Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health.

“R; American Psychiatric Association, 1987) approach to diagnosing MDE (Keyes, 2002).”

“Similarly, much current thinking in psychology suggests that psychological health is broader than the absence of symptoms (Hayes et al., 1999; Keyes, 2007; Snyder & Lopez, 2002).”

“In a controlled experiment (Kiecolt-Glaser et al., 2005) married couples were given blister wounds and assigned to a marital disagreement condition and to a social support interaction during two consecutive stays in a hospital setting. Following the marital conflict condition, participants had slower wound healing and…”

“It underscores that people can be free of mental illness and at the same time be unhappy and exhibit a high level of dysfunction in daily life [10].”

“Rather than subjective well-being research unintentionally yielding mental health symptoms that mirror the symptoms of mental disorders (Keyes 2007) we have intentionally and systematically examined symptoms of the common mental disorders and proposed their mirror opposites as exemplifying the…”

“After noting the crucial importance of first testing for the environmental mediation of risk through “natural experiments,” findings are reviewed on “steeling effects” in animal models and humans.”

“…all perspectives agree that it includes flourishing both personally and relationally (e.g., Benson & Scales, 2009; Bundick et al., 2010; Diener et al., 2010; Keyes, 2003, 2007; Lerner et al., 2010; Ryff & Singer, 1998, 2000, 2008; Seligman, Steen, Park, & Peterson, 2005; Theokas et al., 2005).”

“The findings of this study provide strong support for the two continua model of mental illness and health (Keyes 2002, 2005, 2007).”

“Researchers in occupational health and health psychology have demonstrated that well-being is impacted by: hope (see Snyder, Lehman, Kluck, & Monsson, 2006, for a review), resiliency (Britt, Adler, & Bartone, 2001; Ferris, Sinclair, & Kline, 2005; Keyes, 2007; Williams & Cooper, 1998), selfefficacy (see Axtell et al.”

“Blacks tend to report lower levels of psychological well-being on cognitively focused measures such as life satisfaction and happiness (Hughes and Thomas 1998) but also report higher levels of flourishing than whites (Keyes 2007).”

“Survey (prevalence) data reveal that those who are flourishing report the lowest crosssectional rates of the following: mental illness, limitations of activities of daily living, missed days of work, cardiovascular disease, physical health conditions at all ages, utilization of acute health care service, and prescript…”

“What is the prevalence of mental health, using these definitions? A cross-sectional assessment in the US population [43] (n = 3,032) is shown in Table 1.”

“…as a profile of indicators across multiple domains, rather than as a single factor (Forgeard, Jayawickreme, Kern, & Seligman, 2011; Frey & Stutzer, 2010; Keyes, 2007; Lerner, Phelps, Forman, & Bowers, 2009; Organisation for Economic Co-operation and Development, 2014; Ryff & Keyes, 1995).”

“Other works confirm the plausibility of a condition in which high levels of eudaimonic well-being are combined with low levels of hedonic wellbeing (Keyes 2007).”

“Some studies have independently examined eudaimonic or social well-being (Keyes, 1998; Ryff & Keyes, 1995), some have examined hedonic and eudaimonic well-being in tandem (Keyes et al., 2002), and some have used aggregate measures of eudaimonic, social, and hedonic well-being (Keyes, 2005, 2007).”

“122), and thus indicators of SWB should be complemented with indicators of eudaimonic well-being (EWB) and psychological functioning (Keyes, 2007).”

“…perspective, there is emerging theory and research proposing that mental health is not simply the absence of mental illness but also the capacity to ‘flourish’ (Keyes, 2007)—a theme consistent with the present interest in an asset-oriented and aspirational approach to resilience and buoyancy.”

“Therefore, following Keyes (2005, 2007) as well as previous counseling psychology meta-analyses involving mental health (Yoon et al., 2013), we treated positive mental health and negative mental health as orthogonal constructs.”

“Mitigating pathology is important, but its absence is different from mental health (Keyes, 2007).”

“In sum, studies of the US adult population (see Keyes, 2007) have shown than anything less than flourishing is associated with increased impairment and burden as measured by lost work productivity, increased disability, increased risk of cardiovascular disease, more chronic physical illness at all…”

“Notably, this is the first study to examine the utility of the MHC-SF in a large sample of college students with findings that add to a growing literature on the importance of two continua model of mental health, 17 , 36 and merits further investigation.”

“There is a reciprocally deterministic relationship between thriving individuals and flourishing systems (Buettner 2008, 2010; Gladwell 2008; Keyes 2007; McKnight and Block 2010; Prilleltensky and Prilleltensky 2006).”

“, [31, 36, 52]).”

“[6–9] The predictors and effects of resilience have been examined among those living with chronic illness, overcoming traumatic experiences, and prospering in stressful work environments.”

