mental health in life essay

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Mental Health Essay

Introduction

Mental health, often overshadowed by its physical counterpart, is an intricate and essential aspect of human existence. It envelops our emotions, psychological state, and social well-being, shaping our thoughts, behaviors, and interactions. With the complexities of modern life—constant connectivity, societal pressures, personal expectations, and the frenzied pace of technological advancements—mental well-being has become increasingly paramount. Historically, conversations around this topic have been hushed, shrouded in stigma and misunderstanding. However, as the curtains of misconception slowly lift, we find ourselves in an era where discussions about mental health are not only welcomed but are also seen as vital. Recognizing and addressing the nuances of our mental state is not merely about managing disorders; it's about understanding the essence of who we are, how we process the world around us, and how we navigate the myriad challenges thrown our way. This essay aims to delve deep into the realm of mental health, shedding light on its importance, the potential consequences of neglect, and the spectrum of mental disorders that many face in silence.

Importance of Mental Health

Mental health plays a pivotal role in determining how individuals think, feel, and act. It influences our decision-making processes, stress management techniques, interpersonal relationships, and even our physical health. A well-tuned mental state boosts productivity, creativity, and the intrinsic sense of self-worth, laying the groundwork for a fulfilling life.

Negative Impact of Mental Health

Neglecting mental health, on the other hand, can lead to severe consequences. Reduced productivity, strained relationships, substance abuse, physical health issues like heart diseases, and even reduced life expectancy are just some of the repercussions of poor mental health. It not only affects the individual in question but also has a ripple effect on their community, workplace, and family.

Mental Disorders: Types and Prevalence

Mental disorders are varied and can range from anxiety and mood disorders like depression and bipolar disorder to more severe conditions such as schizophrenia.

• Depression: Characterized by persistent sadness, lack of interest in activities, and fatigue.
• Anxiety Disorders: Encompass conditions like generalized anxiety disorder, panic attacks, and specific phobias.
• Schizophrenia: A complex disorder affecting a person's ability to think, feel, and behave clearly.

The prevalence of these disorders has been on the rise, underscoring the need for comprehensive mental health initiatives and awareness campaigns.

Understanding Mental Health and Its Importance

Mental health is not merely the absence of disorders but encompasses emotional, psychological, and social well-being. Recognizing the signs of deteriorating mental health, like prolonged sadness, extreme mood fluctuations, or social withdrawal, is crucial. Understanding stems from awareness and education. Societal stigmas surrounding mental health have often deterred individuals from seeking help. Breaking these barriers, fostering open conversations, and ensuring access to mental health care are imperative steps.

Conclusion: Mental Health

Mental health, undeniably, is as significant as physical health, if not more. In an era where the stressors are myriad, from societal pressures to personal challenges, mental resilience and well-being are essential. Investing time and resources into mental health initiatives, and more importantly, nurturing a society that understands, respects, and prioritizes mental health is the need of the hour.

• World Leaders: Several influential personalities, from celebrities to sports stars, have openly discussed their mental health challenges, shedding light on the universality of these issues and the importance of addressing them.
• Workplaces: Progressive organizations are now incorporating mental health programs, recognizing the tangible benefits of a mentally healthy workforce, from increased productivity to enhanced creativity.
• Educational Institutions: Schools and colleges, witnessing the effects of stress and other mental health issues on students, are increasingly integrating counseling services and mental health education in their curriculum.

In weaving through the intricate tapestry of mental health, it becomes evident that it's an area that requires collective attention, understanding, and action.

  Short Essay about Mental Health

Mental health, an integral facet of human well-being, shapes our emotions, decisions, and daily interactions. Just as one would care for a sprained ankle or a fever, our minds too require attention and nurture. In today's bustling world, mental well-being is often put on the back burner, overshadowed by the immediate demands of life. Yet, its impact is pervasive, influencing our productivity, relationships, and overall quality of life.

Sadly, mental health issues have long been stigmatized, seen as a sign of weakness or dismissed as mere mood swings. However, they are as real and significant as any physical ailment. From anxiety to depression, these disorders have touched countless lives, often in silence due to societal taboos.

But change is on the horizon. As awareness grows, conversations are shifting from hushed whispers to open discussions, fostering understanding and support. Institutions, workplaces, and communities are increasingly acknowledging the importance of mental health, implementing programs, and offering resources.

In conclusion, mental health is not a peripheral concern but a central one, crucial to our holistic well-being. It's high time we prioritize it, eliminating stigma and fostering an environment where everyone feels supported in their mental health journey.

Frequently Asked Questions

• What is the primary focus of a mental health essay?

Answer: The primary focus of a mental health essay is to delve into the intricacies of mental well-being, its significance in our daily lives, the various challenges people face, and the broader societal implications. It aims to shed light on both the psychological and emotional aspects of mental health, often emphasizing the importance of understanding, empathy, and proactive care.

• How can writing an essay on mental health help raise awareness about its importance?

Answer: Writing an essay on mental health can effectively articulate the nuances and complexities of the topic, making it more accessible to a wider audience. By presenting facts, personal anecdotes, and research, the essay can demystify misconceptions, highlight the prevalence of mental health issues, and underscore the need for destigmatizing discussions around it. An impactful essay can ignite conversations, inspire action, and contribute to a more informed and empathetic society.

• What are some common topics covered in a mental health essay?

Answer: Common topics in a mental health essay might include the definition and importance of mental health, the connection between mental and physical well-being, various mental disorders and their symptoms, societal stigmas and misconceptions, the impact of modern life on mental health, and the significance of therapy and counseling. It may also delve into personal experiences, case studies, and the broader societal implications of neglecting mental health.

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5. Why Do I Miss Being Bipolar? — Sasha Chapin

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6. What My Best Friend And I Didn’t Learn About Loss — Zan Romanoff

"When my closest friend’s first baby was stillborn, we navigated through depression and grief together."

7. I Can’t Live Without Fear, But I Can Learn To Be OK With It — Arianna Rebolini

"I’ve become obsessively afraid that the people I love will die. Now I have to teach myself how to be OK with that."

8. What It’s Like Having PPD As A Black Woman — Tyrese Coleman

"It took me two years to even acknowledge I’d been depressed after the birth of my twin sons. I wonder how much it had to do with the way I had been taught to be strong."

9. Notes On An Eating Disorder — Larissa Pham

"I still tell my friends I am in recovery so they will hold me accountable."

10. What Comedy Taught Me About My Mental Illness — Kate Lindstedt

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11. The Night I Spoke Up About My #BlackSuicide — Terrell J. Starr

"My entire life was shaped by violence, so I wanted to end it violently. But I didn’t — thanks to overcoming the stigma surrounding African-Americans and depression, and to building a community on Twitter."

12. Knitting Myself Back Together — Alanna Okun

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13. I Started Therapy So I Could Take Better Care Of Myself — Matt Ortile

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"I had to learn how to love myself enough to take care of myself. It wasn’t easy."

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• Mental Health

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113 Mental Health Essay Topic Ideas & Examples

Inside This Article

Mental health is a crucial aspect of overall well-being, yet it is often overlooked or stigmatized in society. Writing about mental health can help raise awareness, reduce stigma, and promote understanding and empathy. If you are looking for inspiration for your next mental health essay, here are 113 topic ideas and examples to get you started.

• The impact of social media on mental health
• The stigma surrounding mental illness in society
• How to support a loved one with a mental health condition
• The benefits of therapy for mental health
• The relationship between physical and mental health
• The role of exercise in improving mental health
• Mental health in the workplace
• The connection between trauma and mental health
• The importance of self-care for mental health
• Mental health in the elderly population
• The impact of substance abuse on mental health
• The role of genetics in mental health conditions
• The relationship between sleep and mental health
• Mental health in the LGBTQ+ community
• The effects of chronic stress on mental health
• The link between nutrition and mental health
• Mental health in children and adolescents
• The impact of technology on mental health
• The benefits of mindfulness for mental health
• Mental health in marginalized communities
• The role of medication in treating mental health conditions
• Mental health in the military
• The connection between mental health and creativity
• The impact of climate change on mental health
• Mental health in the criminal justice system
• The effects of bullying on mental health
• The relationship between mental health and homelessness
• The role of music therapy in mental health treatment
• Mental health in the refugee population
• The impact of childhood trauma on adult mental health
• The benefits of art therapy for mental health
• The effects of social isolation on mental health
• The role of spirituality in mental health
• Mental health in the immigrant population
• The connection between mental health and physical illness
• The impact of peer pressure on mental health
• The benefits of journaling for mental health
• Mental health in the entertainment industry
• The relationship between perfectionism and mental health
• The effects of social comparison on mental health
• The role of pets in improving mental health
• Mental health in the age of technology
• The connection between mental health and climate change
• The impact of social media influencers on mental health
• The benefits of volunteering for mental health
• Mental health in the education system
• The relationship between mental health and addiction
• The effects of discrimination on mental health
• The role of exercise in preventing mental health conditions
• Mental health in the aging population
• The connection between mental health and chronic illness
• The impact of poverty on mental health
• The benefits of group therapy for mental health
• The relationship between mental health and personality traits
• The effects of childhood neglect on adult mental health
• The role of mindfulness in preventing mental health conditions
• The connection between mental health and physical health
• The impact of social media on body image and mental health
• The benefits of cognitive-behavioral therapy for mental health
• The relationship between mental health and financial stress
• The effects of trauma on mental health
• The relationship between mental health and social support

These are just a few ideas to get you started on your mental health essay. Remember, mental health is a complex and multifaceted topic, so feel free to explore different angles and perspectives in your writing. By shedding light on mental health issues, you can help promote understanding, empathy, and support for those who may be struggling.

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What Is Mental Health?

Hinterhaus Productions / Taxi / Getty Images

Characteristics

Poor self-esteem.

Mental health is a term used to describe emotional, psychological, and social well-being. The quality of a person's mental health is often measured by how adaptively they can cope with everyday stressors.

Mental health allows people to use their abilities, be productive, make decisions, and play an active role in their communities.

Having poor mental health is often confused with having a mental illness . But mental health actually refers to a person's state of mental well-being whether or not they have a psychiatric condition.

History of Mental Health

A paper in the World Psychiatry journal states that mental health officially emerged as its own field of study in 1946 during the International Health Conference.

It was during this conference that the World Health Organization (WHO) was founded. The WHO Constitutions stated that mental "well-being" is an integral part of overall health, even in the absence of psychiatric illness.

Before mental health, "mental hygiene" was a term used in the 19th and 20th centuries to refer to the impact that mental processes have on overall health.

A mental hygiene movement had formed in the United States in 1908. Its goal was to advocate for people who were "mentally sick," or people who had psychiatric conditions, in a more humane way as historically, people with mental illnesses were abused, neglected, and lacked adequate care.

Though stigma surrounding mental illness still exists, more and more people have realized the importance of receiving treatment—like psychotherapy —for maintenance of their mental well-being, regardless of whether they have a mental illness.

Additionally, an abundance of research has found that positive mental health is linked with improved quality of life, including better productivity, closer social connections, higher educational achievement, and improved relationships.

Mental health refers not only to emotional well-being but also to how people think and behave. There are a number of different factors that have been found to influence mental health.

Life Satisfaction

A person's ability to enjoy life is frequently used as an indicator of mental health and wellness. It is often defined as the degree to which a person enjoys the most important aspects of their life. 

Some factors that have been found to play an important role in life satisfaction include the absence of feeling ill, good relationships , a sense of belonging, being active in work and leisure, a sense of achievement and pride, positive self-perceptions , a sense of autonomy, and feelings of hope.

The ability to bounce back from adversity   has been referred to as resilience . People who are resilient also tend to have a positive view of their ability to cope with challenges and seek out social support when they need it. Those who are more resilient are better able to not only cope with stress but to thrive even in the face of it.

Social support is important for positive mental health. Loneliness is linked with both physical and mental health issues including cardiovascular disease, depression , memory problems, drug misuse , alcohol misuse , and altered brain function.

Decreases in social support caused by life changes such as going to college, facing social adversity, changing jobs, or getting divorced can have a negative impact on mental health.

Fortunately, research suggests that it is not necessarily the number of supportive connections you have that it is the most important but rather the quality of these relationships.  

Flexibility

Having rigid expectations can sometimes create added stress. Emotional flexibility may be just as important as cognitive flexibility. Mentally healthy people experience a range of emotions and allow themselves to express these feelings. Some people shut off certain feelings, finding them to be unacceptable.

Lack of psychological flexibility has been linked to some types of psychopathology , while research suggests that increased flexibility is connected to better life balance and improved resilience.

