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The Royal College of Psychiatrists Improving the lives of people with mental illness

 

Did you know? Information Briefing on Wellbeing

 

Introduction

This briefing on 'Wellbeing' highlights its importance not just for health, but also recovery from illness. It is relevant to shadow health and wellbeing boards, local health and wellbeing strategies, commissioning, health and public health professionals as well as the general public. 

 

Why is wellbeing important?

Health benefits of improved mental wellbeing include:   

  • reduced emotional and behavioural problems in children and adolescent including persistence of such problems 33
  • reduced mental illness in adulthood 22,27
  • reduced suicide 25
  • better general health 29, reduced physical illness 27,37 and reduced health service use
  • reduced mortality in the general population and in those with established illness 6
  • absence of positive well-being is more predictive of 7-year mortality than presence of psychological morbidity 17.

 

Improved wellbeing also has a range of benefits beyond health which include:

  • improved educational outcomes 31,32
  • healthier lifestyle/ reduced health risk behaviour 27, including reduced smoking and harmful levels of drinking 9
  • increased productivity at work 32,4, greater success in work and higher income 27
  • reduced absenteeism 23,28 and burnout 27
  • higher income 27
  • stronger social relationships 37,27,11 and increased participation 18
  • reduced anti-social behaviour, crime and violence 38,8.

 

Such impacts result in significant economic savings 16. For instance, each pound invested in mental health promotion at work results in net savings of £10 within one year as a result of improved productivity and reduced absentee-ism 11. Therefore, even a small increase in the wellbeing of the whole population has a range of significant impacts.

 

Levels of wellbeing in UK

A large ONS survey found that for life satisfaction, 76% of adults responded with 7/10 or more while 7% responded with less than 5/10 33. For how worthwhile life was, 80% responded with 7/10 or more while 5% scored less than 5/10 while for happiness, 71% scored 7/10 or more while 5% responded with less than 5/10 33. Similar levels were found in the most recent Health Survey for England 29.

 

The UK ranked 24th out of 29 European countries in a survey on children’s wellbeing 5.

 

What is wellbeing?

Wellbeing can be defined in many ways two of which are highlighted in Table 1.

 

Table 1: Definition of wellbeing
  • As a state in which the individual realises their own abilities, can cope with normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community 41.
  • As a combination of feeling good and functioning effectively. The concept of feeling good incorporates positive emotions of happiness and contentment, and also interest, engagement, confidence and affection. The concept of functioning effectively (in a psychological sense) involves the development of one’s full potential, having some control over one’s life, having a sense of purpose such as working towards valued goals, and experiencing positive relationships 18.

 

A number of distinct constituents of wellbeing include 39:

  • pleasure (hedonic wellbeing)
  • engagement exemplified by being absorbed in a activities such as work, relationships, leisure, exercise 
  • meaning
  • achievement.

Pleasure (also known as hedonic wellbeing) is important but limited in a number of ways including that it is transitory and does not always lead to fulfilment. Pleasure, engagement and meaning are all important although maximum mental wellbeing occurs with pursuits involving all three. However, meaning and engagement have the largest impact 35,40. Those with poor wellbeing have higher rates of health risk behaviour which although may temporarily increase hedonic wellbeing, result in a range of adverse outcomes.

 

Relationship between wellbeing and mental disorder

Wellbeing is more than the absence of disorder. The absence of mental wellbeing or mental disorder does not imply the presence of the other. However, people with mental disorder have lower levels of wellbeing and this may explain self medication by higher levels of alcohol and drug use. Furthermore, wellbeing is important to nurture as part of recovery. Increased levels of wellbeing in the general population can provide a buffer against adversity.

 

Factors influencing wellbeing

Certain risk factors are associated with poor wellbeing:

  • mental ill-health 29
  • lower household income 29
  • higher income inequality 1
  • occupation: Lower in semi-routine and routine occupations 33
  • gender: Men have lower subjective wellbeing than women 33. However, women have lower hedonic wellbeing but higher eudaimonic wellbeing compared with men 7
  • middle age 33
  • poor sense of belonging and ability to influence community 9
  • poor mobility, poor self-care, difficulties performing daily activities, pain and discomfort 9
  • alcohol, smoking and cannabis use 9.

Particular groups at high risk of poor wellbeing include people with mental illness, drug and alcohol use disorder 33,9, work limiting disability, BME groups 9 and unemployed people 33,29.

Other factors are associated with improved wellbeing: 

  • Early environmental factors, and parenting in particular, powerfully influence an infant’s accumulation psychological wellbeing
  • Activities:
    • intentional activities such as socialising, working towards goals, exercising, engaging in meaningful activities and work may account for up to 40% of the population variation in well-being 26.
    • employment well as autonomy, support, security and control in an individual’s job 29.
  • Social engagement
    • marriage, being in a civil partnership or cohabitating compared to those who are single, widowed, divorced, separated or formerly in a civil partnership 33
    • active participation in social activities and involvement in the local community 15
    • doing things for others has a significant effect on well-being 36, including spending income on others 13
    • number of close personal relationships 2.
  • Higher levels of income and socio-economic status are associated with higher levels of wellbeing 12,2
  • Generic life skills, social competencies and attributes such as communication skills, cognitive capacity, problem-solving, relationship and coping skills, resilience and sense of control enhance mental health 3
  • Certain values such as prioritising relationships with friends and community are associated with wellbeing 21. More materialistic values are associated with reduced mental well-being and life satisfaction 20, as well as more negative emotions and less meaning in life 19.
  • Spirituality associated with improved subjective well-being, particularly positive affect and life satisfaction 14, as well as improved self-esteem, personal development, mastery and control 24
  • Self-reported general health 9,29.

 

Resources

 

 

 

© Royal College of Psychiatrists. August 2012. This leaflet reflects the best available evidence available at the time of writing.

 

Dr Jonathan Campion, consultant pychiatrist at South London and Maudsley NHS Foundation Trust and Professor Kam Bhui, Professor of Cultural Psychiatry and Epidemiology and Hon Consultant Psychiatrist, Queen Mary, University of London.RCPsychlogo

 

 

This leaflet may be downloaded, printed out, photocopied and distributed free of charge as long as the Royal College of Psychiatrists is properly credited and no profit gained from its use. Permission to reproduce it in any other way must be obtained from the Head of Publications. The College does not allow reposting of its materials on other sites, but allows them to be linked directly.

 

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