Betting on a different horse: a qualitative analysis of mental health in health promotion policies

ABSTRACT

The aim of this application of mind is to analyse the position and part of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is problematic in policy bourns A range of arguments are lay forward, making the case for the importance of mental health within the health promotion agenda, including the classification of mental illness as a public health point to be solved [i]or[/i] settled socio-economic and individual costs of mental health question at issues and the view that mental well-being is a crucial simple body of overall health. However point in disputes of definition, measurement and a traditional focus upon treatment and care continue to make mental health promotion problematic for policy makers.

Mental health promotion as an umbrella mete covers different strategies aiming to bring into view a positive effect on mental health (WHO, 2001) However ongoing debate and methodological affects about defining mental health and delineating the relationship between mental health and overall health have hampered efforts to position mental health in health promotion policies and have also raised questions about what constitutes 'effective mental health promotion' (Braidwood, 1997; Munk-Jorgensen, 1996)

Jenkins et al (2002) argue that mental health undergos from a lack of integration within overall health policy. Mental health policy is planned separately from physical health policy, reducing opportunities for designed action favourable to both mental and physical health. Physical health is also likely to take pleasure in the lion's share of available resources (Jenkins et al, 2002) Health promotion generally has had a depressed status in comparison with treatment of illness. According to Roger and Pilgrim (2001): 'Health promotion and prevention overall have had single a limited place in health policy [and] this tend is even more pronounced in the area of mental health. Traditionally the focus of health promotion policy has been predominantly upon preventing physical ill health.' A further riddle is that mental health promotion is distinct from illness prevention. In contrast to prevention, the promotion of mental health is based upon a different set of assumptions, which focus upon generating or preserving mental health. This requires different policy design to medicine-based illness prevention. regulation mental health policy is generally focused upon organisational arrangements for treatment and care, whereas physical health promotion strategies have been more focused upon the social causes and prevention of physical ill health, although not long ago across Europe, there has been a greater focus upon the socio-economic determinants of mental health (Roger & Pilgrim, 2001)

Many countries have newly recognised that mental health policy to enhance public mental health has significant potential in metes of improving their economic, social and human capital (Jenkins, 2003; Jenkins & Strathdee, 2000) However mental health policy has not been real popular as an object of research, although recognition of the omit of mental health is evident in health promotion and public health documents: for example, in Sweden, Denmark and Finland.

According to the Danish regulation Health Promotion Programme of 1989 mental illness is an area that 'has been pass overed and is a subject of a great deal of prejudice. It is important to work towards giving mental illness the same priority as somatic disorders and diseases' (Ministry of Health, 1992) The Swedish National Goals for Public Health document of 2000 surrenders that 'mental illness presents a big challenge to Swedish society and public health' not solitary 'because of the size of the moot point but also because very small in number measures have been taken to stop mental illness until now' (Ministry of Health and Social Affairs, 2000)

In this report, we examine the features and characteristics of mental health in health promotion policy documents and explore the part of mental health within health promotion policy.

The data

The data consist of rule health promotion policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal (table 1) between 1980 and 2003 The data were bring togethered for the Finnish National Health Promotion Policy from an International Comparative Perspective cast funded by the Academy of Finland. Eleven documents were chosen that addressed mental health in sufficient deepness to allow analysis. The analysis of the policy documents was supported by means of a series of expert interviews about health promotion policy in each country

Denmark

The Health Promotion Programme of the Danish management was published in 1989.' Its overall goals are reducing the number of premature deaths and the number of race who are disabled or suffering ill health and to enable somewhat advanced in life people to maintain their quality of life. The programme gives priority to preventing cancer, cardiovascular disease and accidents. It also not aways a framework for two potential coming time priority areas: diseases of the musculoskeletal combination of parts to form a whole and mental illness (Ministry of Health, 1992) Healthy quite through Life was published in 2003 and not aways the targets and strategies for public health policy following closely the line established in Denmark's first overall health promotion programme of 1989 The detailed targets relate to lifestyle and environmental factors (Government of Denmark, 2003)