Past WHO European Advisor for Mental Health, Stockholm, Sweden
Health data, especially those generated in countries of dramatic societal transition and collected in the WHO European “Health for all” database during the last decennia show clearly that physical and mental health is indivisibly linked together and exist in continuous interaction. The parallelism of societal stress and figures of premature mortality even show that individual health is interrelated to public health. Furthermore, experiences from e.g. the internal warfare in the Balkan countries indicate that the mental health of a population, its tendencies to regressive reactions, its resistance to totalitarian developments and, thus, its democratic potential is linked to the status and maturity of mental health in a society. Therefore, efforts on health promotion seem important especially in times of societal crises and stressful changes and have to be implied both on an individual as on an aggregate level.
The public health development of last years as shown in health surveys of especially eastern European stressfully transitional societies and confirmed by new data emanating from on south European countries and their risk populations, as well as collected research evidence on psychosocial determinants of health presented by the World Health Organisation, have identified the determinants of health as following: Sense of existential cohesion, social connectedness and significance, self-determination and absence of helplessness as well as individual dignity and integrity.
In order to promote these determinants of health, culturally and individually a person centred and multidimensional approach is demanded, both on an individual level as well as aggregated on a societal level with focus on risk populations.
Thus, concrete strategies have to address these named health determinants differently in the different stressful processes as well as in different potentially pathogenic individual or societal environments – easily acessible and with low treshold, on a community level where people are existentially, culturally, psychologically and socially at home.
Risk populations have to be supported differently, e.g. immigrants, elderly, people on working places , males in one type of society, females at risk in another one, adolescents , mentally vulnerable or unemployed persons. A person centred way of salutogenic and health promoting action seems inevitable. Hereby a societal engaged psychiatry has an important part to play, following the role that environmental and climate experts have taken for a longer time in their attempts to mitigate the climatic and environmental consequences of adverse policy changes and political decisions.
This would mean that the psychiatric profession offers a pool of expertise to describe the panorama of problems, to analyse risks, to warn for adverse mental health developments, to provide and disseminate an impact awareness of political a decisions and to assess the mental health consequences of political decisions to be expected.
Today, notifying political regressive tendencies in the worlds around, we notice, that the political discourse and decision-making processes badly need professional mental health expertise, knowledgeable about human beings basic human needs and a public value directed to it. . Not only environmental and climatically disasters have to be avoided. Even risks for “mental tsunamis” cannot be excluded.