“…in the individual difference and psychological factors that can promote well-being has increased in recent years as research examining the characteristics and structure of well-being has begun to clarify the nature of positive mental health (Gallagher, Lopez, & Preacher, 2009; Keyes, 2005, 2007).”

“Specifically, missed days of work, cutbacks in the amount of work, limitations of activities of daily living, prevalence of cardiovascular disease, average number of chronic physical health conditions, and poor psychosocial functioning are lowest among flourishing individuals and highest among languishing individuals…”

“This insight builds upon recent theorising by Keyes (2007), whose dualcontinua model proposes that wellbeing and ill-being are not two poles of a continuum, but are two separate dimensions of functioning.”

“This fits with the dual factor model of mental health, acknowledging psychological functioning and mental health problems as separate, yet correlated, unipolar dimensions (Keyes, 2007; Suldo & Shaffer, 2008; Wang, Zhang, & Wang, 2011; Weich et al., 2011).”

“Indeed, as reported in Keyes (2007), there was a main effect of race and an interaction of race and gender when using the continuous measure of overall mental health as the dependent variable.”

“…address these issues, Keyes has successfully integrated the notions of mental illness, mental health, well-being, and other related terms in the literature into a conceptual framework that allows for a more comprehensive understanding of mental health (Keyes, 2005, 2007; Keyes and Michalec, 2010).”

“Keyes (2007) proposed a similar model of wellbeing, which suggests that flourishing includes ‚symptoms‛ of both hedonia and eudaimonia.”

“Keyes (2007) states that, to be defined as flourishing, individuals must have high levels on at least one of two measures of positive emotions (positive affect, and avowed quality of life), and high levels on at least six of 11 measures of positive psychological and social functioning (among them…”

“This is quite surprising, especially considering that it has previously been established that health and mental illness work in a relatively independent manner [153], and that the factors which make either reduce do not necessarily cause the other to increase [154].”

“Second, meaning has been linked to well-being (Brunstein, Schultheiss, & Grässmann, 1998; Diener, Suh, Lucas, & Smith, 1999; Keyes, 2007; McKnight & Kashdan, 2009).”

“In this review, we refer to Keyes’ (2002; 2007) two-continuum model in which MH is characterized as a complete state.”

“…is accumulating evidence that psychopathology and wellbeing are more than merely opposite poles of the same dimension (Huppert & Whittington, 2003; Keyes, 2005, 2007; Lamers et al., 2011; Watson & Tellegen, 1985), and both well-being and mental disorders may have independent impacts on physical…”

“Findings consistently show that adults and adolescents who are diagnosed as anything less than fl ourishing are doing worse in terms of physical health outcomes, healthcare utilization, missed days of work, and psychosocial functioning (Keyes, 2002 , 2005b , 2006 , 2007 , 2009 ).”

“This instrument is based on a review of many theories of psychological health (Ryff, 1989), which is often described as broader than the absence of symptoms (Hayes et al., 1999; Keyes, 2007; Snyder & Lopez, 2002).”

“Existing empirical studies incorporating measures of well-being along with clinical symptoms have shown that these distinct outcomes can have different correlates (e.g., Antaramian, Scott Huebner, Hills, & Valois, 2010; Keyes, 2007).”

“Prior studies with population-based samples investigatng the interdependence of well-being and psychopathology Keyes, 2007; Lamers, Westerhof, Glas, & Bohlmeijer, 2015; rompetter, de Kleine, & Bohlmeijer, 2016) showed that ell-being protects against mental illness through compoents such as positive…”

“Keyes CLM (2007).”

“Another explanation could be that well-being cannot simply be considered as the opposite of psychopathology [33,36,42,48,91].”

“…evidence for flourishing has hitherto been based on a narrow empirical sample because the currently available studies on factors related to flourishing all relied on a single database, the Midlife in the United States (MIDUS) study (Keyes 2002, 2005, 2007; Keyes et al. 2002; Keyes and Simoes 2012).”

“, Keyes, C. L. M., Moore, K. A. and The Center for Child Well-being (Eds.). (2002a). Well-being: Positive Development across the Life Course.”

“The greatest psychological health is theorized to be the result of both the absence of disorder and the ability to adapt to changing life circumstances—acceptance and psychological flexibility (see Keyes, 2005, 2007 for related ideas).”

“Subsequently, some well-being theorists have combined both SWB and PWB into unifying models of well-being, for example, the complete state model of mental health (Keyes, 2005; Keyes, 2007) and the orientations to happiness (Peterson, Park, & Seligman, 2005).”

“Although older adults may retire from market work, the construction of lives that include participation in productive and meaningful personal care work is critical for promoting the kind of flourishing that Keyes (2007) suggests should be a goal of health care policy.”

