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Promoting mental health: recent progress and problems in Australia
  1. Division of Population Health, Central Sydney Area Health Service and Department of Public Health and Community Medicine, University of Sydney, Sydney, NSW, Australia
  1. Peter Sainsbury, Division of Population Health, CSAHS, Level 6, Queen Mary Building, Grose Street, Camperdown, NSW 2050, Australia

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In Australia, as elsewhere, the promotion of mental health has lagged far behind the promotion of physical health.1 For instance, despite the publication of a comprehensive review of the evidence for prevention and early intervention in mental illness in 1993,2 the Australian goals for better health published in 1994 saw improved mental health simply as a possible spin off of strategies to reduce the suicide rate and the effects of mental disorders.3 Also, a review of mental health activities across Australia in 1994 concluded that there was, ‘no identifiable “critical mass” of promotion and prevention work in mental health.’4 Despite this, some mental health promotion programmes have been undertaken by enthusiasts, for example promoting the physical health and enhancing the life skills and social participation of people with severe mental illness. The emphasis, however, has been on health promotion in the context of mental illness rather than mental health.

More recently a broader, better conceptualised notion of mental health promotion has begun to emerge in Australia; one that adopts the principles of public health and, while continuing to recognise the importance of preventing and mitigating the effects of mental illness, also emphasises promoting mental health (what is sometimes referred to as promoting positive mental health).

In 1997 in the state of New South Wales (NSW), the Health Department published a framework for identifying and developing mental health promotion initiatives.5 The framework cross tabulated four aspects of mental health promotion ((a) promoting positive mental health and the (b) primary prevention, (c) early recognition and intervention, and (d) treatment and rehabilitation of mental health problems and mental disorders) with the five actions for health promotion articulated in …

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  • Addendum Since writing this editorial there have been two further significant developments. Firstly, the Health Promotion Journal of Australia produced a special issue (September 1999) on mental health in Australia, which included articles describing and evaluating interventions designed to improve mental health. In addition, the editorial proposed a model that identified three major dimensions of mental health promotion (the influence of settings, the wider social determinants and personal coping skills), which recognises the importance of the interaction of the person and the environment and takes the debate about mental health beyond the traditional two dimensional clinical/promotive scale.14

    Secondly, in the state of Victoria the Health Promotion Foundation has produced a well researched, comprehensive mental health promotion plan.15 The plan's proposed areas of activity are based on a clear framework that incorporates the determinants of mental health, themes and settings for action, outcomes and benefits. The three priority themes for action, based on the perceived determinants of mental health, are social connectedness, freedom from discrimination and violence, and economic participation.