Health policy and mental health

Health policy can be described as policy directed at the determinantsof health, i.e. biological and environmental factors, lifestyleand the health care system. This type of policy now has become a policy objective in anincreasing number of countries. In this article mental health is placed in the broad contextof this policy. The central question is: can the mental healthfield grasp the opportunity of a growing interest in preventionand health promotion in general, as major objectives of healthpolicy? Or will it stay more or less isolated from the mainstreamof current developments? Answering this question means looking at the conditions of healthpolicy. For health policy it is required that a definition begiven of health problems and "causing" conditions. There shouldfurther be available intervention possibilities of a preventiveand intersecloral character and also preventive strategies. It is stated that there is enough standardized information onmental health problems and experience with community-based researchto let mental health participate in drawing up a community diagnosis.It also appears possible to construct an ecological health statusmodel for mental health. Research on the factors in this modelshows a shift in focus from risk populations to risk situations,e.g. unemployment, industrial disability, divorce and isolation.Further it is recognized that the search for causal factorsis substituted by that for precipitating factors. Social-demographicfactors, taken alone, are not precipitating factors. What mattersis the combination of an underdeveloped coping mechanism, littlesocial support, and prolonged stressful conditions or suddenstressful events. Our knowledge on the determinants of mentaldisturbances is growing, but for the sake of credibility weneed more detailed data. The practice of mental health preventionshows an emphasis on mental health education which in most casesconsists of a mild form of group therapy. To become a partnerin the topical health policy debate mental health should also(again) stress the socio-economic factors, as for example isdone in the "Healthy Cities" project. Voluntary organizationscan play an important role in this respect. The conclusion is that mental health prevention has enough knowledgeand skills to take part in the health policy development. Itis hoped that the mental health field takes more initiativeto become a partner in that development.