Challenges to Mental Health

The National Alliance on Mental Illness (NAMI) states that an estimated one in five U.S. adults experiences a mental health problem each year.  There are a number of risk factors that can increase the likelihood that a person may experience poor mental health.

Discrimination

Being treated unfairly due to personal characteristics such as age, race, ethnicity, disability, sexual orientation, or gender identity is linked with increased anxiety and depression.

Exposure to Trauma

Trauma is linked with anxiety, depression, changes in mood (increased anger and irritability), feelings of hopelessness, and post-traumatic stress disorder (PTSD).

Family History of Mental Illness

Research suggests that a variety of mental illnesses run in families such as attention-deficit/hyperactivity disorder (ADHD), bipolar disorder , major depressive disorder (MDD), and schizophrenia .

Low income is linked with increased levels of stress, anxiety, and depression. Low income may also prevent someone from accessing necessary mental health services.

Medical Illness

Illnesses, particularly those that are chronic and force a person to adjust their lifestyle, can create psychological distress (especially depression).

Poor Access to Health Services

Access to health services is linked to positive long-term health outcomes. However, when people can't get access to the health care they need, their physical and mental health may suffer as a result.

Having low self-esteem often means you don't believe you're worthy of being happy or having positive relationships. People with low self-esteem are at higher risk of developing substance use disorders, anxiety, and depression.

Poor Social Skills

Having poor social skills is linked with loneliness and increased stress levels, as well as worsened physical health.

Social Inequalities

Lacking access to goods and services in society based on personal characteristics like your age, gender, religion, race, disability, or another social category can increase the risk of depression.

Substance Use

Substance use is linked with high rates of anxiety, depression, and insomnia.

Impact of Mental Health

The state of a person's mental health has a significant impact on their quality of life. Taking care of your mental health allows you to contribute to your community, cope with stress, have quality relationships, and maintain physical health.

Mental health can help you to work toward your full potential in all aspects of your life. Improved mental health is also linked with better physical health. Research has found that positive mental health can reduce the risk of heart attacks and strokes.

Poor mental health, on the other hand, is linked with issues like increased stress, sleep problems, smoking, and substance use . If your mental health is suffering, you might feel overwhelmed more easily, have trouble maintaining relationships, and experience low self-esteem.

How to Stay Mentally Healthy

The U.S. Department of Health and Human Services suggests that some of the ways that you can promote and maintain mental health include the below.  

Physical Exercise

Physical exercise can reduce stress and even improve the symptoms of anxiety disorders and depression. It reduces the body's levels of stress hormones and elevates levels of endorphins, which promote mood regulation and feelings of well-being.

Your workout doesn't need to be strenuous either. Try taking a 20-minute walk and you might just notice the effect it has on clearing and relaxing your mind.

Adequate Sleep  

Not getting enough sleep can worsen mental health and cause mental distress, especially in people with existing mental health conditions. The American Academy of Sleep Medicine recommends getting at least seven hours per night.

Mental health conditions can make it extra challenging to fulfill your sleep requirements, but there are ways you can improve your sleeping habits.

Try adhering to a consistent sleep schedule (going to bed and waking up at the same times each night), limiting distractions like using your phone before bed, and making sure you get some exercise during the day. Be sure to consult a healthcare provider if your lack of sleep is causing mental distress.

Help Others 

One study found that helping behavior and other kinds of social interactions were linked with reduced stress and even longer lifespans.

Try volunteering in your community or even lending a hand to people in your everyday life. Performing small acts of kindness can make you and the recipient of your generosity feel a boost in mood and well-being.

Learn Coping Skills

Learning healthy coping mechanisms for managing stress can go a long way in improving mental health.

Some productive coping mechanisms include getting emotional support from loved ones, finding humor in your everyday life , and taking action to better your situation. It's all about finding what works best for you.

In cognitive behavioral therapy (CBT), a therapist works with patients to find the best coping skills for their unique circumstances.

Stay Connected to Others

Social interaction can reduce our stress levels, improve the symptoms of depression, and even benefit our physical health.

Research has found that social connection has positive impacts on health categories like cancer, weight management, diabetes, and cardiovascular disease.

Having social interactions in a setting such as group therapy, for instance, might be especially helpful if you are coping with a specific mental health condition like post-traumatic stress disorder or an eating disorder .

Keep a Positive Outlook

There are many health benefits to using optimism and positive thinking in your everyday life.

One study found that participants with generalized anxiety disorder (GAD) who practiced replacing thoughts of negative outcomes with thoughts of positive ones experienced less worry over time than participants who didn't imagine positive outcomes.

A Word From Verywell

There are many factors that influence mental health and overall well-being. Individual factors play an important part, but social, environmental, and financial circumstances can also either enhance or worsen mental health.

It is important to seek help if you are having difficulties. Talk to a doctor or mental health professional if you need help improving your mental health or addressing a psychological problem.

Centers for Disease Control and Prevention. About mental health .

World Health Organization. Mental health .

Bertolote J. The roots of the concept of mental health .  World Psychiatry . 2008;7(2):113-116. doi:10.1002/j.2051-5545.2008.tb00172.x

Connell J, O'Cathain A, Brazier J. Measuring quality of life in mental health: Are we asking the right questions? .  Soc Sci Med . 2014;120:12–20. doi:10.1016/j.socscimed.2014.08.026

Walker FR, Pfingst K, Carnevali L, Sgoifo A, Nalivaiko E.  In the search for integrative biomarker of resilience to psychological stress .  Neurosci Biobehav Rev.  2017;74(Pt B):310-320. doi:10.1016/j.neubiorev.2016.05.003

Hämmig O.  Health risks associated with social isolation in general and in young, middle and old age . PLoS One . 2019;14(7):e0219663. doi:10.1371/journal.pone.0219663

Umberson D, Montez JK. Social relationships and health: A flashpoint for health policy .  J Health Soc Behav . 2010;51 Suppl(Suppl):S54–S66. doi:10.1177/0022146510383501

Kashdan TB, Rottenberg J. Psychological flexibility as a fundamental aspect of health .  Clin Psychol Rev . 2010;30(7):865–878. doi:10.1016/j.cpr.2010.03.001

National Alliance on Mental Health. Mental health by the numbers .

World Health Organization. Risks to mental health: An overview of vulnerabilities and risk factors .

American Psychological Association. The impact of discrimination .

Kleber RJ. Trauma and public mental health: A focused review .  Front Psychiatry . 2019;10:451. doi:10.3389/fpsyt.2019.00451

National Institutes of Health. Common genetic factors found in 5 mental disorders .

Patel V, Burns JK, Dhingra M, Tarver L, Kohrt BA, Lund C. Income inequality and depression: A systematic review and meta-analysis of the association and a scoping review of mechanisms .  World Psychiatry. 2018;17(1):76-89. doi:10.1002/wps.20492

National Institute of Mental Health. Chronic illness and mental health: Recognizing and treating depression .

Coombs NC, Meriwether WE, Caringi J, Newcomer SR. Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study .  SSM Popul Health . 2021;15:100847. doi:10.1016/j.ssmph.2021.100847

National Alliance on Mental Illness. Why self-esteem is important for mental health .

Segrin C. Indirect effects of social skills on health through stress and loneliness . Health Communication. 2017;34(1):118-124. doi:10.1080/10410236.2017.1384434

Yu, S. Uncovering the hidden impacts of inequality on mental health: A global study .  Transl Psychiatry.  2018;8:98. doi:10.1038/s41398-018-0148-0

Morris DH, Davis AK, Lauritsen KJ, et al. Substance use consequences, mental health problems, and readiness to change among Veterans seeking substance use treatment .  J Subst Abuse Treat . 2018;94:113-121. doi:10.1016/j.jsat.2018.08.005

National Library of Medicine. Mental health .

Centers for Disease Control and Prevention. Heart disease and mental health disorders .

U.S. Department of Health and Human Services. What is mental health? .

Harvard Health Publishing. Exercising to relax .

Blackwelder A, Hoskins M, Huber L. Effect of inadequate sleep on frequent mental distress . Preventing Chronic Disease. 2021;18:200573. doi:10.5888/pcd18.200573

Poulin MJ, Brown SL, Dillard AJ, Smith DM. Giving to others and the association between stress and mortality .  Am J Public Health . 2013;103(9):1649-1655. doi:10.2105/AJPH.2012.300876

Saxon L, Makhashvili N, Chikovani I, et al. Coping strategies and mental health outcomes of conflict-affected persons in the Republic of Georgia .  Epidemiol Psychiatr Sci . 2017;26(3):276-286. doi:10.1017/S2045796016000019

Martino J, Pegg J, Frates EP. The connection prescription: Using the power of social interactions and the deep desire for connectedness to empower health and wellness .  Am J Lifestyle Med . 2015;11(6):466-475. doi:10.1177/1559827615608788

Eagleson C, Hayes S, Mathews A, Perman G, Hirsch CR. The power of positive thinking: Pathological worry is reduced by thought replacement in generalized anxiety disorder .  Behav Res Ther . 2016;78:13-18. doi:10.1016/j.brat.2015.12.017

• Taylor, James, 1977.  Secret O' Life  Album: JT; Professional experience of 25 years as a practicing clinical psychologist.

By Leonard Holmes, PhD Leonard Holmes, PhD, is a pioneer of the online therapy field and a clinical psychologist specializing in chronic pain and anxiety.

Laura Harold is an editor and contributing writer for Verywell Family, Fit, and Mind.

Mental Health Essay for Students and Children

500+ words essay on mental health.

Every year world mental health day is observed on October 10. It was started as an annual activity by the world federation for mental health by deputy secretary-general of UNO at that time. Mental health resources differ significantly from one country to another. While the developed countries in the western world provide mental health programs for all age groups. Also, there are third world countries they struggle to find the basic needs of the families. Thus, it becomes prudent that we are asked to focus on mental health importance for one day. The mental health essay is an insight into the importance of mental health in everyone’s life. 

Mental Health

In the formidable years, this had no specific theme planned. The main aim was to promote and advocate the public on important issues. Also, in the first three years, one of the central activities done to help the day become special was the 2-hour telecast by the US information agency satellite system. 

Mental health is not just a concept that refers to an individual’s psychological and emotional well being. Rather it’s a state of psychological and emotional well being where an individual is able to use their cognitive and emotional capabilities, meet the ordinary demand and functions in the society. According to WHO, there is no single ‘official’ definition of mental health.

Thus, there are many factors like cultural differences, competing professional theories, and subjective assessments that affect how mental health is defined. Also, there are many experts that agree that mental illness and mental health are not antonyms. So, in other words, when the recognized mental disorder is absent, it is not necessarily a sign of mental health. 

Get the huge list of more than 500 Essay Topics and Ideas

One way to think about mental health is to look at how effectively and successfully does a person acts. So, there are factors such as feeling competent, capable, able to handle the normal stress levels, maintaining satisfying relationships and also leading an independent life. Also, this includes recovering from difficult situations and being able to bounce back.  

Important Benefits of Good Mental Health

Mental health is related to the personality as a whole of that person. Thus, the most important function of school and education is to safeguard the mental health of boys and girls. Physical fitness is not the only measure of good health alone. Rather it’s just a means of promoting mental as well as moral health of the child. The two main factors that affect the most are feeling of inferiority and insecurity. Thus, it affects the child the most. So, they lose self-initiative and confidence. This should be avoided and children should be constantly encouraged to believe in themselves.

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• Open access
• Published: 22 November 2012

Quality of life of people with mental health problems: a synthesis of qualitative research

• Janice Connell 1 ,
• John Brazier 2 ,
• Alicia O’Cathain 1 ,
• Myfanwy Lloyd-Jones 2 &
• Suzy Paisley 3  

Health and Quality of Life Outcomes volume  10 , Article number:  138 ( 2012 ) Cite this article

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To identify the domains of quality of life important to people with mental health problems.

A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis.

We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization.

Conclusions

Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.

Introduction

There has been a shift in mental health services from an emphasis on treatment focused on reducing symptoms, based on a narrow notion of health and disease, to a more holistic approach which takes into consideration both well-being and functioning [ 1 ]. Mental health services in the United Kingdom, for example, are now being planned and commissioned based on psychological formulations addressing a person’s wider well-being, need, and functional outcome alongside, or sometimes in place of, diagnostic categories and clinical ideas of cure and outcome [ 2 ]. At the same time, there has been an increasing use of generic measures of health related quality of life like EQ-5D and SF-36 in assessing the benefits of health care interventions in order to inform decisions about provision and reimbursement (eg National Institute for Health and Clinical Excellence) [ 3 ] and for assessing patient reported outcomes [ 4 ]. It is claimed these generic measures are appropriate for both physical and mental health conditions; however some argue they are not suitable for people with severe mental health problems, particularly psychosis [ 5 , 6 ].

