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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.
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