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Mental Health Essay

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Introduction

Mental health, often overshadowed by its physical counterpart, is an intricate and essential aspect of human existence. It envelops our emotions, psychological state, and social well-being, shaping our thoughts, behaviors, and interactions. With the complexities of modern life—constant connectivity, societal pressures, personal expectations, and the frenzied pace of technological advancements—mental well-being has become increasingly paramount. Historically, conversations around this topic have been hushed, shrouded in stigma and misunderstanding. However, as the curtains of misconception slowly lift, we find ourselves in an era where discussions about mental health are not only welcomed but are also seen as vital. Recognizing and addressing the nuances of our mental state is not merely about managing disorders; it's about understanding the essence of who we are, how we process the world around us, and how we navigate the myriad challenges thrown our way. This essay aims to delve deep into the realm of mental health, shedding light on its importance, the potential consequences of neglect, and the spectrum of mental disorders that many face in silence.

Importance of Mental Health

Mental health plays a pivotal role in determining how individuals think, feel, and act. It influences our decision-making processes, stress management techniques, interpersonal relationships, and even our physical health. A well-tuned mental state boosts productivity, creativity, and the intrinsic sense of self-worth, laying the groundwork for a fulfilling life.

Negative Impact of Mental Health

Neglecting mental health, on the other hand, can lead to severe consequences. Reduced productivity, strained relationships, substance abuse, physical health issues like heart diseases, and even reduced life expectancy are just some of the repercussions of poor mental health. It not only affects the individual in question but also has a ripple effect on their community, workplace, and family.

Mental Disorders: Types and Prevalence

Mental disorders are varied and can range from anxiety and mood disorders like depression and bipolar disorder to more severe conditions such as schizophrenia.

• Depression: Characterized by persistent sadness, lack of interest in activities, and fatigue.
• Anxiety Disorders: Encompass conditions like generalized anxiety disorder, panic attacks, and specific phobias.
• Schizophrenia: A complex disorder affecting a person's ability to think, feel, and behave clearly.

The prevalence of these disorders has been on the rise, underscoring the need for comprehensive mental health initiatives and awareness campaigns.

Understanding Mental Health and Its Importance

Mental health is not merely the absence of disorders but encompasses emotional, psychological, and social well-being. Recognizing the signs of deteriorating mental health, like prolonged sadness, extreme mood fluctuations, or social withdrawal, is crucial. Understanding stems from awareness and education. Societal stigmas surrounding mental health have often deterred individuals from seeking help. Breaking these barriers, fostering open conversations, and ensuring access to mental health care are imperative steps.

Conclusion: Mental Health

Mental health, undeniably, is as significant as physical health, if not more. In an era where the stressors are myriad, from societal pressures to personal challenges, mental resilience and well-being are essential. Investing time and resources into mental health initiatives, and more importantly, nurturing a society that understands, respects, and prioritizes mental health is the need of the hour.

• World Leaders: Several influential personalities, from celebrities to sports stars, have openly discussed their mental health challenges, shedding light on the universality of these issues and the importance of addressing them.
• Workplaces: Progressive organizations are now incorporating mental health programs, recognizing the tangible benefits of a mentally healthy workforce, from increased productivity to enhanced creativity.
• Educational Institutions: Schools and colleges, witnessing the effects of stress and other mental health issues on students, are increasingly integrating counseling services and mental health education in their curriculum.

In weaving through the intricate tapestry of mental health, it becomes evident that it's an area that requires collective attention, understanding, and action.

  Short Essay about Mental Health

Mental health, an integral facet of human well-being, shapes our emotions, decisions, and daily interactions. Just as one would care for a sprained ankle or a fever, our minds too require attention and nurture. In today's bustling world, mental well-being is often put on the back burner, overshadowed by the immediate demands of life. Yet, its impact is pervasive, influencing our productivity, relationships, and overall quality of life.

Sadly, mental health issues have long been stigmatized, seen as a sign of weakness or dismissed as mere mood swings. However, they are as real and significant as any physical ailment. From anxiety to depression, these disorders have touched countless lives, often in silence due to societal taboos.

But change is on the horizon. As awareness grows, conversations are shifting from hushed whispers to open discussions, fostering understanding and support. Institutions, workplaces, and communities are increasingly acknowledging the importance of mental health, implementing programs, and offering resources.

In conclusion, mental health is not a peripheral concern but a central one, crucial to our holistic well-being. It's high time we prioritize it, eliminating stigma and fostering an environment where everyone feels supported in their mental health journey.

Frequently Asked Questions

• What is the primary focus of a mental health essay?

Answer: The primary focus of a mental health essay is to delve into the intricacies of mental well-being, its significance in our daily lives, the various challenges people face, and the broader societal implications. It aims to shed light on both the psychological and emotional aspects of mental health, often emphasizing the importance of understanding, empathy, and proactive care.

• How can writing an essay on mental health help raise awareness about its importance?

Answer: Writing an essay on mental health can effectively articulate the nuances and complexities of the topic, making it more accessible to a wider audience. By presenting facts, personal anecdotes, and research, the essay can demystify misconceptions, highlight the prevalence of mental health issues, and underscore the need for destigmatizing discussions around it. An impactful essay can ignite conversations, inspire action, and contribute to a more informed and empathetic society.

• What are some common topics covered in a mental health essay?

Answer: Common topics in a mental health essay might include the definition and importance of mental health, the connection between mental and physical well-being, various mental disorders and their symptoms, societal stigmas and misconceptions, the impact of modern life on mental health, and the significance of therapy and counseling. It may also delve into personal experiences, case studies, and the broader societal implications of neglecting mental health.

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The Importance of Mental Health

Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.

Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities.

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Risk Factors for Poor Mental Health

Signs of mental health problems, benefits of good mental health, how to maintain mental health and well-being.

Your mental health is an important part of your well-being. This aspect of your welfare determines how you’re able to operate psychologically, emotionally, and socially among others.

Considering how much of a role your mental health plays in each aspect of your life, it's important to guard and improve psychological wellness using appropriate measures.

Because different circumstances can affect your mental health, we’ll be highlighting risk factors and signs that may indicate mental distress. But most importantly, we’ll dive into all of the benefits of having your mental health in its best shape.

Mental health is described as a state of well-being where a person is able to cope with the normal stresses of life. This state permits productive work output and allows for meaningful contributions to society.

However, different circumstances exist that may affect the ability to handle life’s curveballs. These factors may also disrupt daily activities, and the capacity to manage these changes. 

The following factors, listed below, may affect mental well-being and could increase the risk of developing psychological disorders .

Childhood Abuse

When a child is subjected to physical assault, sexual violence, emotional abuse, or neglect while growing up, it can lead to severe mental and emotional distress.

Abuse increases the risk of developing mental disorders like depression, anxiety, post-traumatic stress disorder, or personality disorders.

Children who have been abused may eventually deal with alcohol and substance use issues. But beyond mental health challenges, child abuse may also lead to medical complications such as diabetes, stroke, and other forms of heart disease.

The Environment

A strong contributor to mental well-being is the state of a person’s usual environment . Adverse environmental circumstances can cause negative effects on psychological wellness.

For instance, weather conditions may influence an increase in suicide cases. Likewise, experiencing natural disasters firsthand can increase the chances of developing PTSD. In certain cases, air pollution may produce negative effects on depression symptoms.  

In contrast, living in a positive social environment can provide protection against mental challenges.

Your biological makeup could determine the state of your well-being. A number of mental health disorders have been found to run in families and may be passed down to members.

These include conditions such as autism , attention deficit hyperactivity disorder , bipolar disorder , depression , and schizophrenia .

Your lifestyle can also impact your mental health. Smoking, a poor diet , alcohol consumption , substance use , and risky sexual behavior may cause psychological harm. These behaviors have been linked to depression.

When mental health is compromised, it isn’t always apparent to the individual or those around them. However, there are certain warning signs to look out for, that may signify negative changes for the well-being. These include:

• A switch in eating habits, whether over or undereating
• A noticeable reduction in energy levels
• Being more reclusive and shying away from others
• Feeling persistent despair
• Indulging in alcohol, tobacco, or other substances more than usual
• Experiencing unexplained confusion, anger, guilt, or worry
• Severe mood swings
• Picking fights with family and friends
• Hearing voices with no identifiable source
• Thinking of self-harm or causing harm to others
• Being unable to perform daily tasks with ease

Whether young or old, the importance of mental health for total well-being cannot be overstated. When psychological wellness is affected, it can cause negative behaviors that may not only affect personal health but can also compromise relationships with others. 

Below are some of the benefits of good mental health.

A Stronger Ability to Cope With Life’s Stressors

When mental and emotional states are at peak levels, the challenges of life can be easier to overcome.

Where alcohol/drugs, isolation, tantrums, or fighting may have been adopted to manage relationship disputes, financial woes, work challenges, and other life issues—a stable mental state can encourage healthier coping mechanisms.

A Positive Self-Image

Mental health greatly correlates with personal feelings about oneself. Overall mental wellness plays a part in your self-esteem . Confidence can often be a good indicator of a healthy mental state.

A person whose mental health is flourishing is more likely to focus on the good in themselves. They will hone in on these qualities, and will generally have ambitions that strive for a healthy, happy life.

Healthier Relationships

If your mental health is in good standing, you might be more capable of providing your friends and family with quality time , affection , and support. When you're not in emotional distress, it can be easier to show up and support the people you care about.

Better Productivity

Dealing with depression or other mental health disorders can impact your productivity levels. If you feel mentally strong , it's more likely that you will be able to work more efficiently and provide higher quality work.

Higher Quality of Life

When mental well-being thrives, your quality of life may improve. This can give room for greater participation in community building. For example, you may begin volunteering in soup kitchens, at food drives, shelters, etc.

You might also pick up new hobbies , and make new acquaintances , and travel to new cities.

Because mental health is so important to general wellness, it’s important that you take care of your mental health.

To keep mental health in shape, a few introductions to and changes to lifestyle practices may be required. These include:

• Taking up regular exercise
• Prioritizing rest and sleep on a daily basis
• Trying meditation
• Learning coping skills for life challenges
• Keeping in touch with loved ones
• Maintaining a positive outlook on life

Another proven way to improve and maintain mental well-being is through the guidance of a professional. Talk therapy can teach you healthier ways to interact with others and coping mechanisms to try during difficult times.

Therapy can also help you address some of your own negative behaviors and provide you with the tools to make some changes in your own life.

A Word From Verywell

Your mental health state can have a profound impact on all areas of your life. If you're finding it difficult to address mental health concerns on your own, don't hesitate to seek help from a licensed therapist .

World Health Organization. Mental Health: Strengthening our Response .

Lippard ETC, Nemeroff CB. The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders . Am J Psychiatry . 2020;177(1):20-36. doi:10.1176/appi.ajp.2019.19010020

 Helbich M. Mental Health and Environmental Exposures: An Editorial. Int J Environ Res Public Health . 2018;15(10):2207. Published 2018 Oct 10. doi:10.3390/ijerph15102207

Helbich M. Mental Health and Environmental Exposures: An Editorial. Int J Environ Res Public Health . 2018;15(10):2207. Published 2018 Oct 10. doi:10.3390/ijerph15102207

National Institutes of Health. Common Genetic Factors Found in 5 Mental Disorders .

Zaman R, Hankir A, Jemni M. Lifestyle Factors and Mental Health . Psychiatr Danub . 2019;31(Suppl 3):217-220.

Medline Plus. What Is mental health? .

National Alliance on Mental Health. Why Self-Esteem Is Important for Mental Health .

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• Mental Health Essay

Essay on Mental Health

According to WHO, there is no single 'official' definition of mental health. Mental health refers to a person's psychological, emotional, and social well-being; it influences what they feel and how they think, and behave. The state of cognitive and behavioural well-being is referred to as mental health. The term 'mental health' is also used to refer to the absence of mental disease. 

Mental health means keeping our minds healthy. Mankind generally is more focused on keeping their physical body healthy. People tend to ignore the state of their minds. Human superiority over other animals lies in his superior mind. Man has been able to control life due to his highly developed brain. So, it becomes very important for a man to keep both his body and mind fit and healthy. Both physical and mental health are equally important for better performance and results.

Importance of Mental Health 

An emotionally fit and stable person always feels vibrant and truly alive and can easily manage emotionally difficult situations. To be emotionally strong, one has to be physically fit too. Although mental health is a personal issue, what affects one person may or may not affect another; yet, several key elements lead to mental health issues.

Many emotional factors have a significant effect on our fitness level like depression, aggression, negative thinking, frustration, and fear, etc. A physically fit person is always in a good mood and can easily cope up with situations of distress and depression resulting in regular training contributing to a good physical fitness standard. 

Mental fitness implies a state of psychological well-being. It denotes having a positive sense of how we feel, think, and act, which improves one’s ability to enjoy life. It contributes to one’s inner ability to be self-determined. It is a proactive, positive term and forsakes negative thoughts that may come to mind. The term mental fitness is increasingly being used by psychologists, mental health practitioners, schools, organisations, and the general population to denote logical thinking, clear comprehension, and reasoning ability.

 Negative Impact of Mental Health

The way we physically fall sick, we can also fall sick mentally. Mental illness is the instability of one’s health, which includes changes in emotion, thinking, and behaviour. Mental illness can be caused due to stress or reaction to a certain incident. It could also arise due to genetic factors, biochemical imbalances, child abuse or trauma, social disadvantage, poor physical health condition, etc. Mental illness is curable. One can seek help from the experts in this particular area or can overcome this illness by positive thinking and changing their lifestyle.

