reality”—is added to this list. Each of these components is subject to normative assessment and therefore requires sensitivity to cultural differences. For instance, although healthy and satisfying relationships in many cultures may serve as a central determinant of mental health, what exactly constitutes “healthy and satisfying relationships” is subject to extensive intercultural variation.
According to sociologists, the structural effects of social support and social integration influence the relative presence of these attributes. Research exploring the relationship between these social variables and mental well-being dates back to Émile Durkheim’s study of suicide. In contrasting the rates of suicide among single men and members of the Protestant faith to those of married couples and Catholics, Durkheim concluded that—among married individuals and members of the Catholic faith—more intense social relationships function to create a sense of meaning and purpose in life. On a broader level, by imposing moral regulations on behavior, well-integrated communities reduce the occurrence of anomie.
In exploring the relationship between mental health and stressful life events, more recent research cites social support and social integration as avenues through which stress is mediated. The presence of external sources of support—particularly in the form of an intimate relationship with a partner, or strong relations with extended family, friends, and other members of the local community—moderates the effect of stress by improving one’s sense of security, self-efficacy, sense of belonging, and self-esteem. Such attributes improve individuals’ ability to cope with personal and social stressors and thereby enable them to achieve greater levels of mental health. Moreover, symbolic interactionists suggest that support networks contribute to the development of a strong sense of self, as identity evolves in part through interaction with others. Residing in well-integrated communities and neighborhoods furthermore functions to affirm residents’ sense of identity and worth, as individuals act as both the benefactors and recipients of activities intended to maintain the general well-being of the community. In comparison, sociologists argue that poorly integrated communities increase the likelihood that residents will suffer from low self-esteem, a weak sense of self-efficacy, and general feelings of pessimism, all of which are potential contributors to poor mental health.
With respect to the relationship between social support mechanisms and stress, experts note that strong social support networks improve individuals’ access to material resources, such as money, transportation, a place to live, and child care. Access to such material resources reduces exposure to stress while simultaneously improving one’s capacity to cope successfully with stressful life events. Social support mechanisms prove to be of particular importance to members of lower socioeconomic classes and minority groups who, on balance, experience greater levels of discrimination, neighborhood crime, unemployment, and poor physical health. In such cases, access to a strong social support network will greatly influence mental health.
The growing emphasis on issues related to mental health has led to the implementation of mental health promotion programs in local communities, through which support structures are developed in order to increase social inclusion and cohesion. Mental health programs also function at the individual level, largely through programs intended to improve self-esteem and coping skills in the workplace and in personal relationships.
Anomie; Cultural Values; Social Networks; Stressors
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