The DOI matches its Crossref record; 72 of the 73 references it cites were found in a registry or an index.
Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health.
Abstract
This article summarizes the conception and diagnosis of the mental health continuum, the findings supporting the two continua model of mental health and illness, and the benefits of flourishing to individuals and society. Completely mentally healthy adults--individuals free of a 12-month mental disorder and flourishing--reported the fewest missed days of work, the fewest half-day or greater work cutbacks, the healthiest psychosocial functioning (i.e., low helplessness, clear goals in life, high resilience, and high intimacy), the lowest risk of cardiovascular disease, the lowest number of chronic physical diseases with age, the fewest health limitations of activities of daily living, and lower health care utilization. However, the prevalence of flourishing is barely 20% in the adult population, indicating the need for a national program on mental health promotion to complement ongoing efforts to prevent and treat mental illness. Findings reveal a Black advantage in mental health as flourishing and no gender disparity in flourishing among Whites.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Increasing evidence demonstrates that mental health or well-being is more than just the absence of mental illness (e.g., Keyes, 2007)”
From Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety (2020) · cites this paper as Keyes, 2007
In the citing paper
“Given the findings that subjective, psychological, and social well-being can contribute to a more complete understanding of mental and physical health (Keyes, 2007)”
From Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety (2020) · cites this paper as Keyes, 2007
In the citing paper
“Given the increasing evidence that mental health is more than just the absence of mental illness (Keyes, 2005, 2007)”
From Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety (2020) · cites this paper as Keyes, 2007
In the citing paper
“Often overlooked is the fact that psychological well-being is not the absence of ill-being (Diener 2000; Keyes 2007).”
From The role of passion in sustainable psychological well-being (2012) · cites this paper as Keyes 2007
In the citing paper
“According to Keyes absence of mental health problems (i.e. languishing) is not similar to good mental health (i.e. flourishing) and mental health should be seen as a continuum”
From Impact of organized activities on mental health in children and adolescents: An umbrella review (2022) · cites this paper as Keyes, 2007
In the citing paper
“Thus, university teachers felt that their professional activity and the quality of their teaching were affected (e.g., when they established a more distant relationship with students, had less ability to prepare classes or lacked mastery in the use of technological tools), and they felt less involvement and flourishing [41, 42].”
From Boundary violations and university teachers' well-being during mandatory telework: Recovery's role and gender differences (2024) · cites this paper as [42]
In the citing paper
“it has previously been established that health and mental illness work in a relatively independent manner [153]”
From Well-Being and Romantic Relationships: A Systematic Review in Adolescence and Emerging Adulthood (2019) · cites this paper as [153]
In the citing paper
“PPWB is associated with higher psychological functioning, 16 lower incidence of chronic diseases (e.g., gastrointestinal disease, arthritis), 18 lower risk of cardiovascular events, 19 and improved health behaviors such as regular exercise, restful sleep, and a decreased sedentary behavior. 1”
From Positive psychological well-being in women with obesity: A scoping review of qualitative and quantitative primary research (2022) · cites this paper as [18]
In the citing paper
“studies have shown that after correcting for psychopathology, low levels of positive mental health are associated with more somatic diseases, increased risk of developing a mental disorder, and decreased social and work-related functioning [56].”
In the citing paper
“The original version of the instrument obtained good internal consistency for the full scale (α = 0.74) and between acceptable and good internal consistency for the sub-scales (α = 0.59 and 0.70; Keyes, 2007 ).”
From A latent profile analysis of aggression and prosocial behavior in relation to adolescent wellbeing (2025) · cites this paper as Keyes, 2007
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
On Happiness and Human Potentials: A Review of Research on Hedonic and Eudaimonic Well-Being
Ryan, R. M., & Deci, E. L. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.141 · Cited by 11,567
Handbook of Positive Psychology
(2001) · doi:10.1093/oso/9780195135336.001.0001 · Cited by 9,158
(1996) · Cited by 6,884
Drake, M. M. (1988) · American Journal of Occupational Therapy · doi:10.5014/ajot.42.10.683b · Cited by 5,303
The mental health continuum: from languishing to flourishing in life.
Keyes, C. L. M. (2002) · Journal of Health and Social Behavior · doi:10.2307/3090197 · Cited by 5,133 · cited 7×
“R; American Psychiatric Association, 1987) approach to diagnosing MDE (Keyes, 2002).”
BackgroundMethodInfluentialSelf-citationStress, adaptation, and disease. Allostasis and allostatic load
McEWEN, B. S. (1998) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1998.tb09546.x · Cited by 5,092
Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study
Murray, C. J., & Lopez, A. D. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07495-8 · Cited by 4,492
(1990) · PsycEXTRA Dataset · doi:10.1037/e530902004-001 · Cited by 3,690
Mental illness and/or mental health? Investigating axioms of the complete state model of health
Keyes, C. L. M. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.3.539 · Cited by 3,357
Self-citationAging, natural death, and the compression of morbidity
Fries, J. F. (1980) · New England Journal of Medicine · doi:10.1056/nejm198007173030304 · Cited by 3,356
Optimizing well-being: The empirical encounter of two traditions.
