Building Community Well-Being
An Exploration of Themes and Issues
2. Influences on mental health and well-being
The discussions with community groups and with services explored the range and nature of influences on mental health and well-being. This indicated a set of positive and negative influences, which were largely shared by different age groups and sectors of local communities.
Positive influences
- Relationships: family, friends, company and social contact
- Social activities, entertainment, hobbies and interests, exercise and sport
- Advice, information, reassurance
- Access to support and services
- Money - to enable people to maintain self-respect, keep warm and clean, have a nice house, feel comfortable
There was a series of more abstract influences which were no less important:
- Feeling that you matter and have a role, are useful and are able to make a contribution
- Choice and involvement: feeling involved in decisions that affect your life and the lives of those around you, having your views heard and respected
- Having hope, feeling valued, having a sense of progress and future prospects for yourself, your children and grandchildren
- Feeling proud of what you are part of, what you have achieved individually and collectively
- Confidence and self-worth: opportunities to learn and develop skills (not just academic skills)
Negative influences
The negative factors were often the opposite of the positive influences:
- Negative drizzle of criticism to which young people are sometimes exposed:
- 'Being tarred with that brush, might as well behave like that'
- Fear: of crime, of victimisation, of stigma and rejection; concerns about safety
- Guilt: about the competing demands of work and home life
- Boredom, inactivity and a sense of pointlessness
- Lack of control and choice about the things which affect you and your family
- Limited horizons - parochialism, territoriality, not being able to think beyond the familiar, patterns repeating themselves within families and within communities because of a lack of belief that things can be better, loss of motivation as a result of past experiences
- Issues of access to services and supports, including distance and transport, delays in getting appointments, having to fight to get what you need, being 'fobbed off', patchy availability of services
- Isolation and loneliness; rejection and exclusion
- Poor housing, poor employment opportunities
A sense of purpose, confidence, hope and self-belief come about through relationships between individuals. The relationships that people value are those where they are treated respectfully. Formal services have a role in enabling and supporting people but are not there to manufacture 'artificial' solutions that cannot substitute for 'authentic' family and social relationships. Service interactions can promote connectivity, put a value on relationships, nurture capacity for self efficacy and peer support. Through social changes and the development of professional caring services, there is a perception that the capacity for mutuality and interdependence has been eroded. Without seeking to go back to the past, we need to find ways of building new forms of connectedness.
Mental health and well-being are mediated through relationships: starting with how an individual perceives themselves and moving out to relationships with others. Actions to improve mental health and well-being have to address the preconditions that facilitate:
- Positive sense of self-confidence, identity, worth
- Relationships between people: within families, within communities, in schools and in workplaces
- Interactions between services and organisations and individuals, families and whole communities
People generally see themselves as part of a complex web of networks and relationships, formed around family, friends, workplace and interests. Local communities where people live are only one dimension. Networks change and evolve through a person's life. However, many people do still have strong affinities to a place or geographical area.
What emerged from the discussion process was that action to promote mental health and well-being has to recognise the wider structural factors that influence and shape capacity for good mental health and well-being in individuals and communities. Actions need to include, but extend beyond, the development of individual coping resources.