One of the challenges of using the concept ‘quality of life’ as a basis for outcome measurement is that it can be defined, and therefore measured, in innumerable ways. The assumptions underlying such measurement can be influenced by both academic discipline and ideological perspective [ 7 ]. As a result there are many different overlapping models of quality of life including objective and subjective indicators, needs satisfaction, psychological and subjective well-being models, health, functioning and social models [ 8 ]. One on-going tension is whether a measure should have a subjective or objective orientation. A subjective orientation may emphasise the importance of ‘being’, which in turn can be viewed either in hedonistic terms as the experience of current happiness or pleasure, or as a more eudemonic approach which considers the more pervading attributes of self-fulfilment, realisation or actualization [ 9 , 10 ]. A subjective evaluative approach may also be taken which asks people to rate how satisfied they are with their lives and aspects of it [ 11 ]. On the other hand, a more objective approach used in social policy places its emphasis on meeting needs, whether they are healthy, have sufficient income for food and satisfactory living conditions, are well educated and have access to resources [ 9 , 12 ]. A review of eleven instruments for measuring quality of life for people with severe mental illness identified that the most commonly assessed domains are employment or work, health, leisure, living situation, and relationships [ 13 ]. These measures combine an objective with a subjective approach that establishes levels of satisfaction with these different objective life domains. However, concerns have been raised regarding the limited coverage of domains assessed in such instruments [ 14 , 15 ]. Furthermore, it is criticised that measures have primarily been generated from the perspective of mental health professionals or other experts using a top-down approach rather than by an assessment of what individuals with mental health problems perceive to be important to their quality of life [ 15 ]. These are also important potential criticisms of the generic measures of health related quality of life like the EQ-5D and SF-36 [ 5 ].

The aim of this literature review was to examine the quality of life domains that are important from the perspective of an individual with mental health problems. This research was part of a larger project considering the applicability and suitability of generic health related quality of life measures for people with mental health problems (MRC project number G0801394).

We sought to identify all primary qualitative research studies (involving methods such as interviews and focus groups) which explicitly asked adults with mental health problems what they considered to be important to their quality of life or how their quality of life had been affected by their mental health problems.

A range of approaches is available for synthesizing qualitative research [ 16 ]. Paterson et al. [ 17 ] recommend that the choice is made on the basis of the nature of the research question and design, the prevailing paradigm, and the researcher’s personal preference. In this review, framework synthesis was used. This is based on the ‘framework’ approach for the analysis of primary data [ 18 ] and is a highly structured approach to organizing and analyzing data which permits the expansion and refinement of an a priori framework to incorporate new themes emerging from the data [ 16 ]. It is appropriate here because the aim of our wider study was to identify whether existing outcomes measures are useful for measuring quality of life for people with mental health problems.

Search methods

Systematic reviews of clinical effectiveness evidence require extensive searching based on a clearly focussed search question. Defining a focussed question was neither possible nor appropriate here because a pre-specified search question would have imposed on the search process an a priori conceptual understanding of the topic under review. Given the abstract nature of the relevant concepts and associated search vocabulary, and given the exploratory and inductive nature of the review process, we needed to use an iterative approach to searching. This incorporated a number of different search techniques including keyword searching, taking advice from experts, hand searching and citation searching of relevant references and world-wide-web searching. The iterative approach provided a means of accommodating within the search process new themes emerging from the review as the scope of our conceptual understanding developed. The identification of relevant search terms was an evolving process. Four search iterations were undertaken. The choice of search terms used in earlier iterations was based on our initial understanding of the review topic and on papers identified by experts at the outset of the review. The choice of search terms used in later iterations was informed by the review of evidence identified by earlier search iterations. Key terms included mental health; mental illness; mental disorder; quality of life; well-being; well being; life satisfaction; life functioning; life change; recovery; subjective experience; lived experience; lifestyle; coping; adaptation; qualitative; qualitative research. For a full list of search terms and details of the evolving search iterations see Additional file 1 : Appendix 1 and Additional file 2: Appendix 2. Database searches were undertaken between October 2009 and April 2010 and included Medline, ASSIA, CINAHL, PsycINFO, and Web of Science. The searches were not restricted by date, language or country.

Inclusion and exclusion criteria

• Quality of life

The search started from a premise of not imposing a pre-conceived definition or model of ‘quality of life’. Whilst some studies retrieved had an explicit aim to explore quality of life we found other studies with very similar findings to those which explicitly examined the concept of quality of life even though quality of life was not the subject of investigation. These studies examined the concepts of: recovery, lived experience, subjective experience, psychosocial issues, health needs, and strategies for living. Complexities thus arose in deciding whether the studies were about the same substantive concept of quality of life or were tapping into a separate but overlapping concept. As Sandelowski [ 19 ] states ‘often research purposes and questions are so broadly stated it is only by looking at the kinds of findings produced that topical similarity can be determined’. We were aware of the danger that the inclusion of these studies could introduce themes that were not central to the concept of quality of life but were rather allied to a separate but related concept. A pragmatic decision was made to examine the research aims and interview questions of those studies which did not directly investigate the concept of quality of life and only include those which asked broad open-ended questions about how participants’ mental health affected their lives, what was important to or would improve their lives, or equated their findings with quality of life in some way. We excluded studies that deliberately started with a premise of the importance of any particular domain of quality of life or were structured solely around a pre-conceived list of domains.

Qualitative research

We included primary qualitative research studies that used qualitative interviews or focus groups data to identify the views of individuals with mental health problems. We excluded studies that used content analysis which presented results as a frequency list with no supporting participant quotes. Some studies sought the views of people with mental health problems and of carers or professionals; in such cases, we only included those studies in which the views of people with mental health problems could be separately identified.

• Mental health

We included research on all mood disorders (eg depression, bi-polar, mania), neurosis and stress related disorders (eg anxiety, phobias, post traumatic stress disorder) personality disorders and schizophrenia, schizotypal and delusional disorders. Included studies had to state that participants had mental health problems as identified either through diagnosis, or through attendance at an establishment for people with mental health problems. Studies where mental health problems were secondary to a physical health problem were excluded.

The use of quality assessment in reviews of qualitative research is contested. Quality assessment is usually used in framework synthesis but this may be associated with its use alongside systematic reviews of effectiveness [ 16 ]. In this review, articles were not quality assessed and systematically excluded on the basis of quality. However, it was of paramount importance that any included study elicited the perspective of individuals with mental health problems and where this appeared not to be the case they were excluded. Consequently, studies were excluded when it was strongly suspected that the views of the researcher, or the method of analysis, had overly influenced the findings. These articles were examined and discussed at length by the research team before being excluded.

Although the searches were not restricted to English language articles, non-English language articles were excluded because of the potential for mis-interpretation. Five potentially relevant articles were excluded on the grounds of language (Figure  1 ).

PRISMA flow diagram of searched articles.

Data extraction and analysis

The following details of the studies were extracted: mental health problem studied; author affiliation; time and location of study; number and demographic details of participants; research aims and questions; recruitment and sampling methods; and method of data collection and analysis. Themes within the findings and discussion sections were extracted for the thematic analysis.

Framework analysis [ 18 ] was used to allow the identification of common and variable patterns of themes within and across different studies. The first stage of framework analysis- familiarisation - was undertaken by reading all included papers. The second stage involved examining the findings from these papers to identify initial themes for a thematic framework. These ten initial descriptive themes were either identified as main themes from more than one study, or arose consistently across studies. These were: activity; relationships; the self; the future/aspirations; symptoms/well-being/emotions; spirituality; control/coping; insight/education; health care services/interventions; and resources/basic needs. The third stage, data organisation, involved charting data from the findings and discussion sections that corresponded to each theme. Text was transferred verbatim to ensure contextual accuracy. It was common for text to be identified as supporting more than one theme, for example a quote describing how work was good for their self-esteem would be placed in the thematic categories ‘activity’ and ‘self’. At the next stage each initial theme was examined and further sub-themes identified and documented within the framework chart. To assist with the final stage of framework - mapping - the sub-themes were listed and examined for their conceptual similarities and differences. To aid this process, we searched the wider literature to find papers which would help us to understand the data, to make connections between sub-themes, and to assist in the development of our final themes. For example, ‘belonging’ was an emerging theme, and we identified Hagerty et al’s [ 20 ] research which explored and defined this concept. We then returned to our framework chart to re-examine our data in light of the wider literature. Other influential literature was on the theory of ‘doing, being, becoming’ [ 21 ], ill-being vs well-being and intrinsic and extrinsic quality of life [ 22 , 23 ] and demoralization [ 24 ]. We have reported this literature when describing the theme in the findings because it was influential in shaping our understanding of the theme. The themes and domains from the included papers were presented and organised in contrasting styles by the authors of those papers. Depending upon the theoretical background of the researcher, and the method of analysis used, this resulted in themes which were either objective and descriptive (e.g. relationships, occupation) or abstract or metaphoric in their presentation (e.g. ‘Upset and calm changes patterns of being with and apart from others’). For the latter, whether a theme was major or minor was the subjective view of the authors. We have reported a theme as being a major theme within the studies if it was: a) a titled theme within the study findings b) was reported as being represented throughout the data or c) formed a substantive part of those studies that used abstract or metaphoric themes or of those that were not organised thematically. For transparency the original themes or section titles from the original papers have been presented after the quotes provided to illustrate our findings.

Validation and trustworthiness

Validation procedures were incorporated into the review at all stages. Two researchers (JC and MLJ) independently identified articles from the first search iteration, and compared results to clarify the inclusion and exclusion criteria. Potential full articles were identified from further searches by the primary researcher and independently checked by the second researcher. The included articles were examined independently by both researchers to identify the main themes for the initial framework. Disagreements at all stages were resolved by discussion. Additionally, a multidisciplinary team of researchers met regularly in addition to meetings with clinicians and a user representative to discuss and challenge the inclusion and exclusion criteria, thematic framework, and conceptual interpretations and conclusions.

Description of included studies

Thirteen studies were identified from 16 articles [ 25 – 40 ]; two had fuller reports available, one an internal report [ 25 , 26 ] and the other a dissertation [ 27 , 28 ], the fuller reports [ 26 , 28 ] have been referenced in the findings. Further, one study indicated that not all emerging themes were presented in the paper and had a supplementary paper dedicated to the impact of bi-polar disorder on work functioning, which was included in our analysis [ 37 , 38 ]. The studies were published between 1994 and 2010 in a number of countries: Canada (5), UK (3), Sweden (2), USA (1), Australia (1) and New Zealand (1). The professional affiliations of the first author were occupational therapy (5), nursing (4), psychology (2), psychiatry (1) and social work (1). The mental health disorder most frequently represented was schizophrenia (or other psychotic disorder): this was the only population researched in three studies and the majority population in a further two. Three studies included individuals with bi-polar disorder only and one panic disorder only. Other studies had a mixed population including the above disorders plus persons with personality disorder, severe depression, and anxiety disorders. Two studies did not specify the disorder; they included persons described as having ‘enduring mental health problems’ and ‘psychiatric disability’.

Two studies had a primarily positive orientation in that they asked ‘what is required for a good quality of life’, and four studies a negative orientation through asking ‘how has your mental health affected your quality of life’. The remainder considered both ‘what had helped and hindered quality of life’. Most studies presented their findings descriptively, and four had a conceptual/abstract orientation. Further details of the studies [ 25 – 40 ] can be found in Table  1 .

We identified six major themes: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. The themes identified within each of the studies can be found in Table  2 .

Well-being and Ill-being

Well-being has long been regarded as an important dimension of health related quality of life scales [ 14 ]. The emotional component of subjective well-being consists of high levels of positive affect (experiencing pleasant emotions and moods), and lack of low levels of negative affect (experiencing few unpleasant emotions and moods) [ 23 ]. Within our papers, symptoms of mental illness and aspects of emotional well-being were intertwined, with an emphasis on the negative rather than the positive. This suggested that ill-being, which is more akin to distress and the symptoms of mental illness, is an important aspect of quality of life for those with severe mental health problems.

The most evident ‘ill-being’ themes were general feelings of distress from symptoms; the experience of psychosis/mania; depressed mood; problems with energy and motivation and fear and anxiety.