Keyes, C. L. M., Shmotkin, D., & Ryff, C. D. (2002) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.82.6.1007 · Cited by 3,322 · cited 2×
“…agenda, the impetus to launch the NIMH may have been responsible for planting the seeds of the study of subjective well-being as it appears today in the traditions of eudaimonic and hedonic well-being (Keyes et al., 2002) and which now form the basis for the review of mental health in this article.”
BackgroundSelf-citationMental Health: A Report of the Surgeon General
United States. Public Health Service. Office of the Surgeon General (1999) · PsycEXTRA Dataset · doi:10.1037/e636982009-001 · Cited by 3,105
Accelerated telomere shortening in response to life stress
Epel, E. S., Blackburn, E. H., Lin, J., Dhabhar, F. S., Adler, N. E., Morrow, J. D., & Cawthon, R. M. (2004) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0407162101 · Cited by 3,002
Keyes, C. L. M. (1998) · Social Psychology Quarterly · doi:10.2307/2787065 · Cited by 2,924
Self-citationThe world health organization composite international diagnostic interview short-form (CIDI-SF)
Kessler, R. C., Andrews, G., Mroczek, D., Ustun, B., & Wittchen, H. (1998) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.47 · Cited by 2,242
The effectiveness of psychotherapy: The Consumer Reports study.
Seligman, M. E. P. (1995) · American Psychologist · doi:10.1037//0003-066x.50.12.965 · Cited by 1,626
Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.102.1.133 · Cited by 1,547
Race, socioeconomic status, and health. The added effects of racism and discrimination
WILLIAMS, D. R. (1999) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1999.tb08114.x · Cited by 1,522
A Handbook for the Study of Mental Health Second Edition
Scheid, T. L., & Brown, T. N. (2009) · Cited by 1,320
Flourishing: Positive psychology and the life well-lived.
(2003) · American Psychological Association eBooks · doi:10.1037/10594-000 · Cited by 1,303
Americans View Their Mental Health, 1957
Gurin, G., Veroff, J., & Feld, S. (1984) · ICPSR Data Holdings · doi:10.3886/icpsr03503 · Cited by 1,111
How healthy are we?: a national study of well-being at midlife
Brim, O. G., Ryff, C. D., & Kessler, R. C. (2004) · Choice Reviews Online · doi:10.5860/choice.41-6842 · Cited by 1,028
Greenberg, P. E., Stiglin, L. E., Finkelstein, S. N., & Berndt, E. R. (1994) · PharmacoResources · doi:10.1007/bf03289581 · Cited by 975
Personal projects, happiness, and meaning: On doing well and being yourself.
McGregor, I., & Little, B. R. (1998) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.74.2.494 · Cited by 890
Mental health in adolescence: is America's youth flourishing?
Keyes, C. L. M. (2006) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.76.3.395 · Cited by 796
Self-citationPromoting Mental Health: Concepts, Emerging Evidence, Practice - Summary Report
Herrman, H., Saxena, S., & Moodie, A. (2004) · Cited by 673
PROMOTING MENTAL HEALTH. CONCEPTS, EMERGING EVIDENCE, PRACTICE
Stenius, K. (2007) · Addiction · doi:10.1111/j.1360-0443.2007.02046.x · Cited by 563
Treatment and prevention of depression
Hollon, S. D., Thase, M. E., & Markowitz, J. C. (2002) · Psychological Science in the Public Interest · doi:10.1111/1529-1006.00008 · Cited by 511
Subjective Well-Being in Mental Health and Human Development Research Worldwide: An Introduction
Keyes, C. L. M. (2006) · Social Indicators Research · doi:10.1007/s11205-005-5550-3 · Cited by 493
Self-citationThe economic burden of depression
Stoudemire, A., Frank, R. W., Hedemark, N., Kamlet, M. S., & Blazer, D. G. (1986) · General Hospital Psychiatry · doi:10.1016/0163-8343(86)90018-6 · Cited by 480
Ryff, C. D., Keyes, C. L. M., & Hughes, D. L. (2003) · Journal of Health and Social Behavior · doi:10.2307/1519779 · Cited by 477
Self-citationThe Changing Rate of Major Depression
Weissman, M. M. (1992) · JAMA · doi:10.1001/jama.1992.03490210080039 · Cited by 410
The new subjective medicine: taking the patient's point of view on health care and health
Sullivan, M. D. (2003) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00159-4 · Cited by 408
A prospective study of risk factors for unipolar depression
Lewinsohn, P. M., Hoberman, H. M., & Rosenbaum, M. (1988) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.97.3.251 · Cited by 404
Complete mental health: An agenda for the 21st century.
