The Mental Health Continuum

Mental health and illness has sometime been described as a spectrum.

People at one end of the line or spectrum are very well, and those at the other end are very unwell with a serious mental illness.

In the middle might be people who have minor mental health problems.

This idea is not a very helpful method to understand mental health, as it can lead us to make false assumptions.

For example, one may falsely assume that most people are ‘well’ and that a few people, who are a long way removed at the other end of the spectrum, are ‘ill’ or ‘mad’.

This assumption creates a distance between people and causes fear. Another assumption is that once you know your place on the spectrum, it is where you will stay unless something dramatic happens to change it.

This denies the fact that we can make a big difference to our own mental health, both positively and negatively.

It also does not take account of the fact that our mental health changes a lot over relatively short periods of time.

A different and more helpful way of thinking about mental health is the continuum (Figure 1).

The four quadrants of the mental health continuum represent different possible times and situations in a person’s life.

On the right hand side of the diagram, two possible situations are described. Even if a person has no diagnosable illness, they can have either positive or negative mental well-being. Usually the person’s mental health will be affected by life events. If faced with redundancy or the break up of a long-term relationship, the person may find themselves at the lower end of the continuum, experiencing poor mental well-being. If things are going well and the person is looking after their emotional, mental, and physical health they may be higher up the continuum.

Similarly, on the left hand side of the diagram we see that a person with a diagnosed illness can also be experiencing either positive or negative mental well-being.

With the right treatment and proper supports in place, the person can live a happy and fulfilled life whether or not they are experiencing symptoms. Living life to the full may involve having meaningful things to do, having good relationships, a satisfying social life, and good self esteem. On the other hand, without the right treatment and support the person may experience negative mental health.

Being at the lower end of the mental health continuum puts people at greater risk of suicide, whether they have a mental illness or not.

Given that 1 in 4 adults will experience mental health problems at some time in their lives, we can see that it is possible for us to move into all four corners of the continuum at different times.

Knowing that mental health changes over time can help us to look after our own well-being. It can also help us to be more understanding and supportive of others when they are experiencing poor mental health.

There are other ways to look at the mental health continuum.

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