Distress from symptoms

Distress, or the subjective experience of the symptoms of mental illness, was evident in the majority of studies [ 26 , 28 , 30 – 32 , 35 , 36 , 40 ] and a major theme in four [ 28 , 30 , 35 , 40 ]. The subjective experience of mental illness was described as wretched [ 36 ] a burden, debilitating, painful [ 40 ], tormenting [ 35 ], and as having a tyrannical power over life [ 28 ]. Pre-occupation with the symptoms of mental health problems interfered greatly with the most basic tasks of everyday living [ 26 , 28 , 31 , 40 ], making it difficult to deal with anything but the present moment [ 40 ]. Instead life was consumed with coping on a daily basis and living ‘one day at a time’ - sometimes on a moment to moment basis [ 28 , 31 , 34 ].

Symptoms of mental illness were described primarily in negative and restrictive ways . Subjects reported continually trying to deal with the symptoms , describing symptoms as “ a great burden .” The symptoms seemed to be so encompassing that these men had difficulty seeing beyond the pain of today . “ This illness is a great burden . Day - to - day survival is a big question , and I just feel in a turmoil a lot of the time ”; “ I ’ ve had terrible suffering for over 20 years.” [ 40 - A pervasive feeling of distress ]

Experience of psychosis/mania

Distressing symptoms reported included hallucinations and delusions (particularly hearing voices, thought disturbances and paranoia) [ 26 , 28 , 30 ], reality disorientation [ 28 ], mania, and hypomania [ 38 ], feelings of discomfort, weirdness or oddness [ 28 ], and irritability or agitation [ 30 ]. These symptoms could interfere directly with day to day living by having an effect on behaviour control [ 26 , 30 , 35 , 38 ], concentration, memory or decision making [ 26 , 30 , 31 ] and sense of self-identity [ 28 , 31 , 37 ].

“ When I hear voices erm , that stops me from doing a day to day existence , I ’ m preoccupied with the voices ”; “ … the voices , how they ’ ve affected my life , erm , er just day to day living basically … Erm just er , getting out , getting out and doing things er … go to the shops , erm , erm , cooking , anything , anything like that ”; “ I daren ’ t go out now , thoughts in my head , make me think bad things ; I get paranoid when there ’ s crowds of people. ” [ 26 - Fear of exacerbating mental health difficulties ].

Depressed mood

Depression was a diagnosis of a proportion of participants in two of the studies [ 28 , 29 ] and bi-polar disorder the primary diagnosis in three further studies [ 35 , 37 , 39 ]. Negative affect, in the more severe form of depression including feeling suicidal [ 26 ] (as opposed to simply being sad, unhappy), was also identified in studies where the primary diagnosis was psychosis related [ 26 , 30 , 34 , 36 , 40 ]. It was also the symptoms of depression in bi-polar patients that were reported as being particularly distressing [ 35 ], together with the unpredictability and instability of mood [ 35 , 38 ].

Energy and motivation

Depression was often expressed as associated with a lack of energy and/or motivation. Although energy and motivation might be regarded as two distinct concepts (physical and psychological), they were closely associated and for the most part reported together within the primary research. Energy, or lack of it, was a major theme in one study [ 39 ] and all but three of the primary research articles [ 32 , 33 , 35 ] described the debilitating effects of lack of energy. The three studies where energy and motivation were not evident focused on the nursing implications of panic disorder [ 32 ] the psycho-social issues related to bipolar disorder [ 35 ] and the positive determinants of health [ 33 ]. Participants reported feeling generally drained of energy [ 26 , 28 – 30 , 38 , 40 ] associated with a lack of motivation, enthusiasm, or interest in things [ 26 , 28 – 31 , 34 , 36 , 40 ]. The side effects of medication [ 26 ] or problems with sleep [ 26 , 30 ] were reported as having a causal effect.

“ The quality of my life in the last few years has been horrible , because it has taken so much energy and struggle to get through so many things …. I ’ ve got to get out , go out and do things or go to concerts or go to school things , or go to meetings or something , and doing some of those things is so tough , to make yourself , you know , get up and go . Just getting up to go out for a walk was really hard for me , whereas walking is one of my , you know , I love to go out and walk .” [ 29 - Distant hopes fuel the relentless struggle to carry on ]

Because lack of energy was a problem, conserving energy for those activities that brought pleasure and joy was important [ 39 ]. Whilst lack of energy was the dominant theme, hypomanic states in bi-polar disorder were associated with increased energy and enthusiasm but were often short-lived with a return to a usual depressed state [ 38 ].

Fear and anxiety

Two studies reported that ‘fear’ was a theme that was represented throughout their interview data [ 28 , 30 ]. Fear, anxiety, or worry was present in some form in all of the studies. The subjective experiences of the symptoms were reported as being very frightening [ 26 , 28 , 31 , 32 , 35 , 40 ]. This tended to be identified in the studies on schizophrenia, bi-polar disorder and panic disorder. As a consequence, individuals lived in fear of relapse or a return to hospital [ 26 , 28 , 30 ]. There were associated financial worries which had implications for planning for the future and making commitments [ 30 , 34 , 37 ].

Living day to day with a psychotic illness was described as a very frightening and isolating experience . The participants described their sense of fear while experiencing symptoms , watchfulness for reoccurrence of illness , concerns over safety , experiences of anxiety and rejection in interactions with others , avoidance of stressors , feelings that they were being treated as “ fragile ” by their families , and a sense of powerlessness in gaining control over symptoms [ 27 - The experience of illness ]

Anxiety in social situations was especially evident and took various forms including anxiety about leaving the house, crowds and public places [ 26 ], concerns for their own safety [ 26 , 28 , 36 ], and that of others [ 26 ], worrying about what others thought of them and how they appeared [ 26 , 28 , 30 ], worries and concerns within relationships [ 29 ] and fears of rejection [ 40 ]. Worries concerning relapse or aggravation of symptoms and social anxiety often resulted in the avoidance of any activity or situation which might be perceived as stressful [ 26 , 28 , 30 , 33 ] thus limiting the possibilities of improving other aspects of quality of life.

Avoiding situations they had previously enjoyed because of fear of how they would appear or that the stress associated with those situations would mean deterioration in mental health : “ I ’ ve cut down on the sort of positions I get myself in … because of bad experiences in the past …. you just try less things with the fear that you ’ re going to get very ill again and go to hospital ” [ 30 - reduced control of behaviour and actions ]

Within the studies reviewed there tended to be an emphasis on the absence of ill-being rather than the presence of well-being. However, the positive themes identified that were important to people included an overall sense of well-being [ 31 , 33 , 39 ], feeling healthy [ 31 ], peaceful, calm and relaxed [ 26 , 30 , 33 , 39 ], stable [ 30 , 35 ], safe [ 33 , 39 ] and free from worry and demands [ 33 , 39 ]. Enjoyment or happiness were not identifiable themes within the reviewed studies but were associated primarily with the need for activities to be enjoyable [ 31 , 36 , 39 ].

Physical well-being

Physical health was not a strong theme within the reviewed studies. The compounding effects of physical health problems were indicated in two studies [ 26 , 36 ] and physical health was listed as the second most important aspect of quality of life by participants in another [ 37 ]. A healthy lifestyle was considered beneficial which included exercise, avoiding drugs and generally taking care of oneself [ 26 , 28 , 33 ].

Control, autonomy and choice

The importance of aspects of choice and control to quality of life was identified in eight studies [ 26 , 28 , 30 , 31 , 34 , 35 , 37 , 39 ] and was a main theme in three of these [ 30 , 34 , 35 ]. It was often discussed in the context of the availability of external resources which enabled choice and control, including medication and treatment, support, information and finances.

Symptom control

One of the most evident aspects of control was the management of the most distressing or pervading aspects of mental illness, particularly for those with psychosis related disorders [ 26 , 28 , 31 – 35 , 38 , 39 ]. Control was usually described as being achieved through medication [ 26 , 28 , 33 – 35 , 39 ]. Having control meant that individuals could move beyond ‘the all encompassing world of their illness’ [ 28 ] and instead attend to other important areas of their lives [ 28 , 31 ]. However, medication could also have a detrimental effect on quality of life through side effects, [ 26 , 28 , 30 , 34 ] feelings of dependency, [ 34 , 35 ] and fear of the consequences of not taking it [ 30 ]. It was therefore necessary to find the right medication to balance symptom management and side effects [ 26 , 28 , 32 , 33 , 35 , 39 ] as a means to a sense of well-being [ 28 ].

“ I ’ m on good medication , no symptoms , no side effects . I used to go through all the side - effects and symptoms and I don ’ t have anything now . . before that , I never really felt human . . I ’ m human , I ’ m flesh , you know like that in my mind and , it ’ s just a good feeling . I can ’ t explain how I was , used to be but since I ’ ve been on this medication I feel like a human … I don ’ t have any side - effects or anything or any problems . . I just take my pills and go . Like I feel like a human being … it ’ s just great ”; “ I think for me , apparently the most important one is just managing the illness … different medications , side - effects , knowing what they are … for me there ' s been limited discomfort ” [ 28 - Experience of illness - gaining control ]

The concept of control was particularly important for those with bipolar disorder, and was related to an inability to control or pre-empt the onset of mood episodes or their behaviour [ 35 , 38 ] and to a need for stability [ 35 ].

Being informed and having an understanding and insight about the illness was considered to be important [ 26 , 28 , 32 , 34 , 39 ]. To achieve this it was important to have an accurate diagnosis [ 32 , 33 ]. This meant that people could receive effective medication [ 33 ], knew what to expect for the future [ 28 , 33 , 39 ] and could develop strategies to manage their illness and deal with it better [ 28 , 34 ]. This was regarded as a first step on the way to recovery [ 32 ] and improving quality of life [ 39 ].

Independence/dependence

There was a complex relationship between independence, dependence, and support. Both support [ 26 , 28 , 31 , 33 , 34 , 37 , 39 , 40 ] and independence [ 32 , 33 , 37 ], particularly financial independence [ 37 ] were regarded as being important for quality of life. Support helped people manage their illness, access resources, and increase their self-confidence [ 33 ]. However, it could also result in feelings of dependency [ 26 , 37 ] with a resulting loss of a sense of control and self-esteem [ 37 ]. Hence there could be a dilemma between wanting help and support and at the same time resenting it [ 29 ]. On the other hand, choosing to be dependent could enhance power and control [ 39 ]. Personal autonomy, finding the optimum balance between support and independence, was therefore important to quality of life [ 25 , 33 ].

“ I think that ’ s a big part of what I recognize now as quality of life is feeling I can take care of myself without being heavily dependent on a long - term basis on either the welfare system or my Dad , unless I ’ m choosing to do so for a specific reason ” [ 33 - Independence : ‘ Or rather , not being independent , but not being dependent ]

Personal strength, determination, and self-sufficiency were also regarded as important [ 26 , 32 , 33 , 38 ]. It meant people were able to make use of available resources and develop self-help and personal coping strategies [ 26 , 28 , 32 , 37 ] which in turn promoted independence and a sense of control [ 28 , 32 , 37 ].

The concept of choice was most associated with the availability of financial resources [ 26 , 28 , 30 , 33 , 34 , 37 ] and with limited employment opportunities [ 26 , 28 , 30 , 34 , 38 , 40 ]. Having sufficient financial resources meant people could more readily have a healthy lifestyle [ 33 ], engage in activities that promoted well-being [ 26 , 28 , 30 , 33 ], facilitate the attainment of an optimum balance between dependency and independence [ 26 , 37 ], have a choice in their surroundings [ 26 , 28 , 34 ] and be able to plan for the future [ 30 ].

“ I ’ d have had more money if I ’ d stayed in the [ job ] … I ’ d have been able to board the animals and go on holiday . I would have been able to afford a bigger house maybe even have some help with some of my domestic tasks . yes . it ’ s limited my choices ”…“ Lack of control of your finances because what you get in benefits goes immediately what with all the things you have to pay out for . So you have to be very careful … That ’ s another sort of loss of control of part of your life which doesn ’ t make you feel very good about yourself ” [ 30 - Financial constraints on activities and plans ]

Also of value was being able to choose whether or not to take part in things (particularly social activities), [ 28 , 34 ] flexible work conditions, [ 38 ] when and with whom to disclose mental illness, [ 34 ] and choices associated with mental health services, workers and interventions [ 26 ].

Self-perception

A number of aspects of self associated with quality of life were identified: self-efficacy - having a belief and confidence in your own abilities; self-identity - having a perception of self and knowing who you are; self-esteem - having a sense of self-worth and self-respect; and self-stigma - internalizing the negative views of others. These were linked to a further theme of self-acceptance. These self concepts were closely associated and used interchangeably within the studies reviewed making them difficult to differentiate. Aspects of the self and self-perception were a major theme in three studies [ 28 , 32 , 35 ] and were present in some form within all of the other studies except one [ 29 ] which had an abstract analytical style and only had undertones suggesting low self- esteem/image.