Regular fitness exercises like morning walks, yoga, and meditation have proved to be great medicine for curing mental health. Besides this, it is imperative to have a good diet and enough sleep. A person needs 7 to 9 hours of sleep every night on average. When someone is tired yet still can't sleep, it's a symptom that their mental health is unstable. Overworking oneself can sometimes result in not just physical tiredness but also significant mental exhaustion. As a result, people get insomnia (the inability to fall asleep). Anxiety is another indicator. 

There are many symptoms of mental health issues that differ from person to person and among the different kinds of issues as well. For instance, panic attacks and racing thoughts are common side effects. As a result of this mental strain, a person may experience chest aches and breathing difficulties. Another sign of poor mental health is a lack of focus. It occurs when you have too much going on in your life at once, and you begin to make thoughtless mistakes, resulting in a loss of capacity to focus effectively. Another element is being on edge all of the time.

It's noticeable when you're quickly irritated by minor events or statements, become offended, and argue with your family, friends, or co-workers. It occurs as a result of a build-up of internal irritation. A sense of alienation from your loved ones might have a negative influence on your mental health. It makes you feel lonely and might even put you in a state of despair. You can prevent mental illness by taking care of yourself like calming your mind by listening to soft music, being more social, setting realistic goals for yourself, and taking care of your body. 

Surround yourself with individuals who understand your circumstances and respect you as the unique individual that you are. This practice will assist you in dealing with the sickness successfully.  Improve your mental health knowledge to receive the help you need to deal with the problem. To gain emotional support, connect with other people, family, and friends.  Always remember to be grateful in life.  Pursue a hobby or any other creative activity that you enjoy.

What does Experts say

Many health experts have stated that mental, social, and emotional health is an important part of overall fitness. Physical fitness is a combination of physical, emotional, and mental fitness. Emotional fitness has been recognized as the state in which the mind is capable of staying away from negative thoughts and can focus on creative and constructive tasks. 

He should not overreact to situations. He should not get upset or disturbed by setbacks, which are parts of life. Those who do so are not emotionally fit though they may be physically strong and healthy. There are no gyms to set this right but yoga, meditation, and reading books, which tell us how to be emotionally strong, help to acquire emotional fitness. 

Stress and depression can lead to a variety of serious health problems, including suicide in extreme situations. Being mentally healthy extends your life by allowing you to experience more joy and happiness. Mental health also improves our ability to think clearly and boosts our self-esteem. We may also connect spiritually with ourselves and serve as role models for others. We'd also be able to serve people without being a mental drain on them. 

Mental sickness is becoming a growing issue in the 21st century. Not everyone receives the help that they need. Even though mental illness is common these days and can affect anyone, there is still a stigma attached to it. People are still reluctant to accept the illness of mind because of this stigma. They feel shame to acknowledge it and seek help from the doctors. It's important to remember that "mental health" and "mental sickness" are not interchangeable.

Mental health and mental illness are inextricably linked. Individuals with good mental health can develop mental illness, while those with no mental disease can have poor mental health. Mental illness does not imply that someone is insane, and it is not anything to be embarrassed by. Our society's perception of mental disease or disorder must shift. Mental health cannot be separated from physical health. They both are equally important for a person. 

Our society needs to change its perception of mental illness or disorder. People have to remove the stigma attached to this illness and educate themselves about it. Only about 20% of adolescents and children with diagnosable mental health issues receive the therapy they need. 

According to research conducted on adults, mental illness affects 19% of the adult population. Nearly one in every five children and adolescents on the globe has a mental illness. Depression, which affects 246 million people worldwide, is one of the leading causes of disability. If  mental illness is not treated at the correct time then the consequences can be grave.

One of the essential roles of school and education is to protect boys’ and girls' mental health as teenagers are at a high risk of mental health issues. It can also impair the proper growth and development of various emotional and social skills in teenagers. Many factors can cause such problems in children. Feelings of inferiority and insecurity are the two key factors that have the greatest impact. As a result, they lose their independence and confidence, which can be avoided by encouraging the children to believe in themselves at all times. 

To make people more aware of mental health, 10th October is observed as World Mental Health. The object of this day is to spread awareness about mental health issues around the world and make all efforts in the support of mental health.

The mind is one of the most powerful organs in the body, regulating the functioning of all other organs. When our minds are unstable, they affect the whole functioning of our bodies. Being both physically and emotionally fit is the key to success in all aspects of life. People should be aware of the consequences of mental illness and must give utmost importance to keeping the mind healthy like the way the physical body is kept healthy. Mental and physical health cannot be separated from each other. And only when both are balanced can we call a person perfectly healthy and well. So, it is crucial for everyone to work towards achieving a balance between mental and physical wellbeing and get the necessary help when either of them falters.

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How to Write a Mental Health in College Students Essay

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Writing is a skill that takes time to build. Essays force you to practice research, critical thinking and communication skills – college is the perfect time for you to practice these. However, there’s only so much you can learn about writing through preparation. If you’ve been assigned an essay on mental health, you may not be sure where to begin. You might also wonder if you should choose mental health as a topic for a college paper. Here’s how to write a “mental health in college students” essay. 

• What Not to Do

If you’re trying to choose a topic for a college application essay, mental health is usually not the way to go. Your personal statement should show colleges why you’re the best candidate to attend their school. Because many students write about mental health , your essay may get lost in the crowd. In addition, your mental health journey is only a part of who you are. 

It can be difficult for many students to write about personal mental struggles without seeming overdramatic. Unless mental health struggles have shaped your whole life, it’s best to discuss other topics. If you mention mental health, stay brief and matter-of-fact. Don’t let it become the whole point of your essay. 

• Review the Instructions

If you’re writing this essay for a college course, start by looking over the assignment instructions. Don’t just listen to what your teacher says – look up the assignment on the syllabus to see if you can find a rubric or other relevant information. 

Highlight the important points to make sure you know what matters to your professor. The instructions are parameters you can operate in to create an essay you enjoy. Make sure you check word count, essay structure and review corrections on past essays. If you’re confused about something, don’t hesitate to ask your professor for clarification. 

• Do the Research 

Regardless of what class you’re writing for, this is the kind of topic that requires hard numbers. You don’t want to make general claims about rates of student anxiety or mental illness – to be credible, you need specifics. Be careful with your wording to avoid all-or-nothing statements. Everyone experiences mental health differently. 

Your professor may or may not allow you to pick the specific mental health topic you write about. However, you can ensure that your paper is well-researched and organized clearly. Before you start writing, create at least a basic outline showing the flow of ideas. This will make the writing phase much faster because you’ll always know what to say next. 

• Write It Out 

Writer’s block often stems from perfectionism. This paper won’t be perfect the first time, so don’t worry about writing it perfectly! Start with an interesting line that gets your reader’s attention and make sure you have a clear thesis statement. Taken by itself, this sentence should describe the contents of your entire paper. 

Build your paragraphs to the right word length by using specific examples. You should start each paragraph with a topic sentence that takes your reader one step in your paper’s argument. Then, describe a specific example that further explains this idea. You can find specific examples in your research or simply explain more about what you mean. 

• Edit Your Work

Editing is an important final step before you turn an essay in. It gives you an opportunity to look at your writing as a whole and ensure everything makes sense. If possible, you should set your first draft aside for a while before you reread it. This will help you see your work with fresh eyes so you can edit it. 

Editing involves strengthening your paper’s organization, rewriting specific sentences and checking for errors. You should make major edits first and then do a final read-through to catch punctuation and spelling mistakes. It can be helpful to read your paper out loud or have a friend look it over as well. 

One Key Takeaway for Writing a Mental Health in College Students Essay

Many students struggle with mental health while in school. Whatever topic you choose and however you organize your essay, make sure to write it with a sensitive tone. This topic is nuanced and shouldn’t be treated as a black-and-white issue. Write from an informed and compassionate point of view and offer your readers hope. 

Use this guide to write an essay on mental health in college students that astounds and delights your professor. Putting in the work will build research and communication skills you’ll use for years – whether you’re a psychology major, a premed student or studying the arts at school. 

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Should You Talk About Mental Health in College Essays?

This article was written based on the information and opinions presented by Shravya Kakulamarri in a CollegeVine livestream. You can watch the full livestream for more info.

What’s Covered:

What are you required to disclose in your application.

• Should You Include Mental Health History in Your Application?

How to Talk about Mental Health in College Applications

Taking care of your health in college.

Many students wonder if they should discuss mental health or disability in their college applications. Mental health history or a disability might be an integral part of who a student is, but that doesn’t necessarily make it relevant to a college application. Keep in mind that it is actually illegal for colleges to ask for these types of details about your life because it can be considered discrimination. So, colleges will never directly ask if you’ve had any sort of mental health issue or if you’ve ever had a disability. Based on this reason alone, you are not required to disclose mental or physical health concerns on your application. 

Disclosing your mental or physical health is strictly a matter of personal choice. If you leave out this information, it is not lying and 100% within your legal right to do so. 

Should You Include Mental Health History in Your Application? 

Before you choose whether to disclose your history of mental health or disability, you should think about the purpose of a college application. Everything that you put in your college application should contribute to an overall positive image of who you are as a student and member of the community. 

You usually don’t want to hide integral parts of who you are, but you also don’t want to be sharing challenges that are not going to strengthen your application. This is true not only for mental health or disabilities but also for academics, extracurriculars, and other experiences. Normally, students don’t bring up the time that they got a C or D in a class on their application. Everything that you include on your application should paint the most positive image of you possible. You always want to put your best foot forward and keep the focus on your strengths. 

You don’t want colleges to doubt your ability to succeed and perform well under pressure. If you mention any mental health concerns, they might use that as a way to question if you will do well at their school and be able to handle their rigorous course load. While colleges are supportive of their students’ mental health challenges and provide resources and services, you don’t want their first impression of you on your application to be something that makes them uncertain of your abilities. So, keep this in mind when deciding whether to disclose your mental health history. 

If you decide to include your mental health or disability history in your application , there are specific aspects of your experience that you should focus on. Rather than talking about the mental illness itself, focus more on the recovery and management aspects and what you have learned from the experience. 

Discuss things like how you have grown and the coping methods that you have cultivated due to the experience. These will give the admissions officer an idea of the types of strategies that you’ll likely use in college anytime that you encounter a stressful situation. 

Overall, if you choose to talk about mental health in your applications, focus on the learning and growth that you’ve gained because of it. 

Mental health is an important part of your well-being, and it’s essential to start good habits in high school . This way, you’ll be better prepared to cope when you face new challenges in college. You’ll likely be experiencing living on your own for the first time and have new responsibilities without the same support system that you had at home. It’s crucial to learn how to take care of your mental health early.

Fortunately, most students will have many resources at college to help them through mental health challenges. If you’re dealing with any mental health struggles, there is usually an office of wellness where you can schedule a time to see a therapist. This is usually provided with your school’s health insurance. If this is something that you are concerned about for your college experience, make sure to look into what mental health resources each college provides before applying. 

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Home — Essay Samples — Nursing & Health — Mental Health — Understanding Mental Health: Definition, Causes, and Impacts

Understanding Mental Health: Definition, Causes, and Impacts

• Categories: Mental Health

About this sample

Words: 638 |

Published: Jan 29, 2024

Words: 638 | Page: 1 | 4 min read

Table of contents

Definition and understanding of mental health, causes of mental health issues, common mental health disorders, impact of mental health on individuals, stigma surrounding mental health, effective ways to promote positive mental health.

• World Health Organization. (2014). Mental health: a state of well-being. Retrieved from https://www.who.int/features/factfiles/mental_health/en/
• National Institute of Mental Health. (n.d.). Mental Health Information. Retrieved from https://www.nimh.nih.gov/health/publications/mental-health-information/index.shtml

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Why is Mental Health Important?

(Note: This article discusses suicide and other serious issues pertaining to mental health.)

Whether through a minor bump in your journey or a full-blown crisis, you may have struggled with your mental health in some capacity in the last few years. Faced with a seemingly endless onslaught of bad news on top of life’s usual challenges, it can be difficult to prioritize yourself while pursuing educational and professional goals. Focusing on your mental health is perhaps the most powerful step you can take to improve your overall quality of life.

According to the National Institute of Mental Health (NIMH), 1 in 5 adults now lives with a moderate to severe mental health condition. The Centers for Disease Control and Prevention (CDC) further notes that over 50% of Americans will be diagnosed with mental illness in their lifetime. But what exactly is mental health, and why is it so important?

What is Mental Health?

“When in a state of good mental health, a person has a general positive outlook, can accomplish daily tasks, maintain relationships and engage in meaningful recreation,” said Dr. Darleen Dempster , a Southern New Hampshire University (SNHU) clinical faculty member in the clinical mental health counseling program . “This includes a sense of balance and empowerment to set boundaries and address life and work goals, step by step.”

In addition to the impact that mental health has on your day-to-day life, serious mental health issues can affect your relationships, career, education and long-term goals. As rates of mental illness increase worldwide, addressing your mental health challenges as they arise can change —or even save — your life.

Why is Mental Health Important for Students?

The World Heath Organization (WHO) reports a sharp rise in the number of people experiencing mental illness in recent years, with the COVID-19 pandemic exacerbating mental health problems throughout the world. For students, it is more important than ever to address your mental health issues to stay mentally healthy and keep up with your educational and personal goals.

