The importance of mental health has gained increasing recognition across the world. However, what we mean by “mental health” has varied greatly across time and place. In this opinion piece, I unpack some aspects of the concept and draw on my counselling experience to highlight what I believe are important considerations when thinking about mental health.
Early Western definitions of mental health were particularly narrow. Mental health was often defined simply as the absence of mental illness, with mental illness understood as thoughts or behaviours that deviated significantly from social norms. Over time, definitions have become more holistic and expansive. A well-known example is the World Health Organisation’s definition, which describes mental health as:
“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.”
While this definition offers a broader understanding of mental health, it is not without its limitations. It does not adequately account for the social, physical, economic, and structural factors that can limit people’s ability to reach their potential. Nor does it recognise differences in people’s access to support or their ability to change these conditions. As such, the definition frames mental health primarily as an individual state, rather than something shaped by forces operating at multiple levels beyond the individual.
In addition, it is possible to meet all aspects of the WHO definition while causing significant harm to others. Historical figures such as Adolf Hitler, Cecil John Rhodes, and Hendrik Verwoerd arguably realised their abilities, coped with stress, worked productively, and contributed to their communities, yet they did so while orchestrating or supporting severe human rights violations. This raises important questions about how we define “well-being” and “contribution.”
I would more simply define mental health as our patterns of thinking, feeling, and behaving over a sustained period of time (across days or longer). Drawing on the WHO definition as well as the DSM-IV-TR’s Global Assessment of Functioning Scale, I believe these patterns both influence—and are influenced by—the following:
Coping with life stressors. Mental health is closely linked to how well we cope with, or resolve, life’s stressors and challenges. What may be considered a “normal” stressor for one person can feel overwhelming or unmanageable for another. Being blocked from meeting basic needs or from realising one’s potential is likely to cause psychological distress for most people. Our ability to cope is shaped by many factors, including the quality of our primary relationships (past and present), the coping strategies we learned from others, how we have made meaning of our life experiences, physiological and neurological factors, and our access to psychological and material resources (such as education, financial stability, or recreational spaces). Examples of common, transient stressors include interpersonal conflict, changes in workload, and uncertainty about the future.
- Psychological-mindedness. Psychological-mindedness refers to our ability to turn inward during difficult moments—to notice our thoughts and feelings, explore where they may come from, and consider different ways of responding. This capacity for self-reflection plays an important role in mental health and is discussed in more detail in a previous blog post.
Coping skills. We all need a broad and flexible range of coping skills to manage the predictable and unpredictable challenges that arise throughout life. There are hundreds of coping strategies, often grouped into categories such as emotion-focused, behavioural, social, cognitive, proactive, reactive, and maladaptive coping. No single coping strategy works in all situations. For example, positively reframing a difficult experience may be helpful in some contexts, but less so in situations that require us to sit with painful emotions—such as the loss of a loved one.
Balance. Balance is a key component of mental health. Difficulties often arise when we struggle to maintain balance between different areas of life, such as work, relationships, rest, and personal meaning. Our capacity and desire to create balance will vary over time and across circumstances.
A balanced view of ourselves, others, and the world is equally important. This includes recognising that we are all fallible; that we have strengths and weaknesses; that we can both be hurt and hurt others; and that mistakes are part of being human. Mental health involves being able to acknowledge these realities and, where needed, reflect on or talk about their impact.
Mental health is a complex and multifaceted concept, shaped by our personal histories, relationships, and broader social contexts.
What does mental health mean to you?