Keyes, C. L. M. (2003) · American Psychological Association eBooks · doi:10.1037/10594-013 · Cited by 346
Self-citationU.S. Health Care Spending In An International Context
Reinhardt, U. E., Hussey, P. S., & Anderson, G. F. (2004) · Health Affairs · doi:10.1377/hlthaff.23.3.10 · Cited by 344
Current Concepts of Positive Mental Health
(1959) · JAMA · doi:10.1001/jama.1959.03000290120032 · Cited by 344
Trading Off Longer Life for Worsening Health
Olshansky, S. J., Rudberg, M. A., Carnes, B. A., Cassel, C. K., & Brody, J. A. (1991) · Journal of Aging and Health · doi:10.1177/089826439100300205 · Cited by 337
Toward a Science of Mental Health Positive Directions in Diagnosis and Interventions
Keyes, C. L. M., & Lopez, S. J. (2001) · Oxford University Press eBooks · doi:10.1093/oso/9780195135336.003.0004 · Cited by 326
Self-citationCure therapeutics and strategic prevention: raising the bar for mental health research
Insel, T. R., & Scolnick, E. M. (2005) · Molecular Psychiatry · doi:10.1038/sj.mp.4001777 · Cited by 321
Your money or your life: strong medicine for America's health care system
(2004) · Choice Reviews Online · doi:10.5860/choice.41-6562 · Cited by 320
Current Concepts of Positive Mental Health
Rome, P. M. S. M. A. O., Jahoda, M., & Fien, R. (1959) · The American Catholic Sociological Review · doi:10.2307/3709002 · Cited by 298
Age-cohort changes in the lifetime occurrence of depression and other mental disorders.
Lewinsohn, P. M., Rohde, P., Seeley, J. R., & Fischer, S. A. (1993) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.102.1.110 · Cited by 288
The Origins of Health and Strength: From ‘Salutogenesis’ to ‘Fortigenesis’
Strümpfer, D. J. W. (1995) · South African Journal of Psychology · doi:10.1177/008124639502500203 · Cited by 284
(1975) · Medical Entomology and Zoology · Cited by 282
The categorical versus dimensional assessment controversy in the sociology of mental illness
Kessler, R. C. (2002) · Journal of Health and Social Behavior · doi:10.2307/3090195 · Cited by 275
Burke, K. C. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810330013002 · Cited by 263
Healthy life expectancy: evaluation of global indicator of change in population health.
Robine, J., & Ritchie, K. A. (1991) · BMJ · doi:10.1136/bmj.302.6774.457 · Cited by 261
Relapse in Major Depressive Disorder
Keller, M. B. (1982) · Archives of General Psychiatry · doi:10.1001/archpsyc.1982.04290080031005 · Cited by 260
Remission and relapse in major depression: a two-year prospective follow-up study
Ramana, R., Paykel, E. S., Cooper, Z., Hayhurst, H., Saxty, M., & Surtees, P. G. (1995) · Psychological Medicine · doi:10.1017/s0033291700033134 · Cited by 236 · cited 1×
“The remission of mental illness using current pharmacotherapies or psychotherapies is partial or short lived, and as much as one third of patients do not respond to the recommended treatments (Keller, Shapiro, Lavori, & Wolfe, 1982; O’Reardon, Brunswick, & Amsterdam, 2000; Ramana et al., 1995).”
BackgroundHealth as a Complete State: The Added Value in Work Performance and Healthcare Costs
Keyes, C. L. M., & Grzywacz, J. G. (2005) · Journal of Occupational and Environmental Medicine · doi:10.1097/01.jom.0000161737.21198.3a · Cited by 219
Self-citationThe Epidemiological Transition
National Research Council (1993) · National Academies Press eBooks · doi:10.17226/2225 · Cited by 211
Keyes, C. L. M. (2004) · Aging & Mental Health · doi:10.1080/13607860410001669804 · Cited by 200
Self-citationLong-Term Cognitive and Academic Effects of Early Childhood Education on Children in Poverty
Barnett, W. S. (1998) · Preventive Medicine · doi:10.1006/pmed.1998.0275 · Cited by 199
Chronic physical conditions and aging: Is mental health a potential protective factor?
Keyes, C. L. M. (2005) · Ageing International · doi:10.1007/bf02681008 · Cited by 172
Self-citationWICKRAMARATNE, P. J., Weissman, M. M., Leaf, P. J., & Holford, T. R. (1989) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(89)90038-3 · Cited by 165
Longitudinal follow-up of unipolar depressives: An investigation of predictors of relapse.