Even before the pandemic, mental health was a prominent concern for students. In 2019, the National College Health Assessment (NCHA) noted that many students reported feeling exhausted, lonely and overwhelmed, among other symptoms and difficulties ( NCHA PDF Source ). Of the surveyed students, 20.2% reported experiencing depression and 27.8% reported experiencing anxiety that affected their studies in the preceding year.

“College can be a stressful time as you manage academic demands on top of other life demands,” Dempster said. “However, just as many students can learn to be successful academically, you can also learn to manage and improve mental health outcomes, including managing stress.”

Ways to Cope with Stress

Stress management can be a vital aspect of student success, especially for busy students who may also be working or caring for others. Dempster and the CDC recommend several methods to help manage stress:

• Adequate sleep
• Avoidance of alcohol and substance abuse
• Breaking down large tasks into smaller, more manageable tasks
• Cultivating healthy relationships
• Eating well
• Meditation, breathing exercises and other self-care activities

“At times, it is necessary also to set boundaries, to communicate needs, to be flexible to changing circumstances and to let go of perfectionistic standards,” Dempster said. “There should be no shame in seeking out mental health care as needed, just as one would not feel shame in seeking medical care for a persistent medical issue.”

Some colleges have free, real-time mental health services for students—for example, students at SNHU can access the school’s HelpU program. If you are a student struggling with mental health, look into what resources are available through your school.

How is Mental Health Connected to Physical Health?

The NIMH reports that some mental illnesses like depression and anxiety can cause physical symptoms that are otherwise unexplained. The CDC also reports that mental illness can increase the risk of diabetes, stroke and heart disease and has recognized that severe mental illness can increase the likelihood of a person becoming seriously ill after contracting COVID-19. At the same time, chronic physical health issues can also contribute to mental health issues.

“Factors like proper diet, sleep and exercise can positively impact our mental health. Conversely, lack of sleep, poor diet and lack of exercise can impede our ability to manage stress and life’s demands,” Dempster said. “Sometimes mental health symptoms can lead to somatic symptoms due to tension, worrisome thoughts or other reactions. Therefore, there is a circular loop between mental and physical symptoms.”

What Are Examples of Mental Health Problems?

Mental health problems can affect your life in various ways, depending upon the issue or disorder. The following are examples of different mental health problems and their corresponding challenges and symptoms.

Anxiety and Depression

Anxiety disorders are a leading mental health issue globally, and the NIMH approximates that almost 1 in 3 people will experience an anxiety disorder in their lifetime. Symptoms of anxiety can range from tenseness or nervousness to panic attacks and physical illness. Anxiety can refer to generalized anxiety disorder, social anxiety, separation anxiety, specific phobias and other anxiety-based disorders.

Depression is another common disorder with the capacity to severely impact a person’s life, according to NIMH. Symptoms typically include persistent sadness, emptiness, irritability, impaired motivation, guilt or feelings of low self-worth. People with depression also may have difficulties focusing, aches, pains, digestive issues or changes in their sleep and eating habits.

Some of the most serious symptoms of depression are suicidal thoughts and actions. Suicide is the 12th leading cause of death in the United States overall—yet it is the 2nd leading cause of death among individuals between the ages of 10-14 and 24-34 and the 3rd leading cause of death for Americans 15-24 years old, per the NIMH. The CDC reports that suicide rates rose 30% between 2000 and 2020.

Trauma and Addiction

The psychological impact of a traumatic event or experience can lead to post-traumatic stress disorder (PTSD). Symptoms of PTSD include flashbacks, unwanted memories, nightmares and panic attacks. Although the disorder is often associated with war veterans, a wide variety of traumatic experiences can lead to PTSD, like assault, abuse, serious accidents and loss.

Addiction is another mental health concern that has been on the rise in recent years, with drug overdose deaths having rapidly increased since the 1990s according to the CDC. Alcohol is the most abused substance, with 5.3% of deaths worldwide attributed to alcohol consumption, according to the National Institute on Alcohol Abuse and Alcoholism. Addiction is a complex disease that many are only able to overcome with professional help.

Other Disorders

Psychotic disorders are among the most stigmatized in our society, which only serves to further alienate people living with psychosis and seeking treatment, according to the National Alliance on Mental Illness (NAMI). Psychosis is defined as a disconnect from reality by way of auditory/visual hallucinations, disorganized thinking or delusions. Some psychotic disorders include schizophrenia and schizoaffective disorder . Despite misconceptions regarding psychosis and violence, the World Psychiatry Journal notes that experiencers of psychosis are far more likely to be victims of violence than perpetrators.

Other common psychiatric disorders include Obsessive Compulsive Disorder (OCD), eating disorders like anorexia and bulimia, personality disorders like borderline personality disorder, and mood disorders like bipolar disorder . Each mental health disorder has its own set of challenges—and its own set of treatments.

What Are Warning Signs and Risk Factors of Mental Illness?

Some mental illnesses may be hereditary, while others are developed. Dempster notes a variety of warning signs that signal mental health issues as well as additional risk factors that can lead to mental health problems.

Some warning signs of mental illness are:

• Appetite changes
• Disruption of sleep
• Engaging in risky behaviors (self-harm, sexual acting out, disordered eating or other compulsive behaviors)
• Mental distress (worrisome thoughts, tension, insecurity)
• Negative impacts on relationships (isolating, arguing, etc.)
• Substance abuse
• Suicidal thoughts

Other risk factors of mental illness include:

• Adverse childhood experiences
• Past or present trauma
• Present or past experiences of being abused or assaulted
• Sudden loss

If you are experiencing warning signs of mental illness, consider reaching out to a professional for help. If someone you know is struggling with any of these symptoms, Dempster recommends the “QPR” approach.

“A great way to help a loved one into care is to remember the acronym QPR, which stands for Question, Persuade, Refer,” Dempster said. “ Question : Directly ask the individual you are concerned about how they are doing, sharing your care and concern. Persuade: Talk to the person about the benefits of seeking out care with a mental health professional who can provide support and resources to address overwhelming thoughts and feelings. Refer: Support the individual in seeking out care by helping them to find available care, helping them to make an appointment or even taking them to the appointment.”

What Mental Health Treatments and Resources Are Available?

A variety of treatment options exist for different mental health issues. “There are times that some mental health problems can be treated by increasing self-care, accessing one’s support system and by careful problem-solving and communication,” Dempster said. “However, there are other times that professional mental health care, including therapy, medication or some other form of treatment offered by a professional can help to address mental health problems much more expediently through evidence-based methods.”

Many patients visit multiple mental health providers–for example, seeing a psychiatrist regarding medications and a therapist for more frequent counseling sessions. Consult the Mayo Clinic’s guide to finding a mental health provider , and reach out to your health insurance provider to find mental health services near you. You can also use Psychology Today’s expansive directory to help locate a provider in your area, and Findtreatment.gov offers a substance abuse treatment locator tool. For serious mental health concerns, The National Substance Abuse and Mental Health Services Administration (SAMHSA) has an early serious mental health treatment locator tool to find treatment centers in the United States.

“Historically, there has been a stigma with seeking mental health care that is not evident in seeking care for physical problems, and this stigma prolonged the suffering of many needlessly and has even cost lives,” Dempster said. “Seeking out care for mental health concerns is a sign of strength and there is robust evidence that demonstrates that mental health care is effective.”

If you or someone you know needs help now, consult these resources or contact a professional mental health provider. In the event of an emergency, please call 911.

• 988 Suicide and Crisis Lifeline : 988
• Substance Abuse and Mental Health Services Administration : 1-800-662-HELP (4357)
• National Action Alliance for Suicide Prevention
• Veterans Crisis Line
• National Strategy for Suicide Prevention

Mars Girolimon '21 is a writer and student at Southern New Hampshire University, pursuing a master's in English and creative writing. Connect with them on LinkedIn .

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Is it OK to discuss mental health in an essay?

Mental health struggles can create challenges you must overcome during your education and could be an opportunity for you to show how you’ve handled challenges and overcome obstacles. If you’re considering writing your essay for college admission on this topic, consider talking to your school counselor or with an English teacher on how to frame the essay.

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The Importance Of Mental Health

Mental health is important. It impacts how we feel, think, and behave each day. Our mental health also contributes to our decision making, problem solving, how we deal with stress, and how we can relate to others in our lives. That's why, we have to always care about our own mental health. It's for the sake of our social well-being. Our mental health plays an important part on a daily basis, promoting productivity in activities like work, school, etc. If you adapt easily to new environments, then it means both your mental and emotional are healthy. 

Have you ever felt down or sad? I bet you all have. And that's normal because it means you have feelings. Let me tell you something. It's ok to feel sad, down, or even upset. But, don't let those feelings inhibit your ability to grow and live. We have to look forward, always. Sometimes, looking back to the past is pretty good for learning something from it but you have to remember that life keeps moving. We can't just live in the circle of past. Our future depends on us. 

I can relate to everyone who feels that they're like losers or useless. To be real honest, I've felt it too. It sucks. I had to deal with that situation for months. But then, I started thinking how I could think like this? I realized that I shouldn't have thought this way. I have life and I'm not useless. I can be anything I want. Ever since then, I promised to myself that I will change the way I think. 

So guys, here are some ways that you could try to look after your mental health : 

1. Feel free to talk and share your feelings. Sharing what you feel can help you to stay in good mental health when you feel troubled. It also can be a good way to cope with a problem that you've been carrying around your head all this time. 

2. Keep In Touch. Catching up with someone you know well can help you maintain good mental health. You will not feel like you're all alone in dealing with all the problems that you have. But, if you feel that keeping in touch with some people can ruin your mental health well-being, it may be better for you to take a break from them. 

3. Stay positive. Focus on the good things in your life. Don't blame yourself if you make a mistake. Mistakes are also the part of our lives. We can't live without making mistakes. 

Actually, there's so much you can do in order to keep your mental health healthy. All you have to do is just ask yourself : "are you happy?" . If your answer is yes , then ok. If your answer is no , then take a look who you are surrounding yourself with. Maybe the people around you could be the factor of why are you unhappy because they might always underestimate you or call you names that you don't want to be called. So, I think that's what I can say. I hope our mental state will always be healthy ♥️. If you have problems, just remember that you're not alone. 

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About Mental Health

• Mental Health Basics
• Types of Mental Illness

What is mental health?

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. 1 Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Why is mental health important for overall health?

Mental and physical health are equally important components of overall health.  For example, depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes , heart disease , and stroke. Similarly, the presence of chronic conditions can increase the risk for mental illness. 2

Can your mental health change over time?

Yes, it’s important to remember that a person’s mental health can change over time, depending on many factors.  When the demands placed on a person exceed their resources and coping abilities, their mental health could be impacted. For example, if someone is working long hours, caring for a relative, or experiencing economic hardship, they may experience poor mental health.

How common are mental illnesses?

Mental illnesses are among the most common health conditions in the United States.

• More than 1 in 5 US adults live with a mental illness.
• Over 1 in 5 youth (ages 13-18) either currently or at some point during their life, have had a seriously debilitating mental illness. 5
• About 1 in 25 U.S. adults lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. 6

What causes mental illness?

There is no single cause for mental illness. A number of factors can contribute to risk for mental illness, such as

• Adverse Childhood Experiences , such as trauma or a history of abuse (for example, child abuse, sexual assault, witnessing violence, etc.)
• Experiences related to other ongoing (chronic) medical conditions, such as cancer or diabetes
• Biological factors or chemical imbalances in the brain
• Use of alcohol or drugs
• Having feelings of loneliness or isolation

People can experience different types of mental illnesses or disorders, and they can often occur at the same time. Mental illnesses can occur over a short period of time or be episodic. This means that the mental illness comes and goes with discrete beginnings and ends. Mental illness can also be ongoing or long-lasting.

There are more than 200 types of mental illness. Some of the main types of mental illness and disorders are listed here .

• Strengthening Mental Health Promotion . Fact sheet no. 220. Geneva, Switzerland: World Health Organization.
• Chronic Illness & Mental Health . Bethesda, MD: National Institutes of Health, National Institute of Mental Health. 2015.
• Kessler RC, Angermeyer M, Anthony JC, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry. 2007;6(3):168-176.
• Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality. Substance Abuse and Mental Health Services Administration. 2016.
• Merikangas KR, He J, Burstein M, et al. Lifetime Prevalence of Mental Disorders in US Adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49(10):980-989. doi:10.1016/j.jaac.2010.05.017.
• Health & Education Statistics . Bethesda, MD: National Institute of Mental Health. National Institutes of Health. 2016.
• Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R). Archives of general psychiatry. 2005;62(6):617-627. doi:10.1001/archpsyc.62.6.617.Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Rockville, MD.
• Rui P, Hing E, Okeyode T.  National Ambulatory Medical Care Survey: 2014 State and National Summary Tables. Atlanta, GA: National Center for Health Statistics. Centers for Disease Control and Prevention. 2014.
• Web-based Injury Statistics Query and Reporting System (WISQARS) . Atlanta, GA: National Center for Injury Prevention and Control. Centers for Disease Control and Prevention. 2015.
• Insel, T.R. Assessing the Economic Costs of Serious Mental Illness. Am J Psychiatry. 2008 Jun;165(6):663-5. doi: 10.1176/appi.ajp.2008.08030366.
• HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2009. Rockville, MD: Agency for Healthcare Research and Quality. 2009.
• Reeves, WC et al. CDC Report: Mental Illness Surveillance Among Adults in the United States. MMWR Morb Mortal Wkly Rep 2011;60(03);1-32.
• Parks, J., et al. Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: National Association of State Mental Health Program Directors Council. 2006.

