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Key points
- Mental health promotion involves actions at individual, community, structural and policy levels to improve mental health and wellbeing of the whole population.
- Prevention frameworks can also improve mental health and wellbeing at individual and population levels by addressing risk factors and promoting resilience.
- People with intellectual disability should be included in mental health promotion and prevention strategies.
- Professionals can make adjustments to their practice to include people with intellectual disability, such as facilitating communication, using strengths-based approaches and promoting decision-making.
Health and mental health promotion
Health promotion enables people to increase control over and improve their health. The Ottawa Charter, [1] provides a framework for effective health promotion and sets out five key action areas. These include:
- Build healthy public policy: policy development at all levels of government should factor in health implications and seek to promote health.
- Create supportive environments: consider the link between people’s social, economic and physical environment and their health.
- Strengthen community actions: involve communities in setting priorities, decision-making, and planning and implementing strategies to improve health outcomes.
- Develop personal skills: enable people to obtain information, knowledge and skills to make healthy choices, improve their health and reach their full potential.
- Reorient health services: shifting the entire health sector towards a health promotion focus rather than clinical or curative services.
Mental health promotion
Mental health promotion involves actions taken to improve mental health and wellbeing.
Mental health promotion, based on the principles of the Ottawa Charter, may include: [2]
- having interventions for the whole population, rather than focusing on individuals or groups at risk from specific mental disorders
- adopting integrated approaches and strategies operating at individual and community levels
- focusing on protective factors for enhancing mental wellbeing and quality of life
- addressing the psychosocial, physical, cultural and economic environments that determine the mental health of individuals and communities
- involving intersectoral action, extending beyond the health and mental health sector (e.g. the disability sector)
- having public participation, engagement and empowerment.
Prevention of mental illness
Professionals can also follow a prevention framework when improving mental health in individuals, communities and populations. A preventative approach to mental illness aims to reduce the incidences and seriousness of specific mental disorders.
Prevention frameworks typically involve addressing risk factors to reduce the incidences and prevalence of mental illness. Understanding how risk factors can prevent the development of protective factors and resilience is also important.
Some of the risk factors that professionals can address when promoting good mental health for people with intellectual disability are:
- difficulties with communication
- not being in control of some aspects of their life
- fewer job opportunities
- small social circle
- medical reasons.
For more information about mental health promotion and prevention approaches, the Prevention First Framework for Mental Health provides a good overview.
Mental health literacy
Mental health literacy involves skills related to accessing, understanding and using health information to access health care in ways that benefit personal and community health. Mental health literacy involves:
- understanding how to obtain and maintain positive mental health
- understanding risk factors and causes of mental disorders and how they are treated, both professionally and through self-treatments
- decreasing stigma related to mental illness
- knowing when and where to seek help.
Good mental health literacy means that people can make their own decisions about health and mental health.
Inclusion of people with intellectual disability in mental health promotion and prevention
Mental health promotion is fundamental to empowering people with intellectual disability to gain equitable access to mental health care.
Strategies for the inclusion of people with intellectual disability include:
Communication impairments are a significant barrier to people with intellectual disability participating in mental health promotion. Mental health promotion often involves education and materials that may not be accessible to people with intellectual disability.
Strategies include:
- tailoring interventions to the person’s cognitive and communication needs
- tailoring information to the needs of people with intellectual disability and supporting them to use it [3]
- providing information in accessible formats, such as Easy Read
- involving an interactive or practical element so that the person can develop and practise skills relevant to them.
Mental health promotion often utilises a strengths-based approach, but people with intellectual disability may not have been supported to recognise and use their strengths in the past.
Strategies include:
- supporting the person to recognise their unique strengths and potential, including examining their values, character traits and resources, such as social support
- using strengths-based language where discussions include solutions or positive outcomes
- using a person-centred and recovery-oriented approach to build on the person’s strengths. For more information see the Guiding principles section
- assisting the person with intellectual disability to recognise what they have learnt through challenging experiences.
Strategies include:
- supporting the person’s power of choice by:
- taking steps to meet their individual needs
- giving the person the tools they need to make choices and communicate these decisions
- seeking feedback from the person
- supporting the person to advocate for themselves
- assisting the person with goal-setting, including establishing what they want to achieve and the steps needed to get there
- supporting the person to reflect on their progress.
There are many ways to build protective factors, including:
- helping the person with intellectual disability work through any trauma and build resilience. You could do this by helping the person recognise and manage their emotions or by using strengths-based activities. The Black Dog Institute’s Healthy Mind program, developed specifically for people with intellectual disability, has some activities that may help
- helping the person with intellectual disability plan ahead for tough times. This could include helping the person make a list of people they could speak to or strategies and activities for relaxing
- addressing common risk factors for people with intellectual disability (e.g. making sure the person with intellectual disability has a strong social network and encouraging social and community participation)
- using annual health assessments (e.g. the Comprehensive Health Assessment Program) to identify and manage any issues early.
We have provided some additional practical tips for how people with intellectual disability can have good mental health here within the I am a person with intellectual disability section. These ideas may be familiar to you already, but you may still find them interesting to read and they can be provided to people with intellectual disability and their supporters.
- World Health Organisation. The Ottawa Charter for Health Promotion Geneva, Switzerland: WHO; 1986 [Available from: https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference.
- Barry MM, Clarke AM, Petersen I, Jenkins R. Implementing mental health promotion: Springer Nature; 2019.
- Chinn D. Critical health literacy health promotion and people with intellectual disabilities. Asia-Pacific Journal of Health, Sport and Physical Education. 2014;5(3):249-65.
