Keyes’ Two continua model of mental health (2003)
Source: Adopted from Keyes, 2003, p.302.
According to Keyes’ (2003) complete state model of mental well-being, the experience of well-being is independent from the experience of mental illness (Refer to Figure 2.1). In other words, well-being can co-exist with mental illness. For example, a person with mental illness can enjoy well-being with productive work, meaningful living, and be contributory to the society, whereas someone without mental illness may not experience well-being if s/he does not have fulfillment in life, sense of purpose, and meaningful engagement in the society.
Less than one-fifth of the individuals are flourishing
Based on several large scale surveys conducted nationally in the United States and the Netherlands across adolescents, adults, and older adults (Keyes, 2006, 2007; Westerhof and Keyes, 2010), less than one-fifth of the individuals in the population are flourishing, meaning that they enjoy well-being without the distress of mental illness. About half of the population has moderate mental well-being, with the remainder 30 per cent having some forms of mental distress. In other words, they are languishing in life, not enjoying mental well-being though with no apparent mental illness. Thus, promoting public mental health in the community is essential to maximize the chance that people can enjoy positive well-being and have fulfilling, meaningful, and contributory lives.
Ecological Model of Well-being – Protective and Risk Factors
Our ecology and the environment play a decisive role on individuals’ mental health and well-being. Factors at the microlevel (individual), mesolevel (family, service systems), and macrolevel (community, environment, culture) and their interactions can impact our personal and collective well-being. Table 2.1 below is a quick reference on the possible risk and protective factors at each level that may be detrimental or conducive to our well-being.
Table 2.1 Well-being and mental health: protective and risk factors
|Macro and Exo
Services: accessible quality health & social services
Income: safe, accessible employment & work conditions
Transport: accessible and affordable
Housing: affordable, accessible
Cultural identity: diversity welcomed, shared, valued , arts cultural engagement
Sports and recreation: participation and access
|Natural/ human-made disasters, climate change
environments: unsafe, poorly resources, overcrowded
Poverty & disadvantages: social & economic
Unemployment: Poor & insecure employment conditions
Education: lack of access
Isolation & exclusion: social & geographic
Discrimination & stigma: fascism, sexism, ageism, heterosexism
Family: resilience, parenting, social competence, positive relationship
Social participation: supportive relationships, involvement in groups, community activities and network
Empathy and respect
|Family: fragmentation, dysfunction child neglect
Violence: interpersonal, intimate & collective
Work: stress and strain
Empowerment & self-determination
Positive childhood experiences, maternal attachment
Personal Resilience & social skills
Physical illness; Alcohol & drugs
Food: inadequate & inaccessible
Source: Partly developed from The Victorian Health Promotion Foundation (2009), The Melbourne Charter for Promoting Mental Health and Preventing Mental and Behavioural Disorders, http://www.vichealth.vic.gov.au/~/media/ProgramsandProjects/Publications/Attachments/Melboure_%20Charter_final.ashx, accessed in July 2014.
Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, pp.207–222
Keyes, C.L.M. (2003). Complete mental health: An agenda for the 21st century. Flourishing: Positive Psychology and the Life Well-Lived, pp. 293-312.
Keyes, C. L. M. (2006). Mental health in adolescence: Is America's youth flourishing? American Journal of Orthopsychiatry, 76(3), pp. 395-402.
Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing: a complementary strategy for improving national mental health. American Psychologist, 62(2), pp. 95-108.
The Victorian Health Promotion Foundation (VicHealth) (2009), The Melbourne Charter for Promoting Mental Health and Preventing Mental and Behavioural Disorders,
http://www.vichealth.vic.gov.au/~/media/ProgramsandProjects/Publications/Attachments/Melboure_%20Charter_final.ashx, accessed in July 2014.
Westerhof, G. J. and Keyes, C. L. M. (2010). Mental Illness and Mental Health: The Two Continua Model Across the Lifespan. Journal of Adult Development, 17(2), pp.110-119.
World Health Organization (2005). Promoting Mental Health: Concepts, Emerging Evidence, Practice: Summary Report. Geneva: World Health Organization.