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“Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society

The nature of mental illness has been the subject of passionate discussion throughout history. In ancient Greece Plato, 1 , 2 promoting a mentalist definition of mental illness, was the first to coin the term “mental health,” which was conceived as reason aided by temper and ruling over passion. At around the same time, Hippocrates, 3 taking a more physicalist approach, defined different mental conditions as a variety of imbalances between different kinds of “humours.” Griesinger 4 , 5 almost 2 centuries ago was the first to state that “mental illness is brain illness,” an expression that has provided a strong impetus to the more recent medical conception of mental illness. The substantial progress accomplished in genomics and brain imaging in the last few decades made biological psychiatry stronger than ever and contributed to the reification of mental disorders as illnesses of the brain. The almost exclusively biogenetic conceptual framework for understanding mental illness has acquired a hegemony that has influenced mental health practitioners while also influencing campaigns designed to improve public attitudes toward the mentally ill. As a result, the statement “mental illness is like any other illness” has become almost axiomatic and, therefore, by definition it embodies an accepted truth not in need of a proof.

This view of mental illness is presented for better acceptance of the mentally ill by the public and of treatment by those experiencing mental illness and is indeed based on accumulated, albeit limited, knowledge in the neurobiology of mental disorders. However, anything that reaches axiomatic proportions needs a serious examination. In this editorial we examine the reasons underlying this perspective, its consequences and the evidence to support or refute its continued justification. We then present a position that we believe best fits the current state of knowledge and is closest to clinical realities and public perceptions of mental illnesses.

What does the statement actually imply?

The statement that “mental illness is like any other medical illness” implies that mental illness has a biological basis just like other medical illnesses and should be treated in the public’s eye in a similar manner. The purpose of this article is not to present a philosophical or ideological argument in favour of or against a biological basis explaining mental illness, but rather to examine the clinical and public utility of presenting a dominant neurobiological model of mental illness to patients, their families and the public at large.

Illness, pathophysiology and the “self’’

To understand the justification of equating mental and medical disorders, a comparison often made between type 2 diabetes and mental disorders, especially schizophrenia, other psychoses and depression, is worth examining in some detail. Diabetes, although very complex, is understood as the result of dysfunctional glucose metabolism related to absolute or relative insufficiency of insulin signalling. This dysfunctional metabolism is the consequence of endogenous predispositions, such as hereditary diathesis, and environmental factors, including personal choices, such as poor diet and sedentary life style. Therefore, by improving glucose metabolism, either through medication, insulin replacement or changes in lifestyle, positive health outcomes can be expected. Diabetes is diagnosed by confirming high levels of fasting glucose and other related biochemical markers of glucose metabolism. Further, the cascade of its effects on other systems (e.g., cardiovascular, central nervous system) are, or could be, well explained on the basis of physiologic mechanisms. They can also be prevented/treated by better and early control of diabetes. All through this, however, the patient is aware of the nature of his or her problems, including personal choices, and diabetes generally does not affect his or her day-today thinking, behaviour or perception. Except for mental health complications due to neurologic illnesses (e.g., delirium in the context of severe metabolic complications, depression as a consequence of awareness of the life and death implication of the disorder, abnormal perceptions in the case of some neurologic conditions), it can be stated that somatic illnesses, such as diabetes do not usually alter the core self of a person substantially. More importantly, the model of attribution presented to the patient is congruent with the scientific “facts,” thereby making it easier for the person as well as society to accept the condition.

Mental disorders, on the other hand, affect the very core of one’s being through a range of experiences and phenomena of varying severity that alter the individual’s thinking, perception and consciousness about the self, others and the world. This is seen to an extreme degree with more serious mental disorders, such as psychoses and bipolar disorders, but to a lesser albeit significant degree with anxiety, mood, eating and other psychiatric disorders. Emotion, perception, thought and action are the essence of human identity and the concept of “self,” and these are the prime domains altered in mental disorders. The precise definition of what constitutes the self and whether the location of a state of self is a material reality in the brain, its form and the brain-related factors that influence it are deeply philosophical issues, 6 , 7 but not the subject of this editorial. Suffice it to say that factors involved in increasing the risk for mental disorders are endogenous (genetics is recognized as a major contributor to most mental disorders) as well as environmental, much like most medical disorders. Psychological deprivation and trauma, social defeat and isolation, poverty and poor family environment are but some of the environmental factors that have been reported to increase the risk for mental disorders. In addition to changes at the physiologic level, common to somatic and mental disorders the latter encompass changes in one’s definition of “self,” and are not situated outside the “self.” It can even be argued that in the absence of any substantiated biological marker for mental disorders (only 1 has been included in the recent DSM-5: orexin change in narcolepsy), 8 the hallmark defining features of mental disorders, at least for now, remain the changes in how the patients feel, think and act and how these changes affect their relation to themselves and to others.

As a first corollary of this definition, contrary to medical conditions where restoring dysfunctional physiologic mechanisms is the main target of therapeutic interventions, this is only 1 part of the therapeutic interventions for mental disorders. The primary focus of therapeutic interventions in mental disorders is helping the patient to feel better and interact more adaptively with his or her social and physical environments. Although there is little doubt that all medical conditions require psychological attention, mental health interventions focus primarily on achieving a positive change in feeling, self-esteem, mood, perceptions, thoughts and action — all changes in the “self” that are not primarily targeted in the treatment of medical conditions. Different models of psychological and social interventions are the main ingredients for these desired changes in the self.

A second corollary of this definition is the fact that mental health is very laden with values, not because scientific factors are lacking, but because values become of the utmost importance — more so than for medical disorders — when we deal with the self and its restoration. While somatic illnesses such as diabetes are primarily defined and shaped by biologically discernible facts, values do play a certain role but do not define the disorder. Societal and personal values are important in the treatment of most medical disorders, but acquire paramount importance in the case of mental disorders. Societal and cultural values even define variations in diagnoses over time and across geographic locations. Compulsory treatments, a particularity in the mental health field, are a strong testimony of how mental health can interfere with the self and how the personal values of the patient can clash with the societal values, thus necessitating legal, value-laden mitigation.

Neurobiology and experience of mental illness

Advances in neurosciences have surely given us much better biological mechanistic explanations of many of the uniquely human cognitive, emotional and conative functions, such as memory, thinking, perception, mood and action. This knowledge has informed us that many mental illnesses derive their vulnerability from underlying biological variations. However, we are far from being able to explain in neurobiological terms many of the behaviours and experiences that constitute the core presentations of mental disorders. Even if neurobiology one day were to provide better explanations of the workings of the brain, more elaborately explain the role of genes in increasing the risk for mental illness and the mechanisms behind complex human behaviour, one would still need to understand the experiences of patients with different forms of mental illness in psychological terms, as recently described by Kendler 9 so eloquently. By equating mental illness with any medical illness and, therefore, situating it in an organ within the human biology and not recognizing its unique nature in the way it affects the “self” cannot be justified on the basis of current state of knowledge nor may it serve our patients and society well, as we explain in the rest of this editorial.

Mental illness and the utility of explanatory models

Indeed, it is envisaged that putting mental illness on the same footing as medical illness, society will understand it better and not react negatively toward those with mental illnesses. It is hoped that as a result those with mental illness may face less social stigma — a major obstacle to people seeking and/or receiving help — and reducing stigma may help individuals regain eventual acceptance by society as productive members. Interestingly, the public’s explanatory models of mental illness do not follow this narrative and, on the contrary, the public have multiple models of explaining mental illness varying across cultures and times.

One needs to ask the pragmatic question of whether the strategy of using a biogenetic model of mental illness and equating it with medical illness has actually helped. There are 2 areas worthy of examination in this regard.

Explanatory models, stigma and society

The first is to examine the effect of the statement, “mental illness is like any other medical illness,” on social stigma toward people with mental illness. As indicated previously, implicit in the axiomatic statement is a primarily biological origin of the behaviour and suffering that characterize mental illness. Let us examine the evidence in this regard. In the last decade or 2, biogenetic attribution of all mental disorders, having acquired a hegemoneous status 10 has been used primarily to inform campaigns for reducing stigma and promoting better acceptance of mental illness and the people with mental illnesses by society. 11 , 12 Several well-conducted studies have concluded, almost uniformly, that this strategy has not only not worked, but also may have worsened public attitudes and behaviour toward those with mental illnesses. Investigations of stigma have shown that those who consider mental disorders as primarily attributable to biological forces, just like other medical disorders, while absolving the mentally ill person of responsibility for their behaviour and actions, tend to feel less optimistic about their ability to get better and function well, are less accepting of them and feel less positively toward them. 13 – 16 In a review of the literature related to the concept of mental illness being like any other illness, Read and colleagues 17 reported that biogenetic causal theories and diagnostic labelling as illness are both positively related to perceptions of dangerousness and unpredictability and to fear of and desire for social distance. The attitudes investigated in these studies are reflected in individuals’ responses to whether they would live next door to, socialize or make friends with or have a close relative get married to a person described as being mentally ill. There is also evidence to suggest that biogenetic explanatory models may have negative consequences for those with mental illness in terms of their implicit self concept and explicit attitudes, such as fear. 18 Further, campaigns to reduce stigma that encourage people to think about mental illness as simply another form of medical illness have produced results that show effects to the contrary. For example, a recent study showed that over a 10-year period of deliberate use of the biogenetic explanatory model for campaigning to reduce stigma has resulted in worsening of most, if not all, aspects of public attitudes toward individuals with mental illnesses. 19 , 20 The strength of these perhaps counterintuitive findings comes from the fact that these studies were adequately designed, well powered and, most importantly, replicated in several countries (e.g., United States, Britain, Germany) with very similar results. It is acknowledged that these relatively negative attitudes may be particularly stronger in relation to certain forms of mental illness (e.g., psychosis, manic depressive illness) and addictions.

Explanatory models of mental illness and the mentally ill person

Another domain — perhaps the most important — of examination is the individual with mental illness. In clinical practice, telling patients that their presenting mental illness is like any other medical illness may initially reassure some and assist them in accepting to take medication, especially during the distressing acute phases of a serious mental disorder. They or their families may welcome a simple explanation for encouraging them to accept treatment, which in many cases includes medication. While this strategy can achieve something very important in acute crisis-like situations, it may become problematic, if persistent over time, in getting individuals to accept other highly effective psychological and social treatments. These latter interventions are highly effective and considerably less noxious than often less effective medications for some forms of mental illness, such as mild to moderate depression, anxiety and eating disorders, and emotional dysregulation associated with several long-standing mental illnesses. Even in the most serious mental disorders, such as psychotic, bipolar and severe major depressive disorders, where medications are invariably an essential part of treatment, psychological and social therapeutic interventions are the essential bridge between pharmacological interventions during the acute crises and the need for their sustained use in the long term while at the same time achieving the essential goals of relief of internal distress, restoration of self and a return to productive social and working lives.

Furthermore, presenting mental illness as any other medical illness often implies a medical treatment (medication in most cases) as the dominant treatment strategy. Patients’ rejection of the treating clinician’s medical illness model is generally described as lack of insight and starts the cycle of nonadherence to medication, which then translates into nonadherence to treatment. In reality, if patients and families are allowed to articulate their attributional models, given credit for their “experiential knowledge” and encouraged to enter into a dialogue with the treating clinician, it is more likely there will be some consensus on acceptance of recommended treatment. This may prevent the cycle of disengagement and decline in the course that follows.

What needs to be done?

In clinical practice, if we are to take seriously the multidimensional goals of providing mental health services, as articulated by those seeking and receiving help for mental illness, clinicians have to work within an attributional model that makes sense to the person receiving service, that can be supported by sound argument and evidence and that provides a framework within which those receiving service and those providing it can share a common language. Such a framework will need to include the biogenetic model of attribution of mental illness as 1 of several parallel and equally authentic social, psychological, environmental and cultural models offered by service providers and researchers (acquired knowledge) as well as those who experience mental illness (experiential knowledge). There is a need to create a common language in order to come to an understanding of the person’s experience and to promote such an understanding among the public at large. Denying the special nature of mental illness is unlikely to achieve these important goals.

Some recent developments, such as the promotion of a recovery model 21 – 23 and the early intervention movement, 24 , 25 may hold more promise in improving both the quality of care and possibly involvement of and improvement in public attitudes. The former has emerged from experiential knowledge and advocacy from service users, supported later by sound qualitative research, whereas the latter has emerged from a combination of a shift in philosophy of delivery of care on the part of service providers, parallel generation of evidence of its effectiveness 26 , 27 and greater acceptance by service users and their families, who have now joined the movement as advocates. A third emerging movement, the concept of positive mental health, 28 , 29 may prove to be effective in combating the negative image of mental illness. This movement promotes and is based on human resilience and positive aspects of the experience of mental illness. There is a burgeoning literature emerging in this field, which may balance the rather deterministic, deficit oriented and largely pessimistic miasma created by using an exclusively biogenetic model to explain mental disorders.

Conclusion and recommendations

Simply seeking an axiom of “mental illness is like any other medical illness” is at best simplifying a complex human problem and at worst doing a major disservice to patients, their families and the mental health field. Our dialogue should incorporate the general complexity of human thinking, behaviour, memories and the idea of self and consciousness, including knowledge emerging from sophisticated biogenetic and social science research while attending to the specific complexities that each of us as human beings carry as part of our life stories. That is true for those receiving and those providing services.

