Four Key Foundations to the ACMHI strategy

1. Mental wellness and mental illness are not opposites

Often people talk as though health is at one end of a continuum and illness or issues are at the other end – they are opposites. In this way of thinking, a person is either ill or healthy and if you just “remove” the illness (by treating or preventing it), then health remains.

Actually, it is not that way at all. Corey Keyes, a positive psychologist, describes the two as building along different but intersecting lines. He calls this the dual continuum perspective. Keyes points out that it is possible for a person to have no mental illness but be in low health. He calls this “languishing.” Likewise it is possible for a student to have signs and symptoms of mental illness or stress, and yet be “flourishing.” A graphic of Keyes’ model follows.

This way of describing the ‘dual continua’ – mental health as one continuum, and mental illness as a separate continuum – makes it clear that health develops along a different trajectory than does illness. So just preventing or treating illness does not create or uncover health. Thus, a holistic strategy needs to include both activities designed appropriately to helping students build their mental wellness as well as activities designed appropriately to preventing students at risk of developing illness, or treating those with mental illness or issues.

2. Mental wellness is process as well as state

ACMHI uses “mental wellness” for the continuum from languishing to flourishing to make it clear that it’s not about mental illness. At any given time we are in a state, which can be assessed, as long as the assessment is able to recognize both outer and inner aspects of mental wellness.

Wellness (or ‘health’) is a resource – it is is our ability to engage with our environment in productive ways so as to achieve our goals.  Because wellness (or ‘health) has a number of dimensions, so we can have different resources – our ability to solve problems (largely cognitive), physical strength, ability to craft creative solutions, our social connections for example.  Note that people have different ideas of which aspects of their health is most important to them – while most want a mixture, some prefer emotional aspects or cognitive aspects (clarity of thinking, systemic thinking), others prefer social or relational aspects, and still others prefer physical aspects such as stamina or muscle strength.  Different assessment tools focus on different aspects of wellness so a single assessment tool may provide only a partial picture of our overall wellness (or ‘health’).

Some use the term ‘resilience’ to describe mental wellness – ‘bouncing back’ after a stressful event, ambiguous situation or a challenging time. In addition to resources such as having caring and supportive relationships, a person can use coping or stress management tools to regain their usual functioning state.

From Resilience to Life Assets

Taking action to bounce back to one’s usual functioning state is important. However, a person who is more purposeful about learning more about strengthening or improving their processes for stress management or resilience can advance from “bouncing back” to “bouncing forward”.  This is more like self discovery and developing growth-oriented resilience where the object is to get better over time. Growth oriented resilience aims to develop more effective skills for coping and even thriving in the face of greater ambiguity and stress.  If a person takes the time to understand their own particular patterns – what are their major sources of stress and what works best for them as ways to cope, then they can call upon those strategies consciously and effectively under stressful conditions. This makes that understanding and skill an asset.

Improving such assets – such as increasing degrees of emotional competence, the ability to work well with others under ambiguous circumstances and other aspects of mental wellness – are critical for career success. A person’s health, or wellness, is a resource that helps them to achieve their goals – but it is personal choices and practices that develop it.  Healthcare can support a person to develop their wellness but is one of many contributors – wellness is not something that can be provided to someone else, it develops from within.

For ACMHI, all students have mental wellness. Because wellness does NOT mean no illness or issues, this includes attention to students experiencing different mental illnesses or issues as well as those who do not. This has been called a “recovery approach to mental illness or addictions” (see the reference list).

3. Mental wellness is both individual and collective

The Public Health Agency of Canada defines positive mental health as:

“the capacity of each and all of us to feel, think, act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity” .

“Culture, equity, social justice, interconnections” all apply to the characteristics of the collective. The collective can be a small group, people in a particular program or department, or the whole campus or whole community. Culture and other characteristics of the collective is influenced by individual attitudes and behaviours, but also by history, larger trends, as well as the physical, policy and digital environments.

For ACMHI, all students contribute to whether the campus culture tips towards stigma or inclusion. Equally, all students benefit from or are harmed by the campus culture.  Sometimes people don’t recognize biases, so strategies that help to turn implicit biases to conscious awareness is important. Strategies can include those that help people to speak and act in ways that support inclusion rather than stigma – in one on one interactions as well as digital communications. Paying attention to overall patterns that are influenced by structural biases is important to make sure that particular groups are not consistently marginalized compared to other members of the community. (see the reference list).

4. Mental wellness relates to brain development as well as behaviours and states we can observe.

Brain development is active from before birth to about age 25.  Our brain can remain plastic through our life as long as we continue to attend to brain health and continue to learn and develop.

We are influenced by, and influence our environments. We contribute to, as well as benefit from positive enabling environments. Our mental wellness, as well as mental illness, addictions and mental issues are associated with a variety of environmental factors, including:

  • Our relationships with close family and personal network as well as the wider social environment;
  • Our relationship with the natural, built and digital environments;
  • The policy environment – which in part provides for services but also influences the way our organizations operate. For example if stress is increased by intense competition and multiple conflicting demands, then the class workload and ways of assessing learning will influence students’ stress;
  • Social norms which emphasize difference or inclusion, fear or connection. Social norms operate in small groups and networks as well as large and can emphasize differences or inclusion related to gender, religion or ethnicity, ability or disability, socioeconomic status, age and other characteristics;
  • The ‘social gradient’ – the degrees of difference between those with less capabilities or resources and those with more.