Focus

Mental health promotion matters

Harnessing the strengths of children and youth

By Marianne Kobus-Matthews and Suzanne Jackson

In some ways, it is obvious that promoting mental health is a good idea for children and youth. Positive mental health is a fundamental building block for learning, development, healthy relationships and employment. The road through childhood and adolescence is often a bumpy one, due to a myriad of internal and external forces and challenges. It is particularly important when working with at-risk youth to recognize the contribution that positive mental health offers in meeting these challenges, and to address the risk and protective factors that influence mental health. In a health care system that has traditionally focused on illness and disease and where mental health promotion is often overlooked, best practices guidelines can help clinicians and community-based service providers integrate mental health promotion practices into their work with youth.

Best Practice Guidelines for Mental Health Promotion Programs: Children and Youth is as web-based resource that provides support and best practice advice for health and social services professionals working with at-risk youth, families and whole communities to promote mental health. For clinicians, the guidelines underscore the fundamental importance of positive mental health in addressing many of the challenges that face at-risk youth. Mental health promotion has an important role to play in prevention, treatment and recovery.

This resource, developed by the Centre for Addiction and Mental Health in Toronto, the Centre for Health Promotion at the University of Toronto and Toronto Public Health, identifies the 10 best practices that will help practitioners improve or develop mental health promotion interventions.

Here, we outline these 10 practices and provide examples of mental health promotion in action around the world.

1. Address risk and protective factors, including the determinants of health, that indicate possible mental health concerns
   Assess which factors and health determinants can be modified and develop a plan to enhance protective factors, reduce risk factors and influence health determinants relevant to the population of concern. Risk factors are characteristics of individuals, their families, social networks, communities and environment that make it more likely for problems to develop. They include individual vulnerabilities such as substance use and stressful environments such as isolation. Protective factors, such as coping skills and social support, enable people to cope with everyday events by acting as buffers in the face of adversity. They moderate the impact of stress on the well-being of individuals, families and communities. Health status is also influenced by the determinants of health, which include personal, social, economic and environmental factors like income, shelter, peace, food and employment. The determinants of health interact with protective and risk factors to influence the quality of life.
2. Intervene in multiple settings, with a focus on schools
   Develop strategies to intervene in multiple settings such as daycares, schools, homes and communities with a focus on schools as a key setting. Examples of interventions in multiple settings include school-wide events, links between the school and the community around youth-friendly issues and parenting programs for pre-school children in libraries, community settings and schools.
3. Focus on skill building, empowerment, self-efficacy and individual resilience and respect
   Build the skills of both young people and their parents. Incorporate into the intervention a focus on individual and parental skills training, family communication and management skills, dealing with feelings of loss, conflict and anger in a respectful manner.
4. Train non-professionals to establish trusting relationships
   Train supervised non-professionals to establish caring and trusting relationships with children and youth. Train youth to be peer supports and educators where appropriate, for example, through mentorship programs in community settings like schools or Big Brothers/Big Sisters programs, and through peer relations and peer tutoring.
5. Involve multiple stakeholders
   Involve multiple stakeholders by including students, school staff, parents, family members and community members in program planning, development and implementation, and ensuring the intended audience is directly involved in planning and decision-making.
6. Provide comprehensive support systems that focus on peer and parent-child relations and academic performance
   Facilitate the development or improvement of a strong support network for the population of concern, including emotional, social and physical support through school, community and health services, and by providing tangible assistance such as transportation in order to allow individuals to attend group sessions.
7. Adopt multiple interventions
   Plan a comprehensive approach by using multiple strategies that include building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services. Also, use strategies to reach multiple audiences in formats appropriate to their needs and preferences.
8. Address opportunities for organizational change, policy development and advocacy
   Work toward these goals by mobilizing parents, teachers and youth; monitoring upcoming legislation and government initiatives to influence change that incorporates a mental health promotion approach; implementing strategies to assess the organizational climate and create health promoting schools and workplaces; and identifying policy initiatives to influence school culture.
9. Demonstrate a long-term commitment to program planning, development and evaluation
   Demonstrate this commitment by conducting a situational assessment to help design an intervention and define its target audience. Involve members of the target group from the start, and ensure that the length and intensity of the intervention is appropriate and will achieve the intended outcomes. Regularly revise program objectives to ensure that progress toward goals is met and ensure that data collection methods and mechanisms are in place.
10. Ensure that information and services provided are culturally appropriate, equitable and holistic
    This goal can be achieved by facilitating access for parents and children to culturally relevant, supportive social networks; providing understandable, culturally appropriate information; facilitating participation from minority groups and considering the possible consequences to socially disadvantaged families; and providing a holistic and integrative approach to dealing with mental health issues.

Marianne Kobus-Matthews is a senior health promotion consultant at the Centre for Addiction and Mental Health.

Suzanne Jackson is director of the Centre for Health Promotion at the University of Toronto.