Self-identity

Problems related to self-identity, having a sense of self and ‘knowing who you are’ appeared particularly to be related to bi-polar disorder, schizophrenia, and panic disorder. The studies described difficulties with having a coherent sense of self, identity, and personality [ 31 , 32 , 35 , 37 , 39 ].

‘ when you end up in the hospital with a full - blown mania and you think that you ’ re a king and you ’ re screaming at the top of your lungs … trying to eat your hospital bed and , and … you don ’ t know how to deal with it or , or how to be . You don ’ t know how to become yourself again . You don ’ t know what happened to you . It ’ s like your identity has been changed . It ’ s like somebody hands you a different driver ’ s license and you ’ re like , ‘ Well who is this person ?’ [ 37 - Identity ]

This loss of a sense of self necessitated a re-negotiation [ 31 ] or reclaiming [ 32 ] of self, based on self-acceptance, self-knowledge and understanding, [ 31 , 32 , 37 , 39 ] and relationships with reliable others [ 39 ]. Spirituality also had a role in achieving a sense of self [ 28 ].

Self-efficacy

This concept was expressed in the reviewed studies primarily as a lack of self-confidence, but also as feelings of inadequacy, uselessness, failure, an inability to cope, and helplessness [ 26 , 28 , 30 – 33 , 35 , 37 ]. Mental health problems were associated with a lack of confidence [ 26 , 31 , 32 , 35 , 38 ]. This lack of confidence limited day to day functioning and activities [ 26 ], and access to helpful resources [ 26 ] and affected choice and opportunities in employment [ 26 , 28 , 38 ] and relationships [ 26 , 28 ]. Bipolar disorder could be associated with an increase in self-confidence during manic episodes [ 38 ].

Self-esteem and self-acceptance

The theme of self- esteem includes the concepts of self-image, worth, value, and shame, and a view of the self as ‘defective’ [ 26 , 28 , 30 , 35 – 37 , 40 ]. It was primarily reported as a negative concept closely associated with loss of self-identity [ 37 ] and confidence [ 35 ]. Occupational activity was considered particularly important for self-esteem and status [ 28 , 36 , 38 ], as was the satisfaction gained from helping others [ 28 ]. However, the difficulties encountered in obtaining employment often resulted in a lowering of self-esteem [ 30 , 40 ]. A closely related concept to self-esteem was the positive concept of self-acceptance, [ 28 , 32 , 37 , 40 ] acceptance of the self as a person with an illness [ 32 ], or the belief that the illness did not represent everything that they were [ 28 , 37 ].

Self-stigma

The theme of ‘the self’ was closely related to the next theme of ‘belonging’, particularly through the concepts of ‘stigma’ and ‘feeling normal’ (see below). This inter-relationship is most evident in the concept of self-stigmatization, an internalisation of the negative views of others [ 28 ].

Individuals living with severe and persistent mental illnesses suffer from a form of stigma - self - stigma - perhaps the most powerful of all stigmas as it affects the inner sense of self in very profound ways . ‘ I stigmatize myself . I just have a very low self - image . I ' m kind of hard on myself for not conducting myself the way I should be … not being as productive as I could be . It ' s a reflection from general community ' s perceptions of what this illness is all about . […] [ 27 - Sense of Self : Self doubt , criticism - a barrier ]

The concept of belonging has been defined as the experience of integration and personal involvement in a system or environment at differing interpersonal levels. It can have two dimensions: ‘valued involvement’ - the experience of feeling valued, needed, accepted; and ‘fit’ - the person’s perception that his or her characteristics articulate with, or complement, the system or environment [ 20 ].

Of the primary research studies included in the review, one identified ‘connecting and belonging’ as being important to quality of life [ 34 ]. Others identified closely related main themes: being part of a social context [ 33 ], rejection and isolation from the community [ 35 ], a need for acceptance by others [ 40 ], social support [ 37 ], relationships [ 28 ], barriers placed on relationships [ 30 ], labeling and attitudes from others [ 30 ], stigma [ 28 , 30 , 37 , 40 ], alienation [ 40 ], detachment and isolation [ 30 ].

Relationships

Relationships were clearly central to the concept of ‘belonging’. These relationships included close connections with family and friends and also more casual relations with the local community, in the workplace, with service providers or with society at large. The complex nature of relationships and the positive and/or negative effects on quality of life were evident in all the primary studies.

The provision of support was a particularly strong theme, being a major theme in three studies [ 33 , 37 , 39 ]. Both practical [ 26 , 28 , 32 , 33 , 37 , 39 ] and emotional [ 26 , 28 , 32 – 34 , 37 , 39 ] care and support was identified as important to quality of life. This could be from family and friends [ 26 , 28 , 31 , 33 , 34 , 37 , 39 , 40 ] or peers and work colleagues [ 28 , 38 , 39 ]. Also important was the support received from professionals [ 26 , 28 , 32 , 33 , 35 , 39 ]. When families and professionals were unsupportive, quality of life declined [ 26 , 28 , 39 ].

“[.] if you have schizophrenia or you have mental illnesses a lot of support helps , helps you get back on track ”; “ The support that they give me means a lot to me . I wouldn ' t be where I am today without my family and my friends . They ' ve supported me in every little way that they could … like my Mom will drive me to doctor ' s appointments … just having my family in [ name ] living around me … I know that if , if I can ' t get somewhere myself I can always rely on family members to take me ” [ 28 - Relationships with supportive family members ]

Within the reviewed studies the most predominant benefits of good and reliable relationships were to feel accepted and understood [ 26 , 28 , 33 – 35 , 37 , 40 ], and having company, camaraderie and shared interests [ 28 – 31 , 33 , 34 , 36 ]. Good relationships also satisfied the need for love, care, and affection [ 26 , 28 , 33 , 34 , 37 ], facilitated the experience of joy, fun, and happiness [ 29 , 33 ], someone to talk to/share problems with [ 26 , 28 , 29 , 33 , 39 ], to feel needed/helpful to others [ 28 , 30 , 33 , 39 ], to have people in whom one had trust and confidence [ 26 , 33 , 39 ] and who provided motivation and encouragement [ 33 ].

Connecting with others and achieving a sense of belonging emerged as key to quality of life : “ You need friends to be happy … you need affection , you need to be loved by people , or else you would never get ahead in life . You will always be miserable and unhappy ” [ 34 - Connecting and Belonging ]

Given the importance of others, their well-being was also important to the quality of life of the study participants [ 33 ].

Whilst relationships which satisfied the need to belong were important, difficulties forming and maintaining these relationships were evident [ 26 , 28 – 30 , 34 – 36 , 40 ]. These difficulties included problems and tensions within supportive long term relationships [ 26 , 28 , 29 , 35 , 37 ].

“ My Dad considers me a problem son . My mother thinking it ' s going to be a bit of a problem … you ' re not treated with the same kind of respect that you were before … you ' re not given the same kind of credibility … it ' s not , not quite the same . You don ' t feel a part anymore . You ' re separated … You ' re not even part of your family … you don ' t feel part of the community ; I don ' t feel part of anything .” [ 28 - Negative reactions from family members - a barrier ]

Problems with relationships represented a complex multidirectional interaction between the person and society at varying interpersonal levels. This interaction involved the effect of the person’s illness when relating to others, other people’s subsequent reactions and attitudes to them, and the effect of those reactions and attitudes in further exacerbating symptoms of anxiety and depression and affecting the person’s perception of themself. Examples of the barriers experienced in connecting and relating to people included cognitive and thought disorders resulting in problems with concentration and attention [ 28 , 30 , 40 ] problems controlling behaviour [ 30 , 35 , 37 ] including acting out [ 30 , 37 ], irritability, volatile or inappropriate behaviour [ 37 ], grandiosity or self-inflation [ 37 ], and feelings of anxiety when talking to or being around people, including problems with trust and paranoia [ 26 , 28 , 38 ].

Stigma can be defined as ‘any condition, attribute, trait or behaviour that symbolically identifies the bearer as culturally unacceptable or inferior’ [ 41 ]. Stigmatisation was a major theme in four of the studies [ 28 , 30 , 37 , 40 ] and evident in three others [ 26 , 34 , 35 ]. The experience and perception of negative reactions on the part of family, friends, service providers, employers, and society at large was shown to have a detrimental effect on quality of life. Individuals felt that they were perceived as lesser human beings who were discriminated against and treated accordingly [ 28 ] and that they were feared, avoided, or not accepted, which in turn led to feelings of rejection, marginalization, or being written off [ 28 , 30 , 35 , 37 , 40 ]. As a result, disclosure of mental illness was problematic and often avoided, and this had consequences for employment and close relationships [ 28 , 34 , 37 ]. Stigma had a detrimental effect on most aspects of life, including relationships [ 26 , 28 , 30 , 37 ], employment and career [ 26 , 28 , 30 , 37 ], going out and pursuing leisure activities [ 26 , 30 ], obtaining services [ 28 ], and planning for the future [ 28 ]. Stigma was considered to be more predominant in bipolar than unipolar depression [ 37 ].

Feeling normal

A major barrier to achieving a sense of belonging was that informants were not perceived by others – and often did not perceive themselves – as “normal” [ 34 ]. Whilst feeling normal was something they held in high regard, instead they were aware of being perceived differently and consequently treated differently [ 40 ]. Feelings that they were different, and attempts to appear normal, do normal things, or be accepted as normal, formed a theme that permeated many of the studies reviewed [ 28 , 30 , 31 , 34 , 35 , 40 ], being a major theme of three [ 28 , 31 , 34 ]. This is consistent with the dimension of ‘fit’ within the concept of ‘belonging’ - the person’s perception that his or her characteristics articulate with, or complement, the system or environment [ 20 ].

… most informants expressed a need to both feel and be perceived as normal . For example , Informant 2 remarked , “ The thing is that I want to be a normal person and achieve something in my life ,” and Informant 25 stated , “ I ’ d like to be treated as equal in society .” Informants spoke about not feeling like other persons and implied that this set them apart . As Informant 16 stated , I don ’ t want to be mentally ill , I wanna be normal so I can study normally , go to school normally , get married , this and that . […]” [ 34 - Connecting and belonging : being normal ]

Loneliness/isolation/alienation

Feelings of isolation, loneliness, and particularly the concept of alienation can be regarded as the antithesis of a sense of belonging. Whilst highlighted as a main theme in one study only [ 40 ], these feelings were evident within the themes of relationships and stigmatization in all studies except one [ 31 ]. The symptoms of mental illness, the barriers these caused in the formation of relationships, the stigma and consequential effects on the self, together with feelings of being different and not accepted, resulted in a pervasive sense of loneliness and isolation. People chose isolation, or avoided relationships, as a way of protecting themselves against rejection and dealing with the fears of how they appeared and what others thought of them [ 28 , 30 , 40 ]. The effects of being consistently treated as undesirable or different became internalised and further influenced their sense of self [ 28 ]. Isolation was further compounded by the feelings that they were the only person suffering in this way [ 28 ]. Hence, isolation was not just feeling as though they did not have any friends but became a painful feeling of despair that affected all aspects of life.

“ I think one of the things about schizophrenia , I don ' t know whether it ' s schizophrenia or whether it ' s , it happens in other mental illnesses too , is this terrible , terrible kind of inner isolation feeling , like you ' re the only person … who is going through what you are going through and you , and you ' re completely alone […] it ' s just a terrible , painful sense of utter loneliness and isolation .” [ 28 - The Tyranny of Psychosis - a barrier ]

For quality of life, people wanted a reciprocal relationship with others [ 33 , 37 ] which involved understanding and acceptance [ 26 , 28 , 33 – 35 , 37 , 40 ]. This could be achieved through ‘supportive own’, those who share their illness and experiences [ 28 , 33 , 34 , 37 , 39 ], or through belonging to a religious community [ 26 ]. However, it was also possible to have a sense of belonging to a social network that was ultimately not beneficial to quality of life [ 37 ], and difficulties disentangling ‘real’ spiritual experience from hyper-religiosity when hypo/manic could make belonging to a religious community problematic [ 37 ].

By ‘doing’, a person achieves a sense of self, mastery, and successfully participates in the external world [ 21 , 42 ]. The importance of activity in some form to quality of life was expressed in all of the studies except one (which examined panic disorder from a nursing perspective) [ 32 ]. There was a difference in emphasis between studies: some focused specifically on the benefit of employment [ 30 , 35 , 38 , 40 ] and others on activity or occupation in its broader sense, including both employment and leisure activity [ 26 , 28 , 31 , 33 , 34 , 36 , 39 ]. Whatever the type of activity, it was stressed that it should be meaningful or fulfilling [ 26 , 28 , 31 , 33 , 34 , 36 , 39 ], enjoyable, [ 31 , 36 , 39 ] and suited to need and capabilities [ 26 , 31 , 33 ].