We therefore argue that we should continue to have a social and a professional conversation where we find a proper place for neurobiology, social, cultural and environmental forces, personal histories and the uniqueness of each individual when trying to understand, explain and treat mental disorders while avoiding a simplistic reductionism that may be perceived at best as patronizing but ultimately harmful, even though the intentions may be noble. We propose that future antistigma campaigns should give up the axiom of “mental illness is like any other medical illness” and instead present the complex and multifaceted explanations of mental illness as unique along with the positive aspects as discussed here. These campaigns need to be informed not only by the acquired knowledge of service providers and scientists but equally by the experiential knowledge from service users and their families, taking into consideration new knowledge emerging from fields of recovery, early intervention and positive mental health. For clinicians, it would be equally important to embrace explanatory models of mental illness that are based on evidence in science and to include biogenetic, social and cultural models as well as those told to them by the very people they are trying to serve.

Editors’ note: The ideas expressed in this editorial are not necessarily those of the journal. Importantly, JPN continues to focus on publishing “papers at the intersection of psychiatry and neuroscience that advance our understanding of the neural mechanisms involved in the etiology and treatment of psychiatric disorders.”

Competing interests: See jpn.ca for R. Joober. None declared by A. Malla or A. Garcia.

Transforming the understanding and treatment of mental illnesses.

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Caring for Your Mental Health

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Mental health includes emotional, psychological, and social well-being. It is more than the absence of a mental illness—it’s essential to your overall health and quality of life. Self-care can play a role in maintaining your mental health and help support your treatment and recovery if you have a mental illness.

How can I take care of my mental health?

Self-care means taking the time to do things that help you live well and improve both your physical health and mental health. This can help you manage stress, lower your risk of illness, and increase your energy. Even small acts of self-care in your daily life can have a big impact.

Here are some self-care tips:

• Get regular exercise.  Just 30 minutes of walking every day can boost your mood and improve your health. Small amounts of exercise add up, so don’t be discouraged if you can’t do 30 minutes at one time.
• Eat healthy, regular meals and stay hydrated.  A balanced diet and plenty of water can improve your energy and focus throughout the day. Pay attention to your intake of caffeine and alcohol and how they affect your mood and well-being—for some, decreasing caffeine and alcohol consumption can be helpful.
• Make sleep a priority . Stick to a schedule, and make sure you’re getting enough sleep. Blue light from devices and screens can make it harder to fall asleep, so reduce blue light exposure from your phone or computer before bedtime.
• Try a relaxing activity.  Explore relaxation or wellness programs or apps, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy activities you enjoy, such as listening to music, reading, spending time in nature, and engaging in low-stress hobbies.
• Set goals and priorities.  Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to appreciate what you have accomplished at the end of the day.
• Practice gratitude.  Remind yourself daily of things you are grateful for. Be specific. Write them down or replay them in your mind.
• Focus on positivity . Identify and challenge your negative and unhelpful thoughts.
• Stay connected.  Reach out to friends or family members who can provide emotional support and practical help.

Self-care looks different for everyone, and it is important to find what you need and enjoy. It may take trial and error to discover what works best for you.

Learn more about  healthy practices for your mind and body  .

When should I seek professional help?

Seek professional help if you are experiencing severe or distressing symptoms that have lasted 2 weeks or more, such as:

• Difficulty sleeping
• Changes in appetite or unplanned weight changes
• Difficulty getting out of bed in the morning because of mood
• Difficulty concentrating
• Loss of interest in things you usually find enjoyable
• Inability to complete usual tasks and activities
• Feelings of irritability, frustration, or restlessness

How can I find help?

If you have concerns about your mental health, talk to a primary care provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find  tips for talking with a health care provider about your mental health.

You can learn more about getting help on the NIMH website. You can also learn about finding support  and locating mental health services  in your area on the Substance Abuse and Mental Health Services Administration website.

If you or someone you know is struggling or having thoughts of suicide, call or text the  988 Suicide & Crisis Lifeline   at 988 or chat at 988lifeline.org   . This service is confidential, free, and available 24 hours a day, 7 days a week. In life-threatening situations, call  911.

Suicide is preventable—learn about warning signs of suicide and action steps for helping someone in emotional distress.

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GREAT: Helpful Practices to Manage Stress and Anxiety:  Learn about helpful practices to manage stress and anxiety. GREAT was developed by Dr. Krystal Lewis, a licensed clinical psychologist at NIMH.

Getting to Know Your Brain: Dealing with Stress:  Test your knowledge about stress and the brain. Also learn how to create and use a “ stress catcher ” to practice strategies to deal with stress.

Guided Visualization: Dealing with Stress:  Learn how the brain handles stress and practice a guided visualization activity.

Mental Health Minute: Stress and Anxiety in Adolescents: Got 60 seconds? Take a mental health minute to learn about stress and anxiety in adolescents.

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• NIH Wellness Toolkits   : NIH provides toolkits with strategies for improving your  emotional health  and  social health  .
• MedlinePlus: How to Improve Mental Health   : MedlinePlus provides health information and tips for improving your mental health.
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• SAMHSA: How to Cope   : SAMHSA offers tips for taking care of your well-being and connecting with others for support.

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Mental Health Matters: Understanding the Vital Importance of Emotional Well-being

B eing mentally and emotionally healthy is essential to living a balanced life. Mental health influences how we think, feel, and act in our day-to-day lives, and it can also help determine how well we handle stress, relate to others, and make choices. 

While many factors contribute to overall mental health well-being—such as managing stress levels through exercise or using positive coping strategies—all of us need to gain a better understanding of what psychological wellness looks like so that we can take steps towards maintaining an optimal state of mental health both now and in the future. In this article, let’s explore the concept and importance of mental health in greater detail – from recognizing its critical components to discovering how establishing emotional resilience plays a vital role in leading a happy and successful life.

Defining Mental Health and Well-being

Mental health and well-being are essential components of a healthy and fulfilling life, and understanding them is crucial. Mental health encompasses a range of emotions, thoughts, and behaviors and refers to a person’s overall psychological well-being. Similarly, well-being refers to a person’s general state of being happy, healthy, and content with life. Attending a mental health retreat is one way to achieve and maintain mental health and well-being. 

Such a retreat creates a conducive environment where individuals can disconnect from the stressors of daily life and focus on their mental and emotional health. At a mental health retreat , individuals can participate in activities such as meditation, counseling, and relaxation techniques that promote mental wellness and a positive outlook on life. Individuals can lead a fulfilling life, free from stress and anxiety, by prioritizing mental health and well-being.

Investigating the Causes and Risk Factors of Poor Mental Health

There is no single cause of poor mental health, which various factors can influence. Some of these factors include biological, environmental, and psychological influences. For example, genetics and brain chemistry can play a role in developing particular mental illnesses, such as depression or anxiety disorders. Environmental factors like childhood trauma or chronic stress can also contribute to poor mental health. 

Furthermore, certain psychological risk factors—like low self-esteem or negative thinking patterns—can also make individuals more susceptible to developing mental health issues. By understanding these causes and risk factors, we can be better equipped to recognize and address potential challenges to our mental well-being.

Exploring Ways to Improve Your Mental Health  

Just like physical health, mental health requires regular maintenance. There are various ways to improve your mental well-being and promote a positive mindset. These include engaging in activities that bring joy and fulfillment, practicing self-care, maintaining healthy relationships, seeking professional help, and developing coping strategies for managing stress and negative emotions.

Additionally, taking care of our physical health through exercise and a balanced diet can significantly impact our mental well-being. We can improve our mental health and cultivate emotional resilience by prioritizing self-care and adopting healthy habits.

Acknowledging the Stigma Surrounding Mental Illness

Despite the importance of mental health, there is still a significant stigma surrounding mental illness in many societies. It can make it difficult for individuals to seek help and support when needed, leading to further challenges with mental health. It’s essential to recognize that mental illness is just like any other physical illness and requires proper treatment and support from healthcare professionals.

Moreover, educating ourselves and those around us about mental health is crucial to reducing the stigma and promoting a more open and supportive environment for individuals struggling with mental illness. We can encourage people to seek help without fear of judgment or discrimination by breaking down these barriers.

Identifying Resources Available for Those Struggling with Mental Health Issues

Fortunately, many resources are available for individuals struggling with mental health issues. These include therapy and counseling services, support groups, hotlines, self-care apps, and online communities. It’s essential to seek help if you’re experiencing challenges with your mental health and to know that it is okay to ask for support.

Furthermore, employers and educational institutions are also increasingly recognizing the importance of mental health and providing resources for their employees and students. Seeking support from these sources can help individuals manage their mental health more effectively and lead a healthier and happier lives.

Celebrating Those Who Are Working to Eradicate the Taboo of Mental Illnesses

As more awareness is raised about mental health, there are many individuals and organizations working to eradicate the taboo surrounding mental illness and promote open discussions about it. These include mental health advocates, healthcare professionals, support groups, and community organizations.

By celebrating and supporting those making a positive impact in the mental health field, we can continue to break down barriers and create a more understanding and inclusive society. Through collective efforts, we can create a world where mental health is equally important to physical health, and individuals are not afraid to seek help when needed.

In Conclusion

Mental health is an essential aspect of our overall well-being, and it’s crucial to prioritize it in our lives. By being aware of its key components, understanding the causes and risk factors of poor mental health, and exploring ways to improve it, we can lead a healthier and more fulfilling life. It’s also essential to acknowledge the stigma surrounding mental illness and utilize available resources for support. Let us work together to create a world where mental health is given the attention and care it deserves.

The post Mental Health Matters: Understanding the Vital Importance of Emotional Well-being appeared first on Sunny Sweet Days .

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Speaking Up About Mental Health

National essay contest.

SUBMIT YOUR ESSAY The contest is open to high school students ages 16-18

PROMOTION TOOLKIT Help spread the word with social media and email tools

December 1, 2023

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January 16, 2024

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May 31, 2024

Mental health is an important part of overall health across all life stages. However, far too often, symptoms are not addressed or recognized among teens.

Speaking Up About Mental Health is an essay contest that challenges high school students ages 16-18 to raise awareness of mental health. The contest gives students a platform to share ways to eliminate and/or reduce mental health stigma faced by young people, especially in diverse communities.

This contest is soliciting essays that:

• Discuss ways to eliminate and/or reduce mental health stigma faced by young people, especially in diverse communities
• Share resilience and coping strategies to overcome mental health issues such as social isolation and loneliness, depression, and anxiety
• Address mental health stigma
• Encourage conversations about mental health, social media, and/or technology
• Suggest school policies or practices that could help reduce stigma
• Describe barriers to mental health treatment
• Cover other areas of concern to individuals and their communities with respect to mental health

Get details on contest rules and submit your entry on Challenge.gov

Promotion toolkit : Help promote the Speaking Up About Mental Health essay contest

The contest is led by:

National Institute of Mental Health

National Institute on Minority Health and Health Disparities

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Page updated Jan. 23, 2024

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There’s a Reason They’re Called ‘Gut’ Feelings

I n the 1800s, a French Canadian named Alexis St. Martin was shot in the stomach while at a fur trading post, when someone’s musket accidentally fired at close range. He survived, but his injuries resulted in a hole in his stomach wall. This provided an early window—literally—into how our emotions and mental health affect the gut. Through careful experiments, the surgeon William Beaumont discovered that St. Martin’s mental state had direct physiological consequences on his stomach’s activity: when he felt irritable, for example, his digestion slowed. Somehow, his emotional states were manifest in the specific, local biology of his gut.

Most people have experienced the gut consequences of their emotional feelings. Nerves before an exam might lead you to feel nauseous or even vomit. Profound sadness might make you lose your appetite, or perhaps cause a hunger impossible to satiate. Gut symptoms are common in mental health conditions, from appetite changes in depression to debilitating “psychosomatic” stomach pains. Many of our feelings are gut feelings.

But the gut doesn’t just respond to emotional feelings: it influences them, too. Take disgust. Disgust is visceral. Our stomach, like our heart, has a regular electrical rhythm; even just seeing something disgusting causes disruptions, called “dysrhythmias,” in this electrical signalling. Although disgust is crucial for survival—helping us avoid disease and stay alive—in many mental health conditions disgust becomes pathological. In obsessive compulsive disorder (OCD), for instance, dirt or germs can preoccupy someone’s thoughts, causing symptoms like compulsive hand-washing. Self-disgust is common in depression and eating disorders. And even post-traumatic disorder can be brought on by profoundly disgusting traumas.

Pathological disgust is particularly hard to treat : exposure therapy and other psychological approaches are much less effective than for fear-based mental health problems. A couple years ago, working as a neuroscientist at the University of Cambridge, I wondered if abnormal signals from the stomach could be causing disgust avoidance. I ran an experiment to test this hypothesis, and found that changing someone’s gut activity with a common anti-nausea drug reduced their disgust avoidance . This could represent a new way of treating pathological disgust in mental health disorders. For example, an anti-nausea drug could be administered just before exposure therapy, enabling patients to engage with therapy under a more optimal gut state.

Read More: How I Learned to Listen to What My Gut Was Telling Me

So gut feelings are not “all in your mind”—but they are not “all in your gut,” either. Sensations from the gut are transmitted to the brain via the vagus nerve, the primary channel of information sent from the body to the brain. A second route to target “gut feelings” is by electrically stimulating this nerve, which changes the electrical rhythm of the stomach . That said,  the idea is not new: vagus nerve stimulation for patients with major depression dates back to 2000 .

