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What is Mental Health?

Mental health is ‘a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’. It is more than the absence of mental illness. It is an integral part of health that is along with physical and social well-being (World Health Organization, 2005, p.2). 

Keyes’ Two continua model of mental health (2003)

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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

Protective Factors
Risk Factors
Macro and Exo

Services: accessible quality health & social services
Income: safe, accessible employment & work conditions
Environments: Safe
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
Political oppression
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
Peer rejection
Work: stress and strain
Micro/ Individual

Physical Health
Empowerment & self-determination
Positive childhood experiences, maternal attachment
Personal Resilience & social skills

Physical illness; Alcohol & drugs
Food: inadequate & inaccessible
Physical inactivity

Source: Partly developed from The Victorian Health Promotion Foundation (2009), The Melbourne Charter for Promoting Mental Health and Preventing Mental and Behavioural Disorders,, 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,, 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.

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