This blog was originally posted on May 21, 2024 under the title "How to promote mental well-being for societies to thrive" at the World Bank Group Investing in Health site:  https://blogs.worldbank.org/en/health/How-to-promote-mental-well-being-for-societies-to-thrive

Patricio V. Marquez, Lara Fleischer, and Jessica Mahoney

“Put simply, the mental health problem is medical, but the solutions are not just medical—they are social, environmental, and political.”

--Thomas Insel, former director, National Institute of Mental Health, United States, Healing (2022)

May is Mental Health Awareness Month.  This is an opportune time to acknowledge the critical importance of mental health in our everyday lives.  

Mental health, as defined by the World Health Organization, is "a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work effectively, and contribute to their community."  This definition highlights that good mental health is more than just the absence of mental illnesses or conditions that affect our thinking, moods, or behaviors: it is a vital resource for overall individual and societal well-being.

The recent OECD report, co-authored by some of us, "How to Make Societies Thrive? Coordinating Approaches to Promote Well-being and Mental Health", examines how people’s economic, social, relational, civic, and environmental experiences, shape and are, in turn, shaped by their mental health.   Key findings from this report are presented below, followed by implications for the global health and development agenda.

Mental health shapes and is shaped by many aspects of life

The OECD report highlights significant disparities in well-being between individuals with poor mental health and the general population. Those experiencing mental distress are almost twice as likely to have low incomes, be unemployed, or be dissatisfied with neighborhood safety and green spaces. Furthermore, they are more than twice as likely to be unhappy with their time use and to have low trust in others, and their likelihood of feeling lonely is over four times higher. Conversely, the report identifies protective factors that enhance resilience and support good mental health, including financial security, good physical health, a safe and clean environment, and healthy social relationships.

These findings are illustrated in more detail by the following interactions:

• Interplay Between Material Conditions and Mental Health:  Material conditions, including income, employment quality, and housing, significantly influence mental health. Adverse material conditions like job insecurity and substandard working environments can trigger stress and mental-ill health. Conversely, mental health issues can also result in negative financial and social consequences. By enhancing access to social services, integrating mental health with employment services, and offering tailored public housing solutions, we can effectively mitigate these effects.

• Quality of Life and Mental Health:  This relationship is bidirectional and multifaceted, encompassing various life aspects such as education, physical health, and environmental conditions.  Education equips individuals with critical skills that improve mental resilience by enhancing problem-solving abilities and social interactions, which are crucial for managing life's stressors. Physical health also significantly impacts mental well-being; good physical health boosts mood and self-esteem, while poor physical health can worsen mental health issues. Additionally, environmental factors like pollution and limited access to green spaces negatively affect mental health, leading to feelings of helplessness and anxiety. Effective strategies to improve this interconnectedness include integrating physical and mental health services, promoting physical activity and lifelong learning, and improving environmental conditions through eco-friendly practices.

• Community Relations and Mental Health:  Mental health is profoundly influenced by the quality of interpersonal and community relationships. Social conditions such as isolation, work-life imbalance, and unsafe environments can significantly heighten mental health risks. Vulnerable groups such as women, sexual and gender minorities, and other marginalized populations, often face additional stresses like intimate partner violence and discrimination.  Creating safe, inclusive communities is critical for mental well-being. Strategies to improve community relations might involve urban design that encourages safety and social interactions, addressing the uneven burden of unpaid work often carried by women, and promoting civic involvement and political participation among those with mental health issues. Such measures can foster stronger social networks and civic participation, which in turn provide emotional support, reduce loneliness, and enhance individuals' sense of belonging and purpose. These factors are essential for not only preventing mental health issues but also for promoting overall well-being in communities.

Implications for the Global Health and Development Agenda

Policy-makers in countries and international agencies need to reflect on how to address mental health in their policies and investment decisions so that they can improve both mental health and other economic, social and environmental policy goals.

The above consideration align well with the World Bank Group's mission to promote development that is inclusive, resilient, and sustainable. By acknowledging human capital-- the knowledge, skills, and health that people accumulate throughout their lives--as a vital element of national wealth and prosperity, it signals the need to prioritize mental health along with physical health and education as vital investments for sustainable development.

The results from a recent meta-analysis of the economic impacts of common treatments for mental ill-health in low- and middle-income countries show that psychosocial interventions significantly improve work outcomes among those suffering from mental disorders. There is a strong correlation between mental health improvements and economic outcomes, suggesting that enhancing mental health can reduce poverty by boosting employment opportunities and livelihood creation.

Going forward, it is crucial to keep in mind that addressing mental health challenges and their consequences in society requires a comprehensive and integrated multi-sector approach beyond biomedical interventions that focuses on the interconnectedness of various aspects of life. To be effective, however, a sustained effort is needed to build coalitions, adopt new ways of working, and leverage resources across sectors.