Just as there is a wide range of different mental health disorders, there is a continuum of mental health itself. This is well represented by the mental health continuum model. In our Mental Health for Managers Workshop, we look at the signs and symptoms of eight conditions. These are anxiety, depression, bipolar disorder, obsessive compulsive disorder, schizophrenia, eating disorders, and both drug and alcohol dependence. We believe however that it is not enough to know about different types of disorders or mental illnesses. It is important to understand mental health as a concept that applies to us all.
The Mental Health Continuum Model: from Wellness to Illness
In our workshop we also look at stress, and there is often confusion between stress and mental health. Stress is a very common reaction to extreme demands at work or to an otherwise toxic environment. It is not considered an illness in itself however. It is only when stress is prolonged and coping skills are poor that ill health can result – both physical and mental. Severe stress such as a trauma can also trigger a genetic predisposition to a mental health disorder.
The point is that mental health is not a binary state – you are not either mentally healthy or ill. We all fall at some point on a spectrum, ranging from excellent mental health to severe symptoms such as panic attacks or major depressive episodes. This spectrum, or continuum, is shown in the graphic below.
So where do people tend to fall on this continuum? One US study of 3,000 people published in the Journal of Health and Social Behavior in 2002 found that 17% of those sampled were flourishing (‘Excelling’ or ‘Well’ in the graphic above), 57% were moderately mentally healthy (‘Well’ with some symptoms of ‘Troubled’), and 12% were languishing (‘Troubled’, ‘Distressed’ or ‘Ill’).
The remaining 14% had a condition fitting a psychiatric diagnosis, but 2/3 of these were coping well. This illustrates an important point: people with a long-term mental disorder can be mentally healthy. If they receive treatment, in the form of psychotherapy such as CBT or medication, and have good support at work and at home, they may find themselves mostly in the yellow, green and even blue zones of the spectrum below.
The Difference Between Stress and Mental Disorders
So if anyone can fall at any point on a continuum of mental health, what defines one person as having a mental disorder and another as being merely stressed?
It’s a question of how much time you spend in the various zones of the continuum. If you are mostly coping well, but experience work stress for a while and recover, in other words you spend most of your life in the yellow to blue zones, you are mentally healthy. If you suffer major symptoms a lot of the time, and spend most of your life in the red and orange zones, then you most likely have a diagnosable mental disorder.
It is also possible that you may be relatively well for your whole life, but then a trauma or prolonged period of stress can precipitate a full-blown mental disorder. This means a big shift from the blue/green/yellow zones to the yellow/orange/red zones. And as we have seen, the reverse can happen, with the right treatment and support.
What Does the Mental Health Continuum Model Mean for Managers?
All this means that managers can have very significant effects on the mental well-being of their staff. This effect could be negative if they do not treat their employees well, or fail to solve issues which are causing them stress. However managers can also have a very positive effect. They can promote staff well-being by:
- identifying and reducing sources of stress in the workplace
- encouraging a healthy approach to life, both physically and mentally, so as to build resilience
- being themselves a role model of mentally healthy behaviours and attitudes
- encouraging open and positive discussions of mental health among staff
- keeping a close eye on the well-being of their staff, checking in now and then with a friendly inquiry
- learning how to spot signs of poor mental health, both in themselves and in their staff, and
- learning how to approach and deal effectively with employees who are experiencing a mental health crisis