Positive mental health and its relationship with resilience

The positive dimension of mental health is emphasized in the World Health Organization's (WHO's) definition of health. The definition highlights; “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Concepts of mental health include subjective well-being, perceived self-efficacy, autonomy, competence, and recognition of the ability to realize one's intellectual and emotional potential. It has also been defined as a state of well-being whereby individuals recognize their abilities, are able to cope with the normal stresses of life, work productively and fruitfully, and make a contribution to their communities. Mental health is about enhancing competencies of individuals and communities and enabling them to achieve their self-determined goals.[1] A growing body of cross-cultural evidence indicates that various psychological, social and behavioral factors can protect health and support positive mental health. Such protection facilitates resistance (resilience) to disease, minimizes and delays the emergence of disabilities, and promotes more rapid recovery from illness.[2]

Mental health has always been centered on the individual coping styles of stress, problem solving, and facing adversity without disintegration. The relationship of stress to disease has been the highest priority among clinicians since Hippocratic times. Freudian views emphasize a hierarchy of defenses that transform conflict-ridden impulses into more acceptable thoughts and actions. Ego psychology promotes reality-oriented, purposeful, conflict-free capacities (i.e. attention, perception, and memory) that are future-oriented and that render one capable of transforming situations rather than being transformed by them. In this formulation, adaptive functioning is seen as the relative use of coping capacities over defense mechanisms.[3]

It will be incomplete to talk about positive mental health without making a mention of resilience. Resilience is often discussed as that aspect of mental health and coping which is paramount to the ability to spring back during adverse circumstances. The mention of positive health necessarily recounts on the ability to withstand and cope with stress adaptively. Resilience refers to overall physical and psychological health, and has been described as the ability to “bounce back from adversity.”[4] The positive psychology approaches always emphasized on individual's ability to enjoy life, and create a balance between life activities and efforts to achieve psychological resilience. Resilience has been defined in many ways; some of them highlighted normal functioning despite negative events or circumstances, disruptions, or changes in demands.[5] The defining characteristic has been overall physical and psychological health.

Like any other psychological construct, there is a moot question to distinguish trainability aspect of resilience. The paradigm shift in thinking assigned importance to identify characteristics of resilient people, and this further contributed to analyze the relationships between resilience training and its impact. Resilience is noted to be trainable.[6,7] Various researchers have contributed to the understanding of trainability dimension of resilience. However, the evidence suggests that it is a part of nature and nurture dimension. In fact, authors also reiterated the most often unresolved debate, i.e. quantum of contribution of nature and nurture,[8,9] that human beings are genetically hardwired to form relationships (social competence), to problem solve (meta-cognition), to develop a sense of identity (autonomy), and to plan and hope (a sense of purpose and future). Some individuals can express these capacities in the absence of a facilitative environment; however, it is the presence of a nurturing climate that encourages their expression. This finding is perhaps the most important and prescriptive for educators.[10]

Mental illness is considered to be a significant risk factor for poorer economic, health, and social outcomes, though socioeconomic status and severity of disorder have a definite role to play. It is noted that healthier lifestyles, better physical health, higher educational attainment, greater productivity, employment, and earnings are affected by positive mental health or “well-being.”[11]

There is enough evidence on the psychological aspects and attributes of resilience. Attributes like optimism, self-esteem, and self-efficacy have positive influence in early developmental years; these traits foster resilient climate for future growth.[12–14]

The positive mental health approaches and resilience development is heavily aligned with global mental health perspective and draws its influence from positive psychology. Resilience is often measured behaviorally on the basis of the person's competence and success in meeting society's expectations despite great obstacles.[15,16]

The modern era can be summed up as an era of challenges and competition. These attributes help building the resilient and positive ecological balance which would thereafter facilitate in enhancing the mental health of future generation.