“…at higher ages because it helps to protect, retain, and replenish personal resources, to frame negative experiences positively, and to deal successfully with age-related demands, dif fi culties, and constraints (Hobfoll and Wells, 1998; Keyes, 2007; Knight et al., 2006; Lazarus and Delongis, 1983).”

“According to the Mental Health Continuum Model (Keyes 2005, 2006, 2007), mental health, like mental illness, is a syndrome of symptoms.”

“…(e.g., Emmons 1986, 1999; Emmons and King 1988; Emmons, Shepherd, and Kaiser 1994), Gollwitzer (1993), Kasser and Ryan (e.g., Kasser 1997; Kasser and Ryan 1993, 1996; Kasser et al. 1995; Sheldon and Kasser 2001), Keyes (2005, 2007), McGregor and Little (1998), and Omodei and Wearing (1990).”

“Keyes ( 2003 , 2005 , 2007 ) described a model of mental health in which mental health and mental disorder are two separate but related dimensions of functioning.”

“Keyes, 2007 ; Rath & Harter, 2010 ; Ryff & Keyes, 1995 ).”

“Keyes has proposed a comprehensive model of mental well-being where both optimal functioning and hedonic well-being are taken into account (Keyes 2002, 2007, 2013).”

“Keyes (2007) articulates this situation as the ‘roadmap to health is through illness’.”

“15; see also Keyes, 2007). The question arises on how mental health, or the ‘good life’ from a positive psychology perspective can be achieved – and what individual contributions may be. Lyubomirsky, Sheldon, and Schkade (2005) argue that there are three major contributors to happiness, i.”

“Rationale for treatment from a positive psychology perspective Based on Keyes (2007), Seligman et al. (2006), Gilbert (2012), among others 2 Positive emotions: identify and name positive emotions and learn to promote them Seligman et al. (2006) Hedonic 3 Savoring to amplify the intensity and…”

“This condition consists not merely in the absence of mental illness but in the presence of various stances, dispositions, and abilities (cf. Keyes 2007).”

“The inspiration for the scale comes from a World Health Organization document in which a definition of a person's wellbeing includes being able ''to make a contribution to his or her community'' (Keyes, 2007:98).”

“This calls for a strong commitment of both scholars and practitioners to the identification of adequate indicators of positive mental functioning or flourishing (Keyes, 2007) to serve in research studies as well as in the design and implementation of interventions.”

“…illness is not necessarily synonymous with the presence of mental health, and curing mental illness will not guarantee a mentally healthy society (Keyes, 2007); but by working with appropriate organizations in health and education, the digital society affords some opportunity to reach…”

“Early detection, accurate diagnosis, and effective treat-ment can alleviate the suffering of people who are dealing with mental health challenges [8].”

“According to the criteria outlined by Keyes (2002, 2005a, 2007), individuals had FMH if they reported a high level on the positive affect scale or the life satisfaction item in combination with a high level on six of the 11 scales of positive functioning (i.e., any of the six psychological, or any…”

“For example, Benson and Scales (2009) identify spiritual development and prosocial orientations as explicit indicators of thriving in adolescent populations, whereas these themes are not pronounced in flourishing research (see, e.g., Keyes, 2007).”

“, Keyes, 2007). However, if one’s passion is obsessive, then the positive effects may not be forthcoming and an increase in poor functioning may even take place. Much research supports the above hypothesis with psychological well-being. For instance, in research with elderly individuals, Rousseau and Vallerand (2003)…”

“First, the factorial structure was investigated using exploratory factor analyses with oblique rotation, in accordance with previous WEMWBS validations (Keyes, 2007; Tennant et al., 2007), and confirmatory factor analyses using weighted least squares estimation.”

“This scale has been used in numerous studies worldwide (Keyes, 2007) and has good internal consistency (>0.80) and validity in the South African context (Keyes et al., 2008).”

“In addition, the long and short forms of the MHC have been useful in improving the scientific understanding of the risk of future mental illness (MDE, GAD, and panic attacks; see Keyes, Dhingra, & Simoes, 2010), risk of premature mortality (Keyes & Simoes, 2012), healthcare utilization, missed days of work, disability…”

“Flourishing refers to a positive state of mental health characterized by the absence of mental disorders along with high levels of psychological well-being on multiple dimensions, including positive emotions and high social and psychological functioning (Keyes, 2007).”

“In our study, we included all these views, following the Mental Health Continuum model [13].”

“In terms of emotional functioning, research showed that mental health is a particularly important resource at higher ages because it helps to protect, retain, and replenish other important resources such as physical health and learning motivation (Hobfoll & Wells, 1998; Keyes, 2007; Warr, 1990).”