Mental health: introduction

What is mental health?

There are many definitions of mental health. It can be used as an umbrella term to refer to both the concepts of mental health conditions and mental wellbeing.

Mental health influences how we think and feel, about ourselves and others, and how we interpret events. It affects our capacity to learn, to communicate and to form, sustain and end relationships. It also influences our ability to cope with change, transition and life events. 

Mental wellbeing

Mental wellbeing includes aspects of subjective wellbeing: ‘affect’ (the subjective experience of happiness), life satisfaction, and psychological wellbeing (such as a sense of control, having a purpose in life, a sense of belonging and positive relationships with others). It is more than the absence of mental health problems.

According to the Mental Health Foundation, individuals with good mental wellbeing:

• develop emotionally, creatively, intellectually and spiritually,
• initiate, develop and sustain mutually satisfying personal relationships,
• face problems, resolve them and learn from them and are able to cope with adversities (i.e., show resilience),
• have the capacity to contribute to family and other social networks, local community and society,
• have a positive sense of wellbeing,
• have individual resources including self-esteem, optimism, and sense of mastery and coherence,
• are confident and assertive,
• are aware of others and empathise with them,
• use and enjoy solitude,
• play and have fun,
• laugh, both at themselves and at the world.

Mental health conditions

Mental health conditions are defined and classified as a range of symptoms that meet the criteria for clinical diagnosis; they affect the way you think, feel and behave. Examples include more common mental health conditions such as depression and anxiety, and severe, enduring mental health conditions such as schizophrenia.

Mental health conditions can be classified for diagnostic purposes through recognised classifications such as the WHO International Classification of Disease (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition, produced by the American Psychiatric Association (2022). 

Mental health as a public health issue

Mental health is an integral part of public health and is as important as physical health to the overall wellbeing of individuals, communities and societies. Indeed, it has been said that 'there is no health without mental health' and everyone has mental health needs (see Mental health: new understanding, new hope (2.5MB)).

Mental wellbeing is important for individuals as well as for society. At an individual level, it enables people to realise their intellectual and emotional potential and to find and fulfil their roles in social, school and working life. At society level, mental wellbeing is a resource for social cohesion and better social and economic welfare (Keyes 2002 (233kB)). This is underpinned by a wealth of evidence that "mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual solutions" (Friedli, 2009 (459kB)).

Mental health and wellbeing problems cause a large and increasing burden that contributes to high costs to societies, long-lasting disability, increased mortality and enormous human suffering. Mental health problems account for a substantial proportion of the burden of disease in Scotland. 

A ‘public mental health’ approach needs to be taken, which means taking a systematic approach to working towards the best mental health possible for the whole population. This includes addressing both the root causes of poor mental health and strengthening the factors that boost positive mental wellbeing, in active partnership with relevant communities.

This kind of approach seeks to address the social, environmental, and individual determinants of mental health, and in doing so, seeks to:

• Improve population mental health through the promotion of mental wellbeing, prevention of mental health problems, and improving the quality of life of those experiencing mental ill health,
• Reduce inequalities in mental health,
• Reduce the health inequalities of those experiencing mental health problems.

Campion (2019) outlines potential avenues for implementation of public mental health interventions and policy actions in the UK.

There is also a strong economic case for improving public mental health. In their report The economic case for investing in the prevention of mental health conditions in the UK (5.1MB), McDaid and Park estimate that mental health conditions cost the Scottish economy £8.8 billion every year.

COVID-19 and mental health

The COVID-19 pandemic has impacted Scotland’s health in direct and indirect ways, including a variety of impacts on public mental health.

The Scottish Government published five reports between 2020 and 2022 as part of the Scottish COVID-19 (SCOVID) Mental Health Tracker Study. The study measured the mental health and wellbeing impacts of the COVID-19 pandemic on adults in Scotland. It found evidence of an overall trend of worse self-reported mental health during times of higher restrictions (e.g., lockdowns), as well as evidence of inequalities in how the pandemic affected different groups of people.

In 2022, Public Health Scotland, Scottish Government, and Healthcare Improvement Scotland published the report, ‘The early impacts of the COVID-19 pandemic on Scotland’s mental health – not just one story’. The report brings together qualitative and quantitative evidence and material around the impacts of the pandemic on people’s mental health in Scotland.