What is mental health?

For many Americans, our health — particularly our mental health — is often taken for granted until something goes wrong. Only then do we realize just how important health is to our sense of fulfillment and happiness.

After all, in today's fast-paced, technological world, there are often a variety of quick treatments for physical ailments, but not so for mental ones. If anything, treatments for mental health take time and patience for maximum effectiveness. In order to understand exactly what is meant by "mental health," we need to first define what the overarching concept of "health" means.

In the past, scientists in the past defined health simply as "an absence of disease or illness." However, in 1948, when the World Health Organization (WHO) was founded, the following definition of health was established: "A complete state of physical, mental and social well-being and not merely the absence of disease or infirmity."

Looking at this definition, we realize that individuals can at once be relatively healthy in some aspects of life (e.g., normal blood pressure of 120/80 mmHg), but unhealthy in others (e.g., suffering from depression). Thus, being healthy is not an "all-or-nothing" principle.

It is easy to assess physical health by taking health status measurements of the body. Blood pressure, temperature, and cholesterol levels, are all precise means by which we can tell if the physical components of the body are healthy. However, mental and social components of health are much more challenging to assess. Thoughts and perceptions of internal states are subjective and difficult to quantify. What then is mental health?

Mental health, as defined by the Surgeon General's Report on Mental Health, "refers to the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and cope with adversity." On the other end of the continuum is mental illness, a term that "refers to all mental disorders.

Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning." This notion of a continuum sees mental health on one end as 'successful mental functioning' compared to mental illness on the other end as 'impaired functioning.'

A key to understanding mental health and mental illness is defining these terms in cultural contexts. The Western notion of mental health divides overall health into three realms; the Eastern notion views health in terms of bodily systems working in harmony. Imbalance or "disharmony" is the cause of illness and results from physical, psychological, nutritional, environmental or spiritual influences tipping that balance.

Why worry about mental health?

Why should Americans care about their mental health? The most obvious answer is that without being mentally healthy, an individual cannot consider herself "healthy" in the true sense of the word. More importantly, however, mental health affects our physical and social health. Researchers in health psychology have conducted numerous studies wherein mental disorders such as depression or social support have affected the outcomes of pregnancy [Source: Nuckolls], gastrointestinal disorders [Source: Craig and Brown], and heart disease [Source: Rozanski]. Components of our mental health not only affects our emotional states, but our bodies physiological and biological states, as well. Psychological and social factors have been linked to physical disease states in three ways: (1) psychophysiological hyperactivity, (2) disease stability and (3) host vulnerability.

Though psychophisiological hyperactivity sounds like a complicated concept, it simply means that there is continuous mental stress being put on the body. If one is continuously exposed to a stressful environment, the body's ability to fight infection is reduced. Stress, in all of its forms, from mental to job-related, affects physical health in a variety of ways. Constant work strain, related to perceived levels of control at work, and lowered levels of social support have been shown to elevate risks for cardiovascular disease [Source: Johnson]. Psychological stress, resulting from both work and personal life, has been shown to increase the risk of heart disease [Source: Rozanski]. Stresses associated with migration from one culture to another has shown a worsening in existing physical illnesses, such as cancer [Source: Cohen] especially where there was a perceived reduction of social support.

Disease stability refers to how psychological or social factors may influence existing disease. For instance, people who have asthma can never exactly predict when an asthma attack will occur or how severe the attack will be. Attacks and severity however, can be influenced by psychosocial factors such as the degree of stress in the immediate environment. The greater the stress the person is feeling, the greater the chance for a severe attack.

Host vulnerability is the prolonged effects of stress on the body. In essence, the patient or "host" is much more vulnerable to disease and illness because of exposure to mental stressors. This concept has been validated by research that shows that people are more likely to develop a common cold when they are under stress [Source: Baider].

When we go to the doctor's to describe a physical ailment (e.g., stomach pains), these physical complaints or symptoms may be affected by the mental stress we encounter in our daily lives. Add to the mental stress a feeling of isolation and lack of social support and many physical symptoms may be exacerbated or prolonged. In effect these three concepts illustrate just how inextricably linked the components of physical, mental and social health are related. In order to more effectively treat these ailments we must therefore treat the entire person—the mind, the body, and the soul of the individual.

Lots More Information

Sources

(Nuckolls, 1972) taken from Steptoe A. & Wardle, J. (Eds) (1994) Psychosocial Processes and Health: A Reader. Cambridge: Cambridge University Press.
(Craig and Brown, 1984) taken from Steptoe A. & Wardle, J. (Eds) (1994) Psychosocial Processes and Health: A Reader. Cambridge: Cambridge University Press.
(Rozanski, 1991) taken from Steptoe A. & Wardle, J. (Eds) (1994) Psychosocial Processes and Health: A Reader. Cambridge: Cambridge University Press.
(Johnson, 1988) taken from Steptoe A. & Wardle, J. (Eds) (1994) Psychosocial Processes and Health: A Reader. Cambridge: Cambridge University Press.
(Rozanski, 1991) taken from Steptoe A. & Wardle, J. (Eds) (1994) Psychosocial Processes and Health: A Reader. Cambridge: Cambridge University Press.
(Cohen, 1991) taken from Steptoe A. & Wardle, J. (Eds) (1994) Psychosocial Processes and Health: A Reader. Cambridge: Cambridge University Press.
Baider, L. Kaufman, B. Ever-Hadani, P. & De-Nour, A. (1996) Coping with additional stresses: comparative study of healthy and cancer patient new immigrants. Social Science and Medicine, 42 (7), 1077-1084.

ABOUT THE AUTHOR

Dr. Grace Tsai received her doctorate from the Johns Hopkins School of Public Health with an emphasis on Social and Behavioral Sciences. She investigated mental health issues in Asian and Asian American communities for her doctoral dissertation. She has served as a Psychiatric Epidemiologist in the Department of Mental Hygiene at Johns Hopkins. Dr. Tsai has also researched other mental health topics such as depression and suicide. She writes on mental health issues for various health organizations.