The benefit of activity is that it can provide the means for many of the factors important to quality of life discussed above. It is through activity that the opportunity arises to interact with others and hence develop a sense of belonging [ 34 ]. Activity can also improve mood [ 26 , 28 , 31 , 33 , 34 ], increase energy and/or motivation [ 28 , 34 , 39 ], relieve stress [ 26 ] and boredom [ 34 , 36 ] and provide a distraction from problems [ 26 , 33 , 34 ]. It also helps self-esteem and self-confidence, engenders a positive self-identity, [ 26 , 28 , 30 , 34 , 36 , 38 , 40 ] and enables people to take control of their lives [ 34 ].

One further factor is how activity provides order, routine, and structure [ 30 , 33 , 34 , 37 , 39 ]. Routine and structure can be achieved through employment [ 30 , 37 ], childcare [ 30 , 37 ] or activity in general, be it work or leisure [ 33 , 34 , 37 , 39 ]. However, one study highlighted how too much structure could be problematic and that what was important was flexibility and choice [ 37 ]. Having a physiological routine - particularly regular sleep, meals, and exercise - was considered important for general well-being [ 37 , 39 ].

Positive outcomes that could be derived from the strategy of using activity to structure and fill time included increased motivation , diversion from present problems , and avoidance of negative moods : [.] “ The actual work , whatever it is , is good for the mind and soul … you forget yourself . You forget your own problems when you are working ” [.] “ In the morning I have to do something . Some job or something I should do . Otherwise , I become bored and then become depressed because I don ’ t have anything to do …. when I have nothing to do I become sad and unhappy and become very depressed , and I don ’ t know what to do . It is very difficult .” [ 34 - Managing time ].

Whilst activity was almost universally considered to be beneficial, taking part could be difficult if the activity was too demanding and not suited to needs [ 33 , 38 , 39 ]. The symptoms of mental illness could make difficult even the most rudimentary of activities, such as self-care, cooking and shopping, [ 26 , 36 ] and taking up employment was especially problematic [ 31 ]. Even potentially enjoyable leisure activities were avoided because of concern regarding other people’s reactions, [ 26 , 30 , 36 ] problems relating to people, [ 36 ] and the associated fear and stress resulting in a deterioration in health [ 26 , 30 ]. Lack of money also put a restriction on enjoyable pastimes [ 30 ].

For those who were employed, interpersonal relationships at work were particularly affected due to social withdrawal and irritability, or interfering, inappropriate, or volatile behaviour during hypomania, although work productivity could increase during hypomania [ 38 ].

Hope and hopelessness

Integral to the concept of hope is having dreams, goals and a positive view of the future. The importance to quality of life of having dreams and goals or personal achievement was evident in six of the studies [ 28 , 29 , 31 , 33 , 34 , 37 ], the importance of activity and/or life in general being fulfilling and having some meaning and purpose was also evident [ 28 , 33 , 34 , 37 , 40 ]. Both having dreams and goals and having meaning and purpose in life were necessary to instigate change, make plans, and to move forward. Again, the difficulty of achieving this was stressed [ 28 , 31 , 34 ]. Losses experienced in the past affected the view of the future with a perception of reduced opportunities and choices [ 35 ] and diminished hopes and dreams, [ 29 , 31 ] particularly in the fields of employment [ 30 , 38 , 40 ] and relationships [ 29 , 40 ]. Loss and the effect of past experiences was a theme in seven of the studies,[ 26 , 28 – 31 , 35 , 38 , 40 ] and a major theme in three of these [ 29 , 31 , 35 ]. These losses included the loss of life roles generally, and more specifically the loss of work and career opportunities, relationship and the parental role, skills and ability, time, financial losses, and, ultimately, the loss of a sense of self and identity. Losses which had occurred in the past were perceived as a burden [ 28 ] with a pervasive sense of ‘something missing’ [ 40 ] which had long-lasting effects and made life a constant struggle [ 29 , 35 , 40 ]. Participants compared their own lives negatively with those of others [ 29 , 35 , 40 ], or with their own lives before illness struck [ 29 , 31 ], and all this brought about feelings of failure, of being cheated, and a sense of unfairness [ 35 , 38 , 40 ].

Past losses, including the loss of meaning and purpose in life, a sense of helplessness and inability to cope, all brought about a sense of hopelessness, necessitating a renegotiation and a lowering of aspirations and priorities [ 28 , 29 , 31 ].

The concepts of ‘hope’ and ‘hopelessness’ permeated the review studies [ 29 , 30 , 35 , 39 , 40 ] and formed a major theme for two [ 29 , 35 ]. Hopelessness was an expression of the view that life would never change for the better, and brought about a pervasive feeling of distress [ 40 ]. Conversely, hope provided a catalyst for change and a better life [ 39 ].

" Well , my whole life feels problematic , I feel as if I ' m not going anywhere … I know it sounds negative and I ' m not really negative like this all the time , but you know , I find it hard , projecting myself into the future , and leading a happy life . I don ' t think my life is very happy at the moment , it ' s not very fulfilling . I haven ' t got any real struggles at the moment , but it could be better . I don ' t know if it ' s because of the illness or the sort of person I am …"; " I don ' t have hope that I ' ll ever have a nice boyfriend , I don ' t have any hope that I ' ll get married , I don ' t have any hope that I ' ll work a full week — week after week after week . I don ' t really have hope for stability …" [ 35 - Bipolar Patients ' View of Their Future ]

We identified six major themes associated with quality of life for those with mental health problems: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness.

Measuring quality of life for people with mental health problems is of interest currently because of concerns about the emphasis of mental health services on reducing symptoms. Yet our review identified the importance of distress and symptom control from the perspective of people with mental health problems. Amongst academic circles quality of life has confusingly come to be known as anything which is not clinical [ 14 ]. However, this review of the qualitative literature indicates that, when those with severe mental health problems are interviewed, the distress related to symptoms is integral to their quality of life, and in some instances seeing beyond this distress is difficult.

One of the strongest themes revealed by the review was a sense of belonging achieved principally by good quality relationships and lack of stigma. It has been stated that people are fundamentally motivated by a need to belong [ 43 ], and that belonging is the missing conceptual link in understanding mental health and mental illness [ 44 ]. Our review also indicates that negative social relationships are detrimental to quality of life. This is supported by research that shows that, whilst a large social network and satisfaction with social relations are associated with a better quality of life [ 45 ], negative social interactions and stigma are related to a worse quality of life [ 46 ]. Social exchange theory emphasizes that social interaction entails both rewards and costs, and that negative social outcomes can have a greater impact on well-being than positive outcomes [ 47 ]. There is also evidence that loneliness is caused more by a lack of intimate connections than by a lack of social contact [ 48 ]. Hence, the important factor is the sense of belonging, rather than social contact. So, whilst there is a strong argument that those people who experience supportive, caring, loving relationships and have a sense of belonging have a better quality of life, it is less clear which is the more detrimental - to experience and risk the negative impact of uncaring and disrespectful relationships, rejection and stigma, or to protect oneself through self-isolation.

As good and poor relationships can have a positive or negative impact, so activity can both help and hinder quality of life. For some, the severity of symptoms can mean that basic self-care and day to day functioning are difficult. Activity beyond perceived capabilities can also result in feelings of anxiety, which in turn can lead to deterioration in other mental health symptoms such as hearing voices and paranoia. This results in avoidance of any potentially stressful situations. This finding is supported by the findings of research into the occupational activity of those with severe mental illness which indicated that, though employment was valued, people made choices constrained by fear of relapse, and entered, avoided, and shaped their social and occupational activity to remain well [ 49 ] It was found that doing too much could exacerbate symptoms, yet doing too little could also cause illness, and therefore people with severe mental illness sought out daily occupations with structure, flexibility, and easily met demands over which they had control [ 49 ]. Therefore, to achieve well-being and quality of life, people need to find a balance and be enabled towards what they are best fitted [ 50 ].

Although avoidance of social and occupational activity may reduce anxiety and the occurrence of other related symptoms, at the same time it can compromise other aspects of quality of life. The consequent reduction in choice and opportunity has a detrimental effect on self-esteem and confidence. However, self-worth is gained through positive social feedback and successfully engaging in activity. Lack of self-esteem has also been shown to increase the risk of psychiatric disorders, the development of delusions, and the maintenance of psychotic symptoms [ 51 ]. The perception of self is therefore both a cause and a consequence of mental health, and can therefore be regarded as being pivotal to quality of life.

In relation to the finding of the importance of hope and hopelessness to quality of life, parallels can be seen between the results of this review and the concept of demoralization [ 24 , 52 ] whereby a persistent inability to cope with internally or externally induced stresses result in feelings of helplessness, incompetence, and loss of mastery and control leading to diminished self-esteem, hopelessness and demoralization which in turn adds to the distress of symptoms and further reduces a person’s capacity to cope. The demoralized person clings to a small number of habitual activities, avoids novelty and challenge, and fears making long term plans [ 24 , 52 ]. This feeling of demoralization further impacts upon ill-being and, if untreated, leads to chronic distress and possible suicide [ 24 , 53 ].

Strengths and limitations of review

The primary studies included those with severe mental health problems only, with a majority having schizophrenia or psychotic disorders. Where there was a mixed population, studies rarely indicated any differences between people with different diagnoses. The findings may therefore have biases towards those with psychotic rather than affective disorders. The evidence base could therefore be improved by undertaking research with a wider range of mental health conditions.

Findings from the primary studies could be negatively or positively oriented depending upon the approach: research that asked how the illness had affected quality of life led to negative concepts (e.g. fear/stigma/isolation) whereas research that asked what would improve participants’ lives resulted in positive concepts (e.g. love, support, understanding). Some research papers addressed both, and identified factors that both helped and hindered quality of life. There was a greater emphasis on negative than positive concepts in the primary studies, and this has influenced the analysis and subsequent findings.

The range of themes included in the reviewed articles was extensive, in this review we have focused on those that are most closely associated with ‘health related’ quality of life.

Setting boundaries

There were difficulties setting boundaries around themes because of the strong inter-relationship of the different domains which make up quality of life. To avoid repetition, sub-themes have been placed in the main theme with which they were considered to be most strongly associated, but aspects of these themes could be placed in other themes. For example, ‘feeling normal’ has been included under the main theme of ‘belonging’ but could also be regarded as an element of ‘ill-being/ well-being’ and ‘the self’. Likewise, symptom management through medication is also an aspect of ‘well-being’ but probably due to the emphasis on psychosis related disorders in the reviewed studies it was the control aspect of medication use that predominated.

Complexities also arose when setting boundaries around the concept of quality of life. It was evident that there was a considerable overlap in findings with studies examining ‘recovery’, ‘lived/subjective experience’, ‘psychosocial issues’, ‘health needs’, and ‘strategies for living’. After much discussion and deliberation within the team, these studies were excluded from the review. Since completing our analysis a systematic review of the concept of ‘personal recovery’ has been undertaken [ 54 ] a concept previously defined as ‘a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness’ [ 55 ]. Interestingly, they identified five recovery processes comprising ‘connectedness’, ‘hope and optimism about the future’, ‘identity’, ‘meaning in life’ and ‘empowerment’ which are very similar to our own final themes. They do not include ‘well-being’ and this may be due to the rejection of an emphasis on symptoms within the recovery movement. This suggests that the concepts of ‘recovery’ and ‘quality of life’ are very closely related. This is important to understand as the concept of ‘recovery’ is gaining prominence as a guiding principle for mental health services [ 56 ].

Implications for measuring quality of life

The findings of this review indicate six major themes associated with quality of life for those with mental health problems: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. This provides important evidence for critically examining the content of measures currently being used in mental health and particularly the generic measures of health related quality of life like EQ-5D that are being used to inform resource allocation decisions and the monitoring of outcomes. Concerns with the generic measures have been that they are designed by experts with little or no input from people with mental health problems and their coverage is too limited. The EQ-5D, for example, has the following five dimensions of health: mobility, self-care, usual activities, pain and discomfort, and depression and anxiety. Respondents are asked to report their level of problems (no problems, some/moderate problems or severe/extreme problem) on each dimension to provide a position on the EQ-5D health state classification. A key concern raised about this measure is the focus on physical health rather than mental health problems [ 5 , 6 ]. These can be seen as a combination of physical functioning (mobility, self-care), well-being (depression and anxiety), social functioning (that may be included in usual activities) and physical symptoms (pain and discomfort). There is only a modest degree of fit between these EQ-5D dimensions and the six themes within our review. Anxiety and depression may reflect, however crudely, ill-being (though not well-being). Usual activity is again rather crude, but arguably covers aspects of activity. However it makes no allowance for the finding that some activity can have a negative as well as a positive impact. This leaves the themes of control, autonomy and choice; self-perception; belonging; and hope/hopelessness which are not addressed within the EQ-5D.