A new theory published in November 2023 proposes that vagus nerve stimulation amplifies signals from the internal body to the brain, which helps us adapt our behaviour to its current challenges and needs. That could explain why the effects of vagus nerve stimulation are so wide-reaching, altering learning, memory, and motivation. That means amplifying signals from the gut using vagus nerve stimulation might improve mental health in some cases, but in others could be ineffective or even detrimental. Ultimately, we need to consider the state and needs of someone’s internal body before amplifying the body’s influence on the brain.

But the importance of the vagus nerve extends to even more established treatments: evidence from mice suggests that the most common type of antidepressant drugs (SSRIs, or selective serotonin reuptake inhibitors) require the vagus nerve to work. This, too, could begin to provide clues why antidepressants do, or don’t, work for a given person, and even help us understand why they might cause side effects in some people.

If the vagus nerve’s role helps us adapt to our bodily needs, perhaps the most important internal need of all is energy. One function of the gut—together with other organs—is metabolism, converting food to energy the body can use. There are mysterious and wide-ranging connections between our metabolic system and mental health. For example, the prevalence of depression in people with diabetes is two or three times higher than in the general population. It’s not clear why: diabetes could increase depression risk, or vice versa. My lab is currently testing a third possibility: that common metabolic factors might increase your risk of both depression and diabetes because of interactions between the body and the brain. If we’re right, this could open up avenues toward metabolic interventions that improve both physical and mental health.

Our brain and wider nervous system adapts to its circumstances, including the body’s internal, metabolic needs, as well as our experience of the environment around us. Because of this, your gut-brain connection is not static, but rather changes and adapts over time. A fascinating study in 2021 discovered that brain cells can re-activate gut inflammation that an animal has previously experienced. The mere “memory” of gut inflammation, stored in cells in the brain, induced the physical state in the body. So sometimes a “gut feeling” actually originates from the brain. This role of the brain in “gut feelings” means our brain has the capacity to produce dysfunctional gut symptoms via brain changes alone. This ability of the brain could have upsides as well, perhaps explaining why psychological therapy—which causes brain changes —can also treat some gut conditions .

Gut feelings originate from many sources: directly through the gut, through channels of communication between gut and brain, or even through the brain itself. In neuroscience, as we unravel the dynamic communications between gut and brain, we can begin to understand how these processes helped our ancestors survive—and how we could better harness them to improve emotional and mental wellbeing. A gut feeling might have many possible causes, but each of these represent a potential solution for mental health.

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Mental health care is hard to find, especially for people with Medicare or Medicaid

Rhitu Chatterjee

With rates of suicide and opioid deaths rising in the past decade and children's mental health declared a national emergency , the United States faces an unprecedented mental health crisis. But access to mental health care for a significant portion of Americans — including some of the most vulnerable populations — is extremely limited, according to a new government report released Wednesday.

The report, from the Department of Health and Human Services' Office of Inspector General, finds that Medicare and Medicaid have a dire shortage of mental health care providers.

The report looked at 20 counties with people on Medicaid, traditional Medicare and Medicare Advantage plans, which together serve more than 130 million enrollees — more than 40% of the U.S. population, says Meridith Seife , the deputy regional inspector general and the lead author of the report.

Medicaid serves people on low incomes, and Medicare is mainly for people 65 years or older and those who are younger with chronic disabilities.

The report found fewer than five active mental health care providers for every 1,000 enrollees. On average, Medicare Advantage has 4.7 providers per 1,000 enrollees, whereas traditional Medicare has 2.9 providers and Medicaid has 3.1 providers for the same number of enrollees. Some counties fare even worse, with not even a single provider for every 1,000 enrollees.

"When you have so few providers available to see this many enrollees, patients start running into significant problems finding care," says Seife.

The findings are especially troubling given the level of need for mental health care in this population, she says.

"On Medicare, you have 1 in 4 Medicare enrollees who are living with a mental illness," she says. "Yet less than half of those people are receiving treatment."

Among people on Medicaid, 1 in 3 have a mental illness, and 1 in 5 have a substance use disorder. "So the need is tremendous."

The results are "scary" but "not very surprising," says Deborah Steinberg , senior health policy attorney at the nonprofit Legal Action Center. "We know that people in Medicare and Medicaid are often underserved populations, and this is especially true for mental health and substance use disorder care."

Among those individuals able to find and connect with a provider, many see their provider several times a year, according to the report. And many have to drive a long way for their appointments.

"We have roughly 1 in 4 patients that had to travel more than an hour to their appointments, and 1 in 10 had to travel more than an hour and a half each way," notes Seife. Some patients traveled two hours each way for mental health care, she says.

Mental illnesses and substance use disorders are chronic conditions that people need ongoing care for, says Steinberg. "And when they have to travel an hour, more than an hour, for an appointment throughout the year, that becomes unreasonable. It becomes untenable."

"We know that behavioral health workforce shortages are widespread," says Heather Saunders , a senior research manager on the Medicaid team at KFF, the health policy research organization. "This is across all payers, all populations, with about half of the U.S. population living in a workforce shortage."

But as the report found, that's not the whole story for Medicare and Medicaid. Only about a third of mental health care providers in the counties studied see Medicare and Medicaid patients. That means a majority of the workforce doesn't participate in these programs.

This has been well documented in Medicaid, notes Saunders. "Only a fraction" of providers in provider directories see Medicaid patients, she says. "And when they do see Medicaid patients, they often only see a few."

Lower reimbursement rates and a high administrative burden prevent more providers from participating in Medicaid and Medicare, the report notes.

"In the Medicare program, they set a physician fee rate," explains Steinberg. "Then for certain providers, which includes clinical social workers, mental health counselors and marriage and family therapists, they get reimbursed at 75% of that rate."

Medicaid reimbursements for psychiatric services are even lower when compared with Medicare , says Ellen Weber , senior vice president for health initiatives at the Legal Action Center.

"They're baking in those discriminatory standards when they are setting those rates," says Steinberg.

The new report recommends that the Centers for Medicare & Medicaid Services (CMS) take steps to increase payments to providers and lower administrative requirements. In a statement, CMS said it has responded to those recommendations within the report.

According to research by Saunders and her colleagues at KFF, many states have already started to take action on these fronts to improve participation in Medicaid.

Several have upped their payments to mental health providers. "But the scale of those increases ranged widely across states," says Saunders, "with some states limiting the increase to one provider type or one type of service, but other states having rate increases that were more across the board."

Some states have also tried to simplify and streamline paperwork, she adds. "Making it less complex, making it easier to understand," says Saunders.

But it's too soon to know whether those efforts have made a significant impact on improving access to providers.

CMS has also taken steps to address provider shortages, says Steinberg.

"CMS has tried to increase some of the reimbursement rates without actually fixing that structural problem," says Steinberg. "Trying to add a little bit here and there, but it's not enough, especially when they're only adding a percent to the total rate. It's a really small increase."

The agency has also started covering treatments and providers it didn't use to cover before.

"In 2020, Medicare started covering opioid treatment programs, which is where a lot of folks can go to get medications for their substance use disorder," says Steinberg.

And starting this year, Medicare also covers "mental health counselors, which includes addiction counselors, as well as marriage and family therapists," she adds.

While noteworthy and important, a lot more needs to be done, says Steinberg. "For example, in the substance use disorder space, a lot of addiction counselors do not have a master's degree. And that's one of their requirements to be a counselor in the Medicare program right now."

Removing those stringent requirements and adding other kinds of providers, like peer support specialists, is key to improving access. And the cost of not accessing care is high, she adds.

"Over the past two decades, [in] the older adult population, the number of overdose deaths has increased fourfold — quadrupled," says Steinberg. "So this is affecting people. It is causing deaths. It is causing people to go to the hospital. It increases [health care] costs."

• Centers for Medicare & Medicaid Services
• mental health

• Open access
• Published: 12 December 2023

Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review

• C. E. Hall 1 , 2 ,
• H. Wehling 1 ,
• J. Stansfield 3 ,
• J. South 3 ,
• S. K. Brooks 2 ,
• N. Greenberg 2 , 4 ,
• R. Amlôt 1 &
• D. Weston 1  

BMC Public Health volume  23 , Article number:  2482 ( 2023 ) Cite this article

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The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?

A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.

The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.

Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.

Peer Review reports

For the general population, public health emergencies and disasters (e.g., natural disasters; infectious disease outbreaks; Chemical, Biological, Radiological or Nuclear incidents) can give rise to a plethora of negative outcomes relating to both health (e.g. increased mental health problems [ 1 , 2 , 3 , 4 ]) and the economy (e.g., increased unemployment and decreased levels of tourism [ 4 , 5 , 6 ]). COVID-19 is a current, and ongoing, example of a public health emergency which has affected over 421 million individuals worldwide [ 7 ]. The long term implications of COVID-19 are not yet known, but there are likely to be repercussions for physical health, mental health, and other non-health related outcomes for a substantial time to come [ 8 , 9 ]. As a result, it is critical to establish methods which may inform approaches to alleviate the longer-term negative consequences that are likely to emerge in the aftermath of both COVID-19 and any future public health emergency.

The definition of resilience often differs within the literature, but ultimately resilience is considered a dynamic process of adaptation. It is related to processes and capabilities at the individual, community and system level that result in good health and social outcomes, in spite of negative events, serious threats and hazards [ 10 ]. Furthermore, Ziglio [ 10 ] refers to four key types of resilience capacity: adaptive, the ability to withstand and adjust to unfavourable conditions and shocks; absorptive, the ability to withstand but also to recover and manage using available assets and skills; anticipatory, the ability to predict and minimize vulnerability; and transformative, transformative change so that systems better cope with new conditions.

There is no one settled definition of community resilience (CR). However, it generally relates to the ability of a community to withstand, adapt and permit growth in adverse circumstances due to social structures, networks and interdependencies within the community [ 11 ]. Social capital (SC) is considered a major determinant of CR [ 12 , 13 ], and reflects strength of a social network, community reciprocity, and trust in people and institutions [ 14 ]. These aspects of community are usually conceptualised primarily as protective factors that enable communities to cope and adapt collectively to threats. SC is often broken down into further categories [ 15 ], for example: cognitive SC (i.e. perceptions of community relations, such as trust, mutual help and attachment) and structural SC (i.e. what actually happens within the community, such as participation, socialising) [ 16 ]; or, bonding SC (i.e. connections among individuals who are emotionally close, and result in bonds to a particular group [ 17 ]) and bridging SC (i.e. acquaintances or individuals loosely connected that span different social groups [ 18 ]). Generally, CR is perceived to be primarily beneficial for multiple reasons (e.g. increased social support [ 18 , 19 ], protection of mental health [ 20 , 21 ]), and strengthening community resilience is a stated health goal of the World Health Organisation [ 22 ] when aiming to alleviate health inequalities and protect wellbeing. This is also reflected by organisations such as Public Health England (now split into the UK Health Security Agency and the Office for Health Improvement and Disparities) [ 23 ] and more recently, CR has been targeted through the endorsement of Community Champions (who are volunteers trained to support and to help improve health and wellbeing. Community Champions also reflect their local communities in terms of population demographics for example age, ethnicity and gender) as part of the COVID-19 response in the UK (e.g. [ 24 , 25 ]).

Despite the vested interest in bolstering communities, the research base establishing: how to understand and measure CR and SC; the effect of CR and SC, both during and following a public health emergency (such as the COVID-19 pandemic); and which types of CR or SC are the most effective to engage, is relatively small. Given the importance of ensuring resilience against, and swift recovery from, public health emergencies, it is critically important to establish and understand the evidence base for these approaches. As a result, the current review sought to answer the following research questions: (1) How are CR and SC quantified in research?; (2) What is the impact of community resilience on mental wellbeing?; (3) What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, (4) What types of interventions enhance community resilience and social capital?

By collating research in order to answer these research questions, the authors have been able to propose several key recommendations that could be used to both enhance and evaluate CR and SC effectively to facilitate the long-term recovery from COVID-19, and also to inform the use of CR and SC in any future public health disasters and emergencies.

A scoping review methodology was followed due to the ease of summarising literature on a given topic for policy makers and practitioners [ 26 ], and is detailed in the following sections.

Identification of relevant studies

An initial search strategy was developed by authors CH and DW and included terms which related to: CR and SC, given the absence of a consistent definition of CR, and the link between CR and SC, the review focuses on both CR and SC to identify as much relevant literature as possible (adapted for purpose from Annex 1: [ 27 ], as well as through consultation with review commissioners); public health emergencies and disasters [ 28 , 29 , 30 , 31 ], and psychological wellbeing and recovery (derived a priori from literature). To ensure a focus on both public health and psychological research, the final search was carried across Medline, PsycInfo, and EMBASE using OVID. The final search took place on the 18th of May 2020, the search strategy used for all three databases can be found in Supplementary file 1 .

Selection criteria

The inclusion and exclusion criteria were developed alongside the search strategy. Initially the criteria were relatively inclusive and were subject to iterative development to reflect the authors’ familiarisation with the literature. For example, the decision was taken to exclude research which focused exclusively on social support and did not mention communities as an initial title/abstract search suggested that the majority of this literature did not meet the requirements of our research question.

