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The kids are alright: The evolution of a positive, preventative approach to youth mental health
Mental health is a ubiquitous term: it’s one we hear about and use frequently, but when we stop to consider what we actually mean when we say someone has ‘good mental health’, we often come to a bit of a roadblock. Is it simply the absence, or effective management, of mental illness? Or is it something more than that?
Our understanding of mental health has shifted considerably over the past few decades, particularly with regards to how we consider the mental health of young people. Traditionally, approaches to youth mental health focused predominantly on responding to existing problems or crises, such as psychiatric disorders, alcohol and drug use, or engagement in juvenile crime1,2. This problem-centred view emphasised the deficits of young people that needed to be corrected in order for them to function optimally, while overlooking their inherent capacities and developmental potentials2. Underpinning this approach was a unidimensional model of mental health, which assumed mental health to be the direct opposite of mental illness – thus, the absence of mental illness and distress was thought to be synonymous with the presence of mental health and wellbeing3.
However, recent research has demonstrated that mental illness and mental health are in fact two distinct constructs that both contribute to positive wellbeing4. Individuals who have poor mental health, even in the absence of mental illness, function as poorly on various outcomes (such as physical health, work productivity, and psychosocial functioning) as those with a mental illness5. The World Health Organisation was instrumental in promoting this approach by conceptualising mental health as not merely the absence of mental illness but the presence of “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”6.
With this positive-focused, rather than deficit-focused, approach came the recognition of the cognitive, affective and behavioural competencies that contribute to mental health and wellbeing, and that everyone has the capacity to develop. As a result, current youth mental health and wellbeing programs take a proactive, preventative approach to mental health by aiming to enhance young people’s self-awareness, self-management, social awareness, relationship skills, and responsible decision making7,8. Successful youth programs use an evidence-based, structured curriculum that typically take a whole school approach – that is, they involve the entire school community and seek to promote a positive whole school climate9,10. The shift to a positive, strengths-based approach to mental health has also reframed how we consider adolescence as a developmental period. Recent research on youth mental health has shown that many stressors during adolescence are normative, age-specific and related to typical development11. Thus, while not undermining or detracting from the very real pressures that adolescents go through or the more complex adversities that some may face, positive approaches to mental health normalise behaviour that was once pathologised and maintain the vision that all young people have the capacity to make important and valuable contributions to society.