The findings of this review can help to provide useful evidence for examining the content validity of different measures. This evidence can be used alongside quantitative psychometric evidence on the performance of measures in different groups. In the case of EQ-5D, for example, recent reviews have found supporting evidence for construct validity and responsiveness in people with depression and personality disorder, but reflected the concerns about their appropriateness for those with anxiety, bipolar disorder and schizophrenia [ 57 – 59 ].

A good quality of life is characterized by feelings of well-being, control and autonomy, a positive self-perception, a sense of belonging, participation in enjoyable and meaningful activity, and a positive view of the future. In contrast, a poor quality of life is associated with feelings of distress, lack of control over symptoms and life in general, a negative perception of self, stigmatization and rejection, diminished activity and difficulties with day to day functioning, and a negative outlook. These life domains interact in a complex and reciprocal way. Generic measures of quality of life may fail to address this complexity and the rich and broad range of domains important to people with mental health problems.

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Acknowledgements

Funding sources for this research were the Medical Research Council Ref No. G0801394. We would also like to thank Prof. Michael Barkham, Prof. Glenys Parry and Eleni Chambers for their helpful and wise comments on draft versions of the paper.

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JC, primary researcher, screened titles and abstracts, reviewed included papers, conducted additional searches, developed the conceptual framework, analysed the data, and drafted the manuscript. JB, principal investigator, reviewed included papers, reviewed and advised on the conceptual framework. AOC, co-investigator, reviewed included papers, reviewed and advised on the conceptual framework. MLJ, co-investigator, screened titles and abstracts, reviewed included papers, and developed the conceptual framework. SP developed the search strategy, conducted the electronic database searches and drafted the related section of the manuscript. All authors reviewed and revised drafts and approved the final manuscript.

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Connell, J., Brazier, J., O’Cathain, A. et al. Quality of life of people with mental health problems: a synthesis of qualitative research. Health Qual Life Outcomes 10 , 138 (2012). https://doi.org/10.1186/1477-7525-10-138

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• Mental Health Essay

Essay on Mental Health

According to WHO, there is no single 'official' definition of mental health. Mental health refers to a person's psychological, emotional, and social well-being; it influences what they feel and how they think, and behave. The state of cognitive and behavioural well-being is referred to as mental health. The term 'mental health' is also used to refer to the absence of mental disease. 

Mental health means keeping our minds healthy. Mankind generally is more focused on keeping their physical body healthy. People tend to ignore the state of their minds. Human superiority over other animals lies in his superior mind. Man has been able to control life due to his highly developed brain. So, it becomes very important for a man to keep both his body and mind fit and healthy. Both physical and mental health are equally important for better performance and results.

Importance of Mental Health 

An emotionally fit and stable person always feels vibrant and truly alive and can easily manage emotionally difficult situations. To be emotionally strong, one has to be physically fit too. Although mental health is a personal issue, what affects one person may or may not affect another; yet, several key elements lead to mental health issues.

Many emotional factors have a significant effect on our fitness level like depression, aggression, negative thinking, frustration, and fear, etc. A physically fit person is always in a good mood and can easily cope up with situations of distress and depression resulting in regular training contributing to a good physical fitness standard. 

Mental fitness implies a state of psychological well-being. It denotes having a positive sense of how we feel, think, and act, which improves one’s ability to enjoy life. It contributes to one’s inner ability to be self-determined. It is a proactive, positive term and forsakes negative thoughts that may come to mind. The term mental fitness is increasingly being used by psychologists, mental health practitioners, schools, organisations, and the general population to denote logical thinking, clear comprehension, and reasoning ability.

 Negative Impact of Mental Health

The way we physically fall sick, we can also fall sick mentally. Mental illness is the instability of one’s health, which includes changes in emotion, thinking, and behaviour. Mental illness can be caused due to stress or reaction to a certain incident. It could also arise due to genetic factors, biochemical imbalances, child abuse or trauma, social disadvantage, poor physical health condition, etc. Mental illness is curable. One can seek help from the experts in this particular area or can overcome this illness by positive thinking and changing their lifestyle.

Regular fitness exercises like morning walks, yoga, and meditation have proved to be great medicine for curing mental health. Besides this, it is imperative to have a good diet and enough sleep. A person needs 7 to 9 hours of sleep every night on average. When someone is tired yet still can't sleep, it's a symptom that their mental health is unstable. Overworking oneself can sometimes result in not just physical tiredness but also significant mental exhaustion. As a result, people get insomnia (the inability to fall asleep). Anxiety is another indicator. 

There are many symptoms of mental health issues that differ from person to person and among the different kinds of issues as well. For instance, panic attacks and racing thoughts are common side effects. As a result of this mental strain, a person may experience chest aches and breathing difficulties. Another sign of poor mental health is a lack of focus. It occurs when you have too much going on in your life at once, and you begin to make thoughtless mistakes, resulting in a loss of capacity to focus effectively. Another element is being on edge all of the time.

It's noticeable when you're quickly irritated by minor events or statements, become offended, and argue with your family, friends, or co-workers. It occurs as a result of a build-up of internal irritation. A sense of alienation from your loved ones might have a negative influence on your mental health. It makes you feel lonely and might even put you in a state of despair. You can prevent mental illness by taking care of yourself like calming your mind by listening to soft music, being more social, setting realistic goals for yourself, and taking care of your body. 

Surround yourself with individuals who understand your circumstances and respect you as the unique individual that you are. This practice will assist you in dealing with the sickness successfully.  Improve your mental health knowledge to receive the help you need to deal with the problem. To gain emotional support, connect with other people, family, and friends.  Always remember to be grateful in life.  Pursue a hobby or any other creative activity that you enjoy.

What does Experts say

Many health experts have stated that mental, social, and emotional health is an important part of overall fitness. Physical fitness is a combination of physical, emotional, and mental fitness. Emotional fitness has been recognized as the state in which the mind is capable of staying away from negative thoughts and can focus on creative and constructive tasks. 

He should not overreact to situations. He should not get upset or disturbed by setbacks, which are parts of life. Those who do so are not emotionally fit though they may be physically strong and healthy. There are no gyms to set this right but yoga, meditation, and reading books, which tell us how to be emotionally strong, help to acquire emotional fitness. 

Stress and depression can lead to a variety of serious health problems, including suicide in extreme situations. Being mentally healthy extends your life by allowing you to experience more joy and happiness. Mental health also improves our ability to think clearly and boosts our self-esteem. We may also connect spiritually with ourselves and serve as role models for others. We'd also be able to serve people without being a mental drain on them. 

Mental sickness is becoming a growing issue in the 21st century. Not everyone receives the help that they need. Even though mental illness is common these days and can affect anyone, there is still a stigma attached to it. People are still reluctant to accept the illness of mind because of this stigma. They feel shame to acknowledge it and seek help from the doctors. It's important to remember that "mental health" and "mental sickness" are not interchangeable.

Mental health and mental illness are inextricably linked. Individuals with good mental health can develop mental illness, while those with no mental disease can have poor mental health. Mental illness does not imply that someone is insane, and it is not anything to be embarrassed by. Our society's perception of mental disease or disorder must shift. Mental health cannot be separated from physical health. They both are equally important for a person. 

Our society needs to change its perception of mental illness or disorder. People have to remove the stigma attached to this illness and educate themselves about it. Only about 20% of adolescents and children with diagnosable mental health issues receive the therapy they need. 

According to research conducted on adults, mental illness affects 19% of the adult population. Nearly one in every five children and adolescents on the globe has a mental illness. Depression, which affects 246 million people worldwide, is one of the leading causes of disability. If  mental illness is not treated at the correct time then the consequences can be grave.

One of the essential roles of school and education is to protect boys’ and girls' mental health as teenagers are at a high risk of mental health issues. It can also impair the proper growth and development of various emotional and social skills in teenagers. Many factors can cause such problems in children. Feelings of inferiority and insecurity are the two key factors that have the greatest impact. As a result, they lose their independence and confidence, which can be avoided by encouraging the children to believe in themselves at all times. 

To make people more aware of mental health, 10th October is observed as World Mental Health. The object of this day is to spread awareness about mental health issues around the world and make all efforts in the support of mental health.

The mind is one of the most powerful organs in the body, regulating the functioning of all other organs. When our minds are unstable, they affect the whole functioning of our bodies. Being both physically and emotionally fit is the key to success in all aspects of life. People should be aware of the consequences of mental illness and must give utmost importance to keeping the mind healthy like the way the physical body is kept healthy. Mental and physical health cannot be separated from each other. And only when both are balanced can we call a person perfectly healthy and well. So, it is crucial for everyone to work towards achieving a balance between mental and physical wellbeing and get the necessary help when either of them falters.

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Mental health includes emotional, psychological, and social well-being. It is more than the absence of a mental illness—it’s essential to your overall health and quality of life. Self-care can play a role in maintaining your mental health and help support your treatment and recovery if you have a mental illness.

How can I take care of my mental health?

Self-care means taking the time to do things that help you live well and improve both your physical health and mental health. This can help you manage stress, lower your risk of illness, and increase your energy. Even small acts of self-care in your daily life can have a big impact.

Here are some self-care tips:

• Get regular exercise.  Just 30 minutes of walking every day can boost your mood and improve your health. Small amounts of exercise add up, so don’t be discouraged if you can’t do 30 minutes at one time.
• Eat healthy, regular meals and stay hydrated.  A balanced diet and plenty of water can improve your energy and focus throughout the day. Pay attention to your intake of caffeine and alcohol and how they affect your mood and well-being—for some, decreasing caffeine and alcohol consumption can be helpful.
• Make sleep a priority . Stick to a schedule, and make sure you’re getting enough sleep. Blue light from devices and screens can make it harder to fall asleep, so reduce blue light exposure from your phone or computer before bedtime.
• Try a relaxing activity.  Explore relaxation or wellness programs or apps, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy activities you enjoy, such as listening to music, reading, spending time in nature, and engaging in low-stress hobbies.
• Set goals and priorities.  Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to appreciate what you have accomplished at the end of the day.
• Practice gratitude.  Remind yourself daily of things you are grateful for. Be specific. Write them down or replay them in your mind.
• Focus on positivity . Identify and challenge your negative and unhelpful thoughts.
• Stay connected.  Reach out to friends or family members who can provide emotional support and practical help.

Self-care looks different for everyone, and it is important to find what you need and enjoy. It may take trial and error to discover what works best for you.

Learn more about  healthy practices for your mind and body  .

When should I seek professional help?

Seek professional help if you are experiencing severe or distressing symptoms that have lasted 2 weeks or more, such as:

• Difficulty sleeping
• Changes in appetite or unplanned weight changes
• Difficulty getting out of bed in the morning because of mood
• Difficulty concentrating
• Loss of interest in things you usually find enjoyable
• Inability to complete usual tasks and activities
• Feelings of irritability, frustration, or restlessness

How can I find help?

If you have concerns about your mental health, talk to a primary care provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find  tips for talking with a health care provider about your mental health.

You can learn more about getting help on the NIMH website. You can also learn about finding support  and locating mental health services  in your area on the Substance Abuse and Mental Health Services Administration website.

If you or someone you know is struggling or having thoughts of suicide, call or text the  988 Suicide & Crisis Lifeline   at 988 or chat at 988lifeline.org   . This service is confidential, free, and available 24 hours a day, 7 days a week. In life-threatening situations, call  911.

Suicide is preventable—learn about warning signs of suicide and action steps for helping someone in emotional distress.

Featured videos

GREAT: Helpful Practices to Manage Stress and Anxiety:  Learn about helpful practices to manage stress and anxiety. GREAT was developed by Dr. Krystal Lewis, a licensed clinical psychologist at NIMH.

Getting to Know Your Brain: Dealing with Stress:  Test your knowledge about stress and the brain. Also learn how to create and use a “ stress catcher ” to practice strategies to deal with stress.

Guided Visualization: Dealing with Stress:  Learn how the brain handles stress and practice a guided visualization activity.

Mental Health Minute: Stress and Anxiety in Adolescents: Got 60 seconds? Take a mental health minute to learn about stress and anxiety in adolescents.

