Groundbreaking study combines expert views, research evidence and public opinion to generate new mental health advice
Spending time in green spaces, getting better sleep and avoiding illicit drugs are among the recommendations of an innovative new study by the Mental Health Foundation. It identifies how people can protect their mental health using methods that are both evidence-based and publicly acceptable.
Avoiding unmanageable debt, prioritising fun and learning to understand and manage one’s mood are other top recommendations to emerge from the study, which is published in the American Journal of Health Promotion - a leading international, peer-reviewed research journal.
The Mental Health Foundation research is thought to be the first ever to draw on a combination of mental health research evidence, experts’ views and public opinion, in order to generate the best advice for use in public mental health advertising.
Dr Antonis Kousoulis, Director for England and Wales at the Mental Health Foundation, said: “There’s surprisingly little agreement about the recommendations designed to help people look after their mental health.
“There’s also a lack of transparency about how the recommendations in existing campaigns were arrived at – in some cases, they’re from a small group of well-networked psychiatrists.
“Our study aims to change things, by offering recommendations that reflect the best available evidence on what is likely to be helpful to people in the real world. Furthermore, we are clearly declaring the rigorous methodology we used to generate these recommendations.
“Our study represents a major step forward on existing public mental health advice, with several applications for health promotion campaigns and courses.”
The new study used a Delphi methodology, which uses qualitative and quantitative techniques to assess available research evidence and reach consensus on a given topic.
It began by asking 23 international experts to suggest what individuals can do to maintain good mental health, and to outline the basis for their suggestions. All the experts had strong and proven expertise in relation to anxiety and depression, which are common mental health problems.
They produced 158 initial recommendations, which the study authors combined and refined down to 29. These 29 were put back to the experts, who were asked to rate each one for its usefulness in protecting mental health.
Finally, the authors showed the 14 suggestions that experts rated most highly to the members of the public who participated in the study, using an online survey.
The members of the public were asked to rate each one according to its usefulness and applicability to their own lives. Of the 14 ‘expert’ suggestions, eight were chosen by at least 50 per cent of the public participants as “very” or “extremely” useful and applicable.
The 1,447 members of the public who took part were recruited via Mental Health Foundation social media channels. Most had past or current experience of problems with their mental health. The study’s recommendations therefore have the critical benefit of those people’s experience and hindsight.
The recommendations are (in order of popularity):
- Be aware of using drugs to cope with difficult feelings
- Build money skills and seek financial support if you need it
- Get more from your sleep
- Develop awareness of your feelings and emotions
- Have something to look forward to
- Get closer to nature
- Speak to someone you trust for support
- Stay curious and open to new experiences
Almost as popular (chosen by at least 45 per cent of the public panel) were:
- Have a healthy diet
- Help others, contribute to something bigger
- Engage in physical activity
- Practice gratitude and cultivate hope
- Strengthen social connections
The study acknowledges that some of its recommendations will be harder to follow for many people, because of influences beyond their control. These include living in poverty or in places with heavy traffic noise and lack of green space.
Dr Kousoulis continued: “We know that the means to practice this advice are not readily available to everyone. For example, poverty, low education and isolation may mean that for some individuals, it is not possible to avoid unmanageable debt.
“Now that we have this clear evidence, governments should take action that empowers people to better look after their own mental health.”
He also attacked the notion of ‘miracle cures’. “Our research shows that it’s the fundamentals of life that protect our mental health: our finances, our relationships and our experiences,” said Dr Kousoulis.
“Time and time again, we’ve seen a powerful wellness industry taking advantage of people’s vulnerability to offer ‘miracle cures’ in exchange for improved wellbeing. Our evidence challenges the notion that this is what most people want.
“The majority of people in our study, with the hindsight of their experience of poor mental health, told us that getting some support to avoid illicit drugs and unmanageable debt, to sleep better and to regulate their emotions, is what would have made the biggest difference to them.”
Some of the study’s suggestions found more favour among the expert participants than among the members of the public. These included including taking exercise, eating a healthy diet and drinking alcohol in moderation.
Notes to Editors
The full, published study is available at: https://journals.sagepub.com/doi/full/10.1177/0890117121998536
About the Mental Health Foundation
Our vision is of good mental health for all. The Mental Health Foundation works to prevent mental health problems. We drive change towards a mentally healthy society for all, and support communities, families and individuals to lead mentally healthy lives with a particular focus on those at greatest risk. The Foundation is the home of Mental Health Awareness Week. www.mentalhealth.org.uk