Conceptualisations of Public Mental Health: The Role of Primary Prevention and the Social Determinants of Mental Health

Background: Within the area of public mental health there is a lack of consensus regarding how best to deliver a preventative and population-level approach to mental health. There has been increased interest in how psychologists can contribute towards developing a public mental health approach that focuses on the prevention of mental health problems, as opposed to treatment. A study that explores how psychologists think about, and engage with, public mental health and prevention has not been carried out before.
Aims: This study aimed to explore how practitioner psychologists understand the concept of mental health prevention, how this informs their practice, and how they engage with the evidence on the social determinants of mental health as part of this.
Method: Eleven semi-structured interviews were conducted with clinical and community psychologists involved in the area of public health and prevention. Interview transcripts were analysed using thematic analysis.
Results: Participants’ understanding and use of public mental health and prevention approaches were captured in five themes. A description of these themes and associated sub-themes is presented.
Conclusion: The findings indicate that there are a range of understandings regarding the concept of mental health prevention and that this relates to beliefs and values about mental health and where change should occur. The psychologists in this study had employed a variety of skills, models and theories in their prevention work. Most participants felt that prevention ought to address the social determinants of poor mental health, and some had found ways to do this through multi-sector work and influencing key decision makers. The implications for the theory and practice of applied psychologists involved in prevention, and for decision making in public mental health are discussed.