Featured fact sheets

• NIH Wellness Toolkits   : NIH provides toolkits with strategies for improving your  emotional health  and  social health  .
• MedlinePlus: How to Improve Mental Health   : MedlinePlus provides health information and tips for improving your mental health.
• CDC: Emotional Well-Being   : CDC provides information on how to cope with stress and promote social connectedness.
• SAMHSA: How to Cope   : SAMHSA offers tips for taking care of your well-being and connecting with others for support.

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Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

Essay on Mental Health

Students are often asked to write an essay on Mental Health in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Mental Health

Understanding mental health.

Mental health is as important as physical health. It refers to our emotional, psychological, and social well-being. It affects how we think, feel, and act.

The Importance of Mental Health

Good mental health allows us to handle stress, make choices, and relate to others. It’s crucial at every stage of life, from childhood to adulthood.

Factors Affecting Mental Health

Many factors can impact mental health, including biological factors, life experiences, and family history of mental health issues.

Mental Health and Stigma

Unfortunately, there’s a stigma around mental health. People with mental health problems are often misunderstood and judged.

Mental Health Care

It’s important to seek help if you’re struggling with mental health. Therapy, medication, and self-care can all help improve mental health.

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• Speech on Mental Health

250 Words Essay on Mental Health

Introduction.

Mental health, an often overlooked aspect of overall well-being, is as significant as physical health. It encompasses our emotional, psychological, and social well-being, affecting how we think, feel, and act.

Mental health is integral to living a balanced, fulfilling life. It influences our ability to cope with stress, relate to others, and make decisions. In the college years, mental health is especially crucial as students deal with academic pressure, social changes, and the transition into adulthood.

Challenges to Mental Health in College

College students face unique mental health challenges. The pressure to perform academically, social anxiety, and the struggle to fit into new environments can all contribute to mental health issues. These can manifest as depression, anxiety disorders, eating disorders, and more.

The Role of Society and Institutions

Society and institutions play a substantial role in promoting mental health. By creating an environment that acknowledges mental health issues and provides support, we can help mitigate these challenges. Colleges should provide mental health resources and encourage students to seek help when needed.

Mental health is integral to our overall well-being. As we navigate through life, particularly during challenging college years, it’s essential to prioritize mental health, seek help when needed, and create environments that support mental wellness.

500 Words Essay on Mental Health

Mental health, a critical aspect of overall wellbeing, is often overlooked in the hustle and bustle of modern life. It’s a broad term encompassing our emotional, psychological, and social well-being. It affects how we think, feel, and act, influencing our handling of stress, relationships, and decisions.

Mental health is as vital as physical health. It contributes to our cognitive functions, behavioral patterns, and emotional stability. Good mental health enhances our productivity, effectiveness, and ability to contribute to our community. Conversely, poor mental health can lead to severe complications like depression, anxiety, and even suicide.

Various factors contribute to mental health problems. Biological factors include genetics and brain chemistry. Life experiences, such as trauma or abuse, can also play a role. Additionally, family history of mental health problems can make individuals more susceptible.

Stigma and Mental Health

Stigma is a significant barrier to mental health care. It can lead to discrimination and misunderstanding, discouraging individuals from seeking help. Education is crucial to dispel myths and stereotypes, fostering a more supportive and understanding society.

Mental Health in College Students

College students are particularly vulnerable to mental health issues. They face unique challenges such as academic pressure, social struggles, and the stress of transitioning into adulthood. Colleges should prioritize mental health services, providing resources and support to students in need.

The Role of Therapy

Therapy is a powerful tool for managing mental health. It provides a safe space for individuals to express their feelings and learn coping strategies. Therapists can help identify underlying issues and develop personalized treatment plans.

Mental Health and Technology

Technology has revolutionized mental health care. Digital platforms provide access to therapy and self-help tools, making mental health resources more accessible. However, the overuse of technology can negatively impact mental health, highlighting the need for balance.

In conclusion, mental health is an integral part of our lives. It’s crucial to understand its importance, recognize the factors that affect it, and work towards reducing stigma. As society becomes more aware of mental health, we can hope for a future where mental health care is as mainstream and accepted as physical health care.

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Importance of Mental Health

This essay will highlight the importance of mental health, discussing its impact on overall well-being, relationships, and productivity. It will explore the stigma associated with mental health issues and the need for greater awareness and understanding. The piece will emphasize the benefits of mental health care and the significance of addressing mental health with the same urgency as physical health. PapersOwl showcases more free essays that are examples of Mental Health.

How it works

• 1 What is Mental Health?
• 2 Mental Health Evolution
• 3 Importance of Self Care

What is Mental Health?

According to(mentalhealth.gov) “mental health includes our emotional, psychological and social well-being, which affects how we think, feel, act, relate to others and handle stress and everyone is affected by it.” In life, you are faced with countless challenges and some being more extreme than the other. For example, dealing with the loss of a loved one now, although that’s something very hard to deal with eventually people with bounce back and cope overtime but sadly some people don’t and all they think about is that person.

Bad mental health has a lot of signs and some are more obvious than the other such as less/more sleep, use of drugs and severe mood swings, And then there is some not so noticeable ones such as hearing voices and feeling helpless, and just eating more than normal, but they all have things in common traits of bad mental health.

Mental Health Evolution

Additionally, in the past years, mental health was viewed as a joke or as a disease. Many people with poor mental health or psychological behaviors were told they were possessed by Demons and were often shunned from the world. According to (sunrisehouse.com), (” The humans of the Neolithic era believed that opening up a hole in the skull would allow the evil spirit (or spirits) that inhabited the head of the mentally ill to be released, thereby curing them of their affliction)”. Over time mental health support got better, such as doctors who specialize in specific disorders and also social media influencers also try to promote and help, hence usually their audience is younger and it makes a larger impact because “ studies show that 20% of youth have a mental health condition” according to dworakpeck.com and something like that can make a large impact on society.

Importance of Self Care

When I say self care is important I don’t mean doing a face mask once a week I mean things such as meditation because it can help your body rest and relax. According to healthprep.com “All in all, a self-care regimen helps replenish energy and gets individuals in touch with their own needs, which allows them to function better in every area of their life.” and doing this is a major stress reliever. Secondly another big thing to do is surround yourself with loved ones who make you feel comfortable and happy because if you don’t it could make everything worse. According to “More than ten percent of the entire US population share they have emotional issues, children starting from the age of 12 experience various depressions and anxiety conditions regularly” so its better to star those healthy habits now than later because they could do wonders for you in the long run.

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100+ argumentative essay topics on mental health | example & outline, bob cardens.

• September 2, 2022
• Essay Topics and Ideas

Argumentative Essay Topics on Mental Health. Mental health is an important and often overlooked topic. In this article, we’ll explore some argumentative essay topics related to mental health .

As you continue,  thestudycorp.com  has the top and most qualified writers to help with any of your assignments. All you need to do is  place an order  with us.

What You'll Learn

Argumentative Essay Topics about Mental Health

1. Is there a connection between mental health and physical health? 2. How does mental illness affect a person’s ability to function in society? 3. What are the most effective treatments for mental illness? 4. Are there any effective prevention strategies for mental illness? 5. What is the relationship between mental health and substance abuse? 6. How does poverty affect mental health? 7. What are the most common mental disorders? 8. What are the consequences of untreated mental illness? 9. What are the risk factors for developing mental illness? 10. How can mental illness be effectively diagnosed?

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The guidelines include  How to write DNP capstone project Methodology Chapter

Argumentative essay topics about depression

1. Depression is a real mental health condition.

2. Depression is more than just feeling sad.

3. Depression can lead to serious physical health problems.

4. Depression is treatable with medication and therapy.

5. People with depression can lead happy, fulfilling lives.

6. Untreated depression can be deadly.

7. Depression is often misunderstood and stigmatized.

8. Depression is not a sign of weakness or a character flaw.

9. Anyone can develop depression, even people who seem to have it all together.

10. There is no single cause of depression, but there are risk factors that can make someone more likely to develop the condition.

Argumentative Essay Topics on Mental Health. Mental health is an important and often overlooked topic. In this article, we’ll explore some argumentative essay topics related to mental health.

Argumentative essay about mental health in schools

1. Mental health should be taught in schools. 2. There should be more support for mental health in schools. 3. Mental health should be taken more seriously in schools. 4. Schools should do more to prevent mental health problems. 5. Schools should do more to help students with mental health problems. 6. Mental health problems are increasing in schools. 7. school counselors are not trained to deal with mental health issues 8. most school don’t have a mental health policy 9. lack of awareness about mental health among school staff 10. stigma and discrimination against mental health patients

Argumentative essay on mental health stigma

Argumentative essay topics about mental health can be very controversial and sensitive. However, there are many people who are open to discussing these topics and raising awareness about mental health. Here are twenty argumentative essay topics about mental health that you can use for your next essay.

1. How does society view mental health? 2. Do we need to break the stigma around mental health? 3. How can we better support those with mental health conditions? 4. What is the link between mental health and addiction? 5. How does trauma affect mental health? 6. What are the most effective treatments for mental health conditions? 7. Are there any natural remedies for mental health conditions? 8. How does diet affect mental health? 9. How does exercise affect mental health? 10. What is the link between sleep and mental health? 11. What are the warning signs of a mental health condition? 12. When should someone seek professional help for a mental health condition? 13. How can family and friends support someone with a mental health condition? 14. What are the most common myths about mental health? 15. How does stigma impact those with mental health conditions?

16. How can we destigmatize mental health? 17. What is the link between mental health and violence? 18. How does mental health affect overall health? 19. What are the most common mental health disorders? 20. What are the most effective treatments for mental health disorders?

Mental health debate topics for students

1. The definition of mental health 2. The different types of mental illness 3. The causes of mental illness 4. The treatments for mental illness 5. The side effects of mental illness 6. The impact of mental illness on society 7. The cost of mental health care 8. Mental health in the workplace 9. Mental health in the media 10. Stigma and discrimination against those with mental illness 11. The impact of trauma on mental health 12. Mental health during pregnancy and postpartum 13. Children’s mental health 14. Geriatric mental health 15. Global perspectives on mental health 16. Religion and mental health 17. Cultural competence in mental health care 18. Social media and mental health 19.Nutrition and mental health

20. Exercise and mental health

Expository essay topics about mental illness

1. How does mental illness affect one’s ability to work? 2. What are the most common types of mental illness? 3. How can mental illness be prevented? 4. What are the most effective treatments for mental illness? 5. How does mental illness impact relationships? 6. What are the financial costs of mental illness? 7. How does stigma affect those with mental illness? 8. What are the most common myths about mental illness? 9. How does mental illness differ from addiction? 10. What are the early warning signs of mental illness?

Debates about mental health

1. The definition of mental health is contested and argued by professionals in the field. 2. Some people argue that mental health is a social construction, while others believe that it is a real and valid medical condition. 3. Mental health is often stigmatized in society, and those who suffer from mental illness are often seen as weak or crazy. 4. Mental health is often viewed as something that can be cured, when in reality it is a lifelong battle for many people. 5. Mental illness is often seen as an individual responsibility to deal with, when in reality it affects not just the individual but also their families and loved ones. 6. It is often said that people with mental illness are not able to function in society, when in fact many people with mental illness are high-functioning individuals. 7. Mental health is often viewed as an all-or-nothing proposition, when in reality there is a spectrum of mental health conditions that range from mild to severe. 8. People with mental illness are often treated differently than other people, and they are often discriminated against. 9. There is a lot of misinformation about mental health, and this leads tomisunderstanding and fear. 10. Mental health is a complex issue, and there is no one-size-fits-all solution to addressing it.

Persuasive topics related to mental health

1. The link between mental health and physical health. 2. The benefits of therapy and counseling. 3. The importance of early intervention for mental health issues. 4. The impact of trauma on mental health. 5. The correlation between mental health and substance abuse. 6. The connection between mental health and chronic illness. 7. The relationship between mental health and chronic pain. 8. Mental health in the workplace. 9. Mental health in the military. 10. Mental health in schools. 11. Children’s mental health issues. 12. Teens and mental health issues. 13. Elderly mental health issues. 14. Cultural issues and mental health. 15. Religion and mental health. 16. The stigma of mental illness. 17. Mental health awareness and education. 18. Mental health advocacy. 19. Funding for mental health services. 20. Access to mental health care.

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Home / Essay Samples / Health / Mental Illness / The Importance of Mental Health: Prioritizing Well-being

The Importance of Mental Health: Prioritizing Well-being

• Category: Health
• Topic: Mental Illness , Stress

Pages: 2 (874 words)

• Downloads: -->

The Foundation of Well-Being

Building resilience, seeking support and treatment.

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