Gonzales, L. R., Lewinsohn, P. M., & Clarke, G. N. (1985) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.53.4.461 · Cited by 161
Outcome of Depression in Psychiatric Settings
Piccinelli, M. P., & Wilkinson, G. (1994) · The British Journal of Psychiatry · doi:10.1192/bjp.164.3.297 · Cited by 131
Nusselder, W. J., van der Velden, K., van Sonsbeek, J. L. A., Lenior, M. E., & van den Bos, G. A. M. (1996) · American Journal of Public Health · doi:10.2105/ajph.86.2.187 · Cited by 110
Mental Health Promotion: Paradigms and Practice
Tudor, K. (1996) · Medical Entomology and Zoology · Cited by 109
Socioeconomic Stratification and Mental Disorder
Eaton, W. W., Muntaner, C., & Sapag, J. C. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.016 · Cited by 109
Prospective Medicine: The Next Health Care Transformation
D, R. S. M., & Williams, R. S. (2003) · Academic Medicine · doi:10.1097/00001888-200311000-00002 · Cited by 106
The Epidemiology of Depression among Women
Kessler, R. C. (2006) · Cambridge University Press eBooks · doi:10.1017/cbo9780511841262.004 · Cited by 103
Clinical Course of Affective Disorders
Angst, J. (1988) · Springer eBooks · doi:10.1007/978-3-642-73546-2_1 · Cited by 99
Gender and mental health: Do women have more psychopathology, men more, or both the same (and why)?
Rosenfield, S. (1999) · Cited by 85
Women and Depression: A Handbook for the Social, Behavioral, and Biomedical Sciences
Keyes, C. L. M., & Goodman, S. H. (2006) · Cited by 67
Self-citationPharmacracy: Medicine and Politics in America
SZASZ, T. S. (2001) · Medical Entomology and Zoology · Cited by 53
Improving the lives of millions of school children.
Weissberg, R. P. (2000) · American Psychologist · doi:10.1037/0003-066x.55.11.1360 · Cited by 33
Treatment-resistant depression in the age of serotonin: evolving strategies
O’Reardon, J. P., Brunswick, D. J., & Amsterdam, J. D. (2000) · Current Opinion in Psychiatry · doi:10.1097/00001504-200001000-00016 · Cited by 26
Prevention of Depression in Women
Hamilton, J. A., & Russo, N. F. (2006) · Cambridge University Press eBooks · doi:10.1017/cbo9780511841262.020 · Cited by 5
Health care: A faustian bargain
Lamm, R. D., & Morreim, E. H. (2002) · Society · doi:10.1007/bf02712638 · Cited by 2
Cited by
Sorted by citations
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008) · Assessment · doi:10.1177/1073191107313003 · Cited by 2,930
“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).”
BackgroundHappy People Live Longer: Subjective Well‐Being Contributes to Health and Longevity
Diener, E., & Chan, M. Y. (2011) · Applied Psychology: Health and Well-Being · doi:10.1111/j.1758-0854.2010.01045.x · Cited by 2,260
“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…”
BackgroundMethodInfluentialPositive psychology interventions: a meta-analysis of randomized controlled studies
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-119 · Cited by 1,996
“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].”
Flourishing Across Europe: Application of a New Conceptual Framework for Defining Well-Being
Huppert, F. A., & So, T. T. C. (2013) · Social Indicators Research · doi:10.1007/s11205-011-9966-7 · Cited by 1,864
“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…”
BackgroundInfluentialResilience as a dynamic concept
Rutter, M. (2012) · Development and Psychopathology · doi:10.1017/s0954579412000028 · Cited by 1,853
“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.”
Background
Metadata
- Authors
- Keyes, C. L. M.
- Affiliations
- Emory University (US)
- Corresponding author
- Keyes, Corey L. M.
- ORCID
- Keyes, Corey L. M.
- Venue
- American Psychologist
- Published
- 2007
- Volume
- 62
- Issue
- 2
- Pages
- 95-108
- ISSN
- 0003-066X (ISSN-L)
- 1935-990X
- OpenAlex
- W2037808094
- Cited by
- 2,268
- References
- 73
- Citations by year
- 2026: 149 · 2025: 161 · 2024: 159 · 2023: 164 · 2022: 216 · 2021: 176 · 2020: 146 · 2019: 140 · 2018: 117 · 2017: 154 · 2016: 112 · 2015: 105 · 2014: 83 · 2013: 107 · 2012: 78
- FWCI
- 61.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Psychologist (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- eudaimonia, mental health continuum, mental health promotion, mental illness prevention, psychosocial functioning, resilience, helplessness, cardiovascular risk, chronic physical illness, health care utilization, labor productivity, National Mental Health Policy
- MeSH terms
- Adult, Age Factors, Aged, Mental Disorders, Educational Status, Female, Health Promotion, Humans, Male, Mental Health, Middle Aged, Quality of Life, Sex Factors, Socioeconomic Factors, United States, Racial Groups
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review