The full and final inclusion and exclusion criteria used can be found in Supplementary file 2 . In summary, authors decided to focus on the general population (i.e., non-specialist, e.g. non-healthcare worker or government official) to allow the review to remain community focused. The research must also have assessed the impact of CR and/or SC on mental health and wellbeing, resilience, and recovery during and following public health emergencies and infectious disease outbreaks which affect communities (to ensure the research is relevant to the review aims), have conducted primary research, and have a full text available or provided by the first author when contacted.

Charting the data

All papers were first title and abstract screened by CH or DW. Papers then were full text reviewed by CH to ensure each paper met the required eligibility criteria, if unsure about a paper it was also full text reviewed by DW. All papers that were retained post full-text review were subjected to a standardised data extraction procedure. A table was made for the purpose of extracting the following data: title, authors, origin, year of publication, study design, aim, disaster type, sample size and characteristics, variables examined, results, restrictions/limitations, and recommendations. Supplementary file 3 details the charting the data process.

Analytical method

Data was synthesised using a Framework approach [ 32 ], a common method for analysing qualitative research. This method was chosen as it was originally used for large-scale social policy research [ 33 ] as it seeks to identify: what works, for whom, in what conditions, and why [ 34 ]. This approach is also useful for identifying commonalities and differences in qualitative data and potential relationships between different parts of the data [ 33 ]. An a priori framework was established by CH and DW. Extracted data was synthesised in relation to each research question, and the process was iterative to ensure maximum saturation using the available data.

Study selection

The final search strategy yielded 3584 records. Following the removal of duplicates, 2191 records remained and were included in title and abstract screening. A PRISMA flow diagram is presented in Fig.  1 .

PRISMA flow diagram

At the title and abstract screening stage, the process became more iterative as the inclusion criteria were developed and refined. For the first iteration of screening, CH or DW sorted all records into ‘include,’ ‘exclude,’ and ‘unsure’. All ‘unsure’ papers were re-assessed by CH, and a random selection of ~ 20% of these were also assessed by DW. Where there was disagreement between authors the records were retained, and full text screened. The remaining papers were reviewed by CH, and all records were categorised into ‘include’ and ‘exclude’. Following full-text screening, 26 papers were retained for use in the review.

Study characteristics

This section of the review addresses study characteristics of those which met the inclusion criteria, which comprises: date of publication, country of origin, study design, study location, disaster, and variables examined.

Date of publication

Publication dates across the 26 papers spanned from 2008 to 2020 (see Fig.  2 ). The number of papers published was relatively low and consistent across this timescale (i.e. 1–2 per year, except 2010 and 2013 when none were published) up until 2017 where the number of papers peaked at 5. From 2017 to 2020 there were 15 papers published in total. The amount of papers published in recent years suggests a shift in research and interest towards CR and SC in a disaster/ public health emergency context.

Graph to show retained papers date of publication

Country of origin

The locations of the first authors’ institutes at the time of publication were extracted to provide a geographical spread of the retained papers. The majority originated from the USA [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ], followed by China [ 42 , 43 , 44 , 45 , 46 ], Japan [ 47 , 48 , 49 , 50 ], Australia [ 51 , 52 , 53 ], The Netherlands [ 54 , 55 ], New Zealand [ 56 ], Peru [ 57 ], Iran [ 58 ], Austria [ 59 ], and Croatia [ 60 ].

There were multiple methodological approaches carried out across retained papers. The most common formats included surveys or questionnaires [ 36 , 37 , 38 , 42 , 46 , 47 , 48 , 49 , 50 , 53 , 54 , 55 , 57 , 59 ], followed by interviews [ 39 , 40 , 43 , 51 , 52 , 60 ]. Four papers used both surveys and interviews [ 35 , 41 , 45 , 58 ], and two papers conducted data analysis (one using open access data from a Social Survey [ 44 ] and one using a Primary Health Organisations Register [ 56 ]).

Study location

The majority of the studies were carried out in Japan [ 36 , 42 , 44 , 47 , 48 , 49 , 50 ], followed by the USA [ 35 , 37 , 38 , 39 , 40 , 41 ], China [ 43 , 45 , 46 , 53 ], Australia [ 51 , 52 ], and the UK [ 54 , 55 ]. The remaining studies were carried out in Croatia [ 60 ], Peru [ 57 ], Austria [ 59 ], New Zealand [ 56 ] and Iran [ 58 ].

Multiple different types of disaster were researched across the retained papers. Earthquakes were the most common type of disaster examined [ 45 , 47 , 49 , 50 , 53 , 56 , 57 , 58 ], followed by research which assessed the impact of two disastrous events which had happened in the same area (e.g. Hurricane Katrina and the Deepwater Horizon oil spill in Mississippi, and the Great East Japan earthquake and Tsunami; [ 36 , 37 , 38 , 42 , 44 , 48 ]). Other disaster types included: flooding [ 51 , 54 , 55 , 59 , 60 ], hurricanes [ 35 , 39 , 41 ], infectious disease outbreaks [ 43 , 46 ], oil spillage [ 40 ], and drought [ 52 ].

Variables of interest examined

Across the 26 retained papers: eight referred to examining the impact of SC [ 35 , 37 , 39 , 41 , 46 , 49 , 55 , 60 ]; eight examined the impact of cognitive and structural SC as separate entities [ 40 , 42 , 45 , 48 , 50 , 54 , 57 , 59 ]; one examined bridging and bonding SC as separate entities [ 58 ]; two examined the impact of CR [ 38 , 56 ]; and two employed a qualitative methodology but drew findings in relation to bonding and bridging SC, and SC generally [ 51 , 52 ]. Additionally, five papers examined the impact of the following variables: ‘community social cohesion’ [ 36 ], ‘neighbourhood connectedness’ [ 44 ], ‘social support at the community level’ [ 47 ], ‘community connectedness’ [ 43 ] and ‘sense of community’ [ 53 ]. Table  1 provides additional details on this.

How is CR and SC measured or quantified in research?

The measures used to examine CR and SC are presented Table  1 . It is apparent that there is no uniformity in how SC or CR is measured across the research. Multiple measures are used throughout the retained studies, and nearly all are unique. Additionally, SC was examined at multiple different levels (e.g. cognitive and structural, bonding and bridging), and in multiple different forms (e.g. community connectedness, community cohesion).

What is the association between CR and SC on mental wellbeing?

To best compare research, the following section reports on CR, and facets of SC separately. Please see Supplementary file 4  for additional information on retained papers methods of measuring mental wellbeing.

• Community resilience

CR relates to the ability of a community to withstand, adapt and permit growth in adverse circumstances due to social structures, networks and interdependencies within the community [ 11 ].

The impact of CR on mental wellbeing was consistently positive. For example, research indicated that there was a positive association between CR and number of common mental health (i.e. anxiety and mood) treatments post-disaster [ 56 ]. Similarly, other research suggests that CR is positively related to psychological resilience, which is inversely related to depressive symptoms) [ 37 ]. The same research also concluded that CR is protective of psychological resilience and is therefore protective of depressive symptoms [ 37 ].

• Social capital

SC reflects the strength of a social network, community reciprocity, and trust in people and institutions [ 14 ]. These aspects of community are usually conceptualised primarily as protective factors that enable communities to cope and adapt collectively to threats.

There were inconsistencies across research which examined the impact of abstract SC (i.e. not refined into bonding/bridging or structural/cognitive) on mental wellbeing. However, for the majority of cases, research deems SC to be beneficial. For example, research has concluded that, SC is protective against post-traumatic stress disorder [ 55 ], anxiety [ 46 ], psychological distress [ 50 ], and stress [ 46 ]. Additionally, SC has been found to facilitate post-traumatic growth [ 38 ], and also to be useful to be drawn upon in times of stress [ 52 ], both of which could be protective of mental health. Similarly, research has also found that emotional recovery following a disaster is more difficult for those who report to have low levels of SC [ 51 ].

Conversely, however, research has also concluded that when other situational factors (e.g. personal resources) were controlled for, a positive relationship between community resources and life satisfaction was no longer significant [ 60 ]. Furthermore, some research has concluded that a high level of SC can result in a community facing greater stress immediately post disaster. Indeed, one retained paper found that high levels of SC correlate with higher levels of post-traumatic stress immediately following a disaster [ 39 ]. However, in the later stages following a disaster, this relationship can reverse, with SC subsequently providing an aid to recovery [ 41 ]. By way of explanation, some researchers have suggested that communities with stronger SC carry the greatest load in terms of helping others (i.e. family, friends and neighbours) as well as themselves immediately following the disaster, but then as time passes the communities recover at a faster rate as they are able to rely on their social networks for support [ 41 ].

Cognitive and structural social capital

Cognitive SC refers to perceptions of community relations, such as trust, mutual help and attachment, and structural SC refers to what actually happens within the community, such as participation, socialising [ 16 ].

Cognitive SC has been found to be protective [ 49 ] against PTSD [ 54 , 57 ], depression [ 40 , 54 ]) mild mood disorder; [ 48 ]), anxiety [ 48 , 54 ] and increase self-efficacy [ 59 ].

For structural SC, research is again inconsistent. On the one hand, structural SC has been found to: increase perceived self-efficacy, be protective of depression [ 40 ], buffer the impact of housing damage on cognitive decline [ 42 ] and provide support during disasters and over the recovery period [ 59 ]. However, on the other hand, it has been found to have no association with PTSD [ 54 , 57 ] or depression, and is also associated with a higher prevalence of anxiety [ 54 ]. Similarly, it is also suggested by additional research that structural SC can harm women’s mental health, either due to the pressure of expectations to help and support others or feelings of isolation [ 49 ].

Bonding and bridging social capital

Bonding SC refers to connections among individuals who are emotionally close, and result in bonds to a particular group [ 17 ], and bridging SC refers to acquaintances or individuals loosely connected that span different social groups [ 18 ].

One research study concluded that both bonding and bridging SC were protective against post-traumatic stress disorder symptoms [ 58 ]. Bridging capital was deemed to be around twice as effective in buffering against post-traumatic stress disorder than bonding SC [ 58 ].

Other community variables

Community social cohesion was significantly associated with a lower risk of post-traumatic stress disorder symptom development [ 35 ], and this was apparent even whilst controlling for depressive symptoms at baseline and disaster impact variables (e.g. loss of family member or housing damage) [ 36 ]. Similarly, sense of community, community connectedness, social support at the community level and neighbourhood connectedness all provided protective benefits for a range of mental health, wellbeing and recovery variables, including: depression [ 53 ], subjective wellbeing (in older adults only) [ 43 ], psychological distress [ 47 ], happiness [ 44 ] and life satisfaction [ 53 ].

Research has also concluded that community level social support is protective against mild mood and anxiety disorder, but only for individuals who have had no previous disaster experience [ 48 ]. Additionally, a study which separated SC into social cohesion and social participation concluded that at a community level, social cohesion is protective against depression [ 49 ] whereas social participation at community level is associated with an increased risk of depression amongst women [ 49 ].

What is the impact of Infectious disease outbreaks / disasters and emergencies on community resilience?

From a cross-sectional perspective, research has indicated that disasters and emergencies can have a negative effect on certain types of SC. Specifically, cognitive SC has been found to be impacted by disaster impact, whereas structural SC has gone unaffected [ 45 ]. Disaster impact has also been shown to have a negative effect on community relationships more generally [ 52 ].

Additionally, of the eight studies which collected data at multiple time points [ 35 , 36 , 41 , 42 , 47 , 49 , 56 , 60 ], three reported the effect of a disaster on the level of SC within a community [ 40 , 42 , 49 ]. All three of these studies concluded that disasters may have a negative impact on the levels of SC within a community. The first study found that the Deepwater Horizon oil spill had a negative effect on SC and social support, and this in turn explained an overall increase in the levels of depression within the community [ 40 ]. A possible explanation for the negative effect lays in ‘corrosive communities’, known for increased social conflict and reduced social support, that are sometimes created following oil spills [ 40 ]. It is proposed that corrosive communities often emerge due to a loss of natural resources that bring social groups together (e.g., for recreational activities), as well as social disparity (e.g., due to unequal distribution of economic impact) becoming apparent in the community following disaster [ 40 ]. The second study found that SC (in the form of social cohesion, informal socialising and social participation) decreased after the 2011 earthquake and tsunami in Japan; it was suggested that this change correlated with incidence of cognitive decline [ 42 ]. However, the third study reported more mixed effects based on physical circumstances of the communities’ natural environment: Following an earthquake, those who lived in mountainous areas with an initial high level of pre-community SC saw a decrease in SC post disaster [ 49 ]. However, communities in flat areas (which were home to younger residents and had a higher population density) saw an increase in SC [ 49 ]. It was proposed that this difference could be due to the need for those who lived in mountainous areas to seek prolonged refuge due to subsequent landslides [ 49 ].

What types of intervention enhance CR and SC and protect survivors?

There were mixed effects across the 26 retained papers when examining the effect of CR and SC on mental wellbeing. However, there is evidence that an increase in SC [ 56 , 57 ], with a focus on cognitive SC [ 57 ], namely by: building social networks [ 45 , 51 , 53 ], enhancing feelings of social cohesion [ 35 , 36 ] and promoting a sense of community [ 53 ], can result in an increase in CR and potentially protect survivors’ wellbeing and mental health following a disaster. An increase in SC may also aid in decreasing the need for individual psychological interventions in the aftermath of a disaster [ 55 ]. As a result, recommendations and suggested methods to bolster CR and SC from the retained papers have been extracted and separated into general methods, preparedness and policy level implementation.

General methods

Suggested methods to build SC included organising recreational activity-based groups [ 44 ] to broaden [ 51 , 53 ] and preserve current social networks [ 42 ], introducing initiatives to increase social cohesion and trust [ 51 ], and volunteering to increase the number of social ties between residents [ 59 ]. Research also notes that it is important to take a ‘no one left behind approach’ when organising recreational and social community events, as failure to do so could induce feelings of isolation for some members of the community [ 49 ]. Furthermore, gender differences should also be considered as research indicates that males and females may react differently to community level SC (as evidence suggests males are instead more impacted by individual level SC; in comparison to women who have larger and more diverse social networks [ 49 ]). Therefore, interventions which aim to raise community level social participation, with the aim of expanding social connections and gaining support, may be beneficial [ 42 , 47 ].

Preparedness

In order to prepare for disasters, it may be beneficial to introduce community-targeted methods or interventions to increase levels of SC and CR as these may aid in ameliorating the consequences of a public health emergency or disaster [ 57 ]. To indicate which communities have low levels of SC, one study suggests implementing a 3-item scale of social cohesion to map areas and target interventions [ 42 ].

It is important to consider that communities with a high level of SC may have a lower level of risk perception, due to the established connections and supportive network they have with those around them [ 61 ]. However, for the purpose of preparedness, this is not ideal as perception of risk is a key factor when seeking to encourage behavioural adherence. This could be overcome by introducing communication strategies which emphasise the necessity of social support, but also highlights the need for additional measures to reduce residual risk [ 59 ]. Furthermore, support in the form of financial assistance to foster current community initiatives may prove beneficial to rural areas, for example through the use of an asset-based community development framework [ 52 ].

Policy level

At a policy level, the included papers suggest a range of ways that CR and SC could be bolstered and used. These include: providing financial support for community initiatives and collective coping strategies, (e.g. using asset-based community development [ 52 ]); ensuring policies for long-term recovery focus on community sustainable development (e.g. community festival and community centre activities) [ 44 ]; and development of a network amongst cooperative corporations formed for reconstruction and to organise self-help recovery sessions among residents of adjacent areas [ 58 ].

This scoping review sought to synthesise literature concerning the role of SC and CR during public health emergencies and disasters. Specifically, in this review we have examined: the methods used to measure CR and SC; the impact of CR and SC on mental wellbeing during disasters and emergencies; the impact of disasters and emergencies on CR and SC; and the types of interventions which can be used to enhance CR. To do this, data was extracted from 26 peer-reviewed journal articles. From this synthesis, several key themes have been identified, which can be used to develop guidelines and recommendations for deploying CR and SC in a public health emergency or disaster context. These key themes and resulting recommendations are summarised below.

Firstly, this review established that there is no consistent or standardised approach to measuring CR or SC within the general population. This finding is consistent with a review conducted by the World Health Organization which concludes that despite there being a number of frameworks that contain indicators across different determinants of health, there is a lack of consensus on priority areas for measurement and no widely accepted indicator [ 27 ]. As a result, there are many measures of CR and SC apparent within the literature (e.g., [ 62 , 63 ]), an example of a developed and validated measure is provided by Sherrieb, Norris and Galea [ 64 ]. Similarly, the definitions of CR and SC differ widely between researchers, which created a barrier to comparing and summarising information. Therefore, future research could seek to compare various interpretations of CR and to identify any overlapping concepts. However, a previous systemic review conducted by Patel et al. (2017) concludes that there are nine core elements of CR (local knowledge, community networks and relationships, communication, health, governance and leadership, resources, economic investment, preparedness, and mental outlook), with 19 further sub-elements therein [ 30 ]. Therefore, as CR is a multi-dimensional construct, the implications from the findings are that multiple aspects of social infrastructure may need to be considered.

Secondly, our synthesis of research concerning the role of CR and SC for ensuring mental health and wellbeing during, or following, a public health emergency or disaster revealed mixed effects. Much of the research indicates either a generally protective effect on mental health and wellbeing, or no effect; however, the literature demonstrates some potential for a high level of CR/SC to backfire and result in a negative effect for populations during, or following, a public health emergency or disaster. Considered together, our synthesis indicates that cognitive SC is the only facet of SC which was perceived as universally protective across all retained papers. This is consistent with a systematic review which also concludes that: (a) community level cognitive SC is associated with a lower risk of common mental disorders, while; (b) community level structural SC had inconsistent effects [ 65 ].

Further examination of additional data extracted from studies which found that CR/SC had a negative effect on mental health and wellbeing revealed no commonalities that might explain these effects (Please see Supplementary file 5 for additional information)

One potential explanation may come from a retained paper which found that high levels of SC result in an increase in stress level immediately post disaster [ 41 ]. This was suggested to be due to individuals having greater burdens due to wishing to help and support their wide networks as well as themselves. However, as time passes the levels of SC allow the community to come together and recover at a faster rate [ 41 ]. As this was the only retained paper which produced this finding, it would be beneficial for future research to examine boundary conditions for the positive effects of CR/SC; that is, to explore circumstances under which CR/SC may be more likely to put communities at greater risk. This further research should also include additional longitudinal research to validate the conclusions drawn by [ 41 ] as resilience is a dynamic process of adaption.

Thirdly, disasters and emergencies were generally found to have a negative effect on levels of SC. One retained paper found a mixed effect of SC in relation to an earthquake, however this paper separated participants by area in which they lived (i.e., mountainous vs. flat), which explains this inconsistent effect [ 49 ]. Dangerous areas (i.e. mountainous) saw a decrease in community SC in comparison to safer areas following the earthquake (an effect the authors attributed to the need to seek prolonged refuge), whereas participants from the safer areas (which are home to younger residents with a higher population density) saw an increase in SC [ 49 ]. This is consistent with the idea that being able to participate socially is a key element of SC [ 12 ]. Overall, however, this was the only retained paper which produced a variable finding in relation to the effect of disaster on levels of CR/SC.

Finally, research identified through our synthesis promotes the idea of bolstering SC (particularly cognitive SC) and cohesion in communities likely to be affected by disaster to improve levels of CR. This finding provides further understanding of the relationship between CR and SC; an association that has been reported in various articles seeking to provide conceptual frameworks (e.g., [ 66 , 67 ]) as well as indicator/measurement frameworks [ 27 ]. Therefore, this could be done by creating and promoting initiatives which foster SC and create bonds within the community. Papers included in the current review suggest that recreational-based activity groups and volunteering are potential methods for fostering SC and creating community bonds [ 44 , 51 , 59 ]. Similarly, further research demonstrates that feelings of social cohesion are enhanced by general social activities (e.g. fairs and parades [ 18 ]). Also, actively encouraging activities, programs and interventions which enhance connectedness and SC have been reported to be desirable to increase CR [ 68 ]. This suggestion is supported by a recent scoping review of literature [ 67 ] examined community champion approaches for the COVID-19 pandemic response and recovery and established that creating and promoting SC focused initiatives within the community during pandemic response is highly beneficial [ 67 ]. In terms of preparedness, research states that it may be beneficial for levels of SC and CR in communities at risk to be assessed, to allow targeted interventions where the population may be at most risk following an incident [ 42 , 44 ]. Additionally, from a more critical perspective, we acknowledge that ‘resilience’ can often be perceived as a focus on individual capacity to adapt to adversity rather than changing or mitigating the causes of adverse conditions [ 69 , 70 ]. Therefore, CR requires an integrated system approach across individual, community and structural levels [ 17 ]. Also, it is important that community members are engaged in defining and agreeing how community resilience is measured [ 27 ] rather than it being imposed by system leads or decision-makers.

In the aftermath of the pandemic, is it expected that there will be long-term repercussions both from an economic [ 8 ] and a mental health perspective [ 71 ]. Furthermore, the findings from this review suggest that although those in areas with high levels of SC may be negatively affected in the acute stage, as time passes, they have potential to rebound at a faster rate than those with lower levels of SC. Ongoing evaluation of the effectiveness of current initiatives as the COVID-19 pandemic progresses into a recovery phase will be invaluable for supplementing the evidence base identified through this review.

• Recommendations

As a result of this review, a number of recommendations are suggested for policy and practice during public health emergencies and recovery.

Future research should seek to establish a standardised and validated approach to measuring and defining CR and SC within communities. There are ongoing efforts in this area, for example [ 72 ]. Additionally, community members should be involved in the process of defining how CR is measured.

There should be an enhanced effort to improve preparedness for public health emergencies and disasters in local communities by gauging current levels of SC and CR within communities using a standardised measure. This approach could support specific targeting of populations with low levels of CR/SC in case of a disaster or public health emergency, whilst also allowing for consideration of support for those with high levels of CR (as these populations can be heavily impacted initially following a disaster). By distinguishing levels of SC and CR, tailored community-centred approaches could be implemented, such as those listed in a guide released by PHE in 2015 [ 73 ].

CR and SC (specifically cognitive SC) should be bolstered if communities are at risk of experiencing a disaster or public health emergency. This can be achieved by using interventions which aim to increase a sense of community and create new social ties (e.g., recreational group activities, volunteering). Additionally, when aiming to achieve this, it is important to be mindful of the risk of increased levels of CR/SC to backfire, as well as seeking to advocate an integrated system approach across individual, community and structural levels.

It is necessary to be aware that although communities with high existing levels of resilience / SC may experience short-term negative consequences following a disaster, over time these communities might be able to recover at a faster rate. It is therefore important to ensure that suitable short-term support is provided to these communities in the immediate aftermath of a public health emergency or disaster.

Robust evaluation of the community resilience initiatives deployed during the COVID-19 pandemic response is essential to inform the evidence base concerning the effectiveness of CR/ SC. These evaluations should continue through the response phase and into the recovery phase to help develop our understanding of the long-term consequences of such interventions.

Limitations

Despite this review being the first in this specific topic area, there are limitations that must be considered. Firstly, it is necessary to note that communities are generally highly diverse and the term ‘community’ in academic literature is a subject of much debate (see: [ 74 ]), therefore this must be considered when comparing and collating research involving communities. Additionally, the measures of CR and SC differ substantially across research, including across the 26 retained papers used in the current review. This makes the act of comparing and collating research findings very difficult. This issue is highlighted as a key outcome from this review, and suggestions for how to overcome this in future research are provided. Additionally, we acknowledge that there will be a relationship between CR & SC even where studies measure only at individual or community level. A review [ 75 ] on articulating a hypothesis of the link to health inequalities suggests that wider structural determinants of health need to be accounted for. Secondly, despite the final search strategy encompassing terms for both CR and SC, only one retained paper directly measured CR; thus, making the research findings more relevant to SC. Future research could seek to focus on CR to allow for a comparison of findings. Thirdly, the review was conducted early in the COVID-19 pandemic and so does not include more recent publications focusing on resilience specifically in the context of COVID-19. Regardless of this fact, the synthesis of, and recommendations drawn from, the reviewed studies are agnostic to time and specific incident and contain critical elements necessary to address as the pandemic moves from response to recovery. Further research should review the effectiveness of specific interventions during the COVID-19 pandemic for collation in a subsequent update to this current paper. Fourthly, the current review synthesises findings from countries with individualistic and collectivistic cultures, which may account for some variation in the findings. Lastly, despite choosing a scoping review method for ease of synthesising a wide literature base for use by public health emergency researchers in a relatively tight timeframe, there are disadvantages of a scoping review approach to consider: (1) quality appraisal of retained studies was not carried out; (2) due to the broad nature of a scoping review, more refined and targeted reviews of literature (e.g., systematic reviews) may be able to provide more detailed research outcomes. Therefore, future research should seek to use alternative methods (e.g., empirical research, systematic reviews of literature) to add to the evidence base on CR and SC impact and use in public health practice.

This review sought to establish: (1) How CR and SC are quantified in research?; (2) The impact of community resilience on mental wellbeing?; (3) The impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, (4) What types of interventions enhance community resilience and social capital?. The chosen search strategy yielded 26 relevant papers from which we were able extract information relating to the aims of this review.

Results from the review revealed that CR and SC are not measured consistently across research. The impact of CR / SC on mental health and wellbeing during emergencies and disasters is mixed (with some potential for backlash), however the literature does identify cognitive SC as particularly protective. Although only a small number of papers compared CR or SC before and after a disaster, the findings were relatively consistent: SC or CR is negatively impacted by a disaster. Methods suggested to bolster SC in communities were centred around social activities, such as recreational group activities and volunteering. Recommendations for both research and practice (with a particular focus on the ongoing COVID-19 pandemic) are also presented.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Social Capital

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This study was supported by the National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, Public Health England, the UK Health Security Agency or the Department of Health and Social Care [Grant number: NIHR20008900]. Part of this work has been funded by the Office for Health Improvement and Disparities, Department of Health and Social Care, as part of a Collaborative Agreement with Leeds Beckett University.

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DW, JSo and JSt had the main idea for the review. The search strategy and eligibility criteria were devised by CH, DW, JSo and JSt. CH conducted the database searches. CH and DW conducted duplicate, title and abstract and full text screening in accordance with inclusion criteria. CH conducted data extraction, CH and DW carried out the analysis and drafted the initial manuscript. All authors provided critical revision of intellectual content. All authors approved the final manuscript.

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Hall, C.E., Wehling, H., Stansfield, J. et al. Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review. BMC Public Health 23 , 2482 (2023). https://doi.org/10.1186/s12889-023-17242-x

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DOI : https://doi.org/10.1186/s12889-023-17242-x

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