A–Z of public mental health
Public mental health (PMH) is present in every aspect of our lives. This page provides an A-Z overview of important PMH terms and factors.
This resource was developed by Dr Peter Byrne (pictured); Consultant Liaison Psychiatrist at the Royal London Hospital; Joint Clinical and Strategic Director of the PMHIC and visiting Professor at University of Strathclyde. Thanks to the experts by experience at PMHIC, Abiola Johnson, Janet Seale, Sian Ogle and Dr Sarah Markham, for their contributions in reviewing the concepts and content of the A–Z Glossary.
The resource explains terms that people may be less familiar with (in italics), and many more that demonstrate the reach of PMH. A printable version of this resource is also available. For ongoing evidence reviews, please see our Public Mental Health Implementation Centre (PMHIC) webpage.
Alcohol is the most widely misused substance in the UK. Current guidelines recommend 3 days, but any amount is harmful to physical and mental health and it increases violence (see V is for Violence) and suicide (see S is for Suicide prevention).
Bias clouds all aspects of promotion and prevention in PMH. What works for some people may not help others; we need (and have) evidence, not value judgments. Also see I for Inequalities.
Childhood adversity Abuse, including neglect, and deprivation are major causes of mental disorders: 75% start by early adulthood. PMH works to prevent, and reduce the impact of, adverse childhood events (ACEs).
Drugs including nicotine: Misusing drugs and tobacco do not fix mental disorders – they cause and can worsen them. Preventing misuse and engaging people who have a substance-use disorder is central to PMH.
Exercise: Walking for 30 minutes at least four times a week improves mood and reduces stress. Exercising with others increases the chance of it becoming a habit.
‘Vitamin F’: In PMH, F is for contact with friends and family. It is the 5+ conversations a day we all need to maintain good mental health, and access to support when needed.
Groups: Doctors see one person at a time – PMH intervenes with groups of people. It can reach everyone (universal), or selected groups (targeted, such as people who are homeless) that will benefit from specific PMH interventions.
Justice: Achieving the best possible public health is about fairness (equity), with equal access to health and other services for excluded groups – then, justice is about outcomes. PMH is rights-based, not an add on.
Mental Health in all Policies (MHIAP) is the key to PMH. Government at every level, from council to parliament, produce policies to address specific challenges. We ask of each policy: how will this impact on the public’s mental health?
Prevention: No one wants to divert money from hospitals. We ask for modest resources to prevent mental disorders and drug misuse, including alcohol and cigarettes. Many forms of dementia are preventable.
Suicide is the worst possible outcome of mental illness. We know how to prevent the final pathways to despair – PMH also works to reduce access to lethal methods and improve access to crisis support. Drinking (see A for Alcohol) is known to increase suicide risk.
Violence is not a symptom of mental disorder, but PMH activities that reduce alcohol excess and substance misuse also reduce acts of violence. See also A for Alcohol and D for Drugs.
Years Lived with Disability (YLD): Too many people spend the latter years of their adult lives carrying the burden of preventable mental and physical illnesses.
Housing: Suitable, safe and good-quality housing is a basic human right. Inadequate or no housing are major drivers of mental disorders and addictions. PMH supports Housing First and sustainable housing (also see N for Noxious environments).
Knowledge: We live in an era of improved mental health awareness, but there is a lot of knowledge (evidence) about mental health that is not widely known or adequately resourced. We call this the PMH Implementation Gap.
Noxious environments: Toxic air pollution, badly designed living environments with inadequate playgrounds, crime and antisocial behaviour, and lack of access to green and blue spaces all combine to damage our physical and mental health.
Quality Improvement (QI) is a proven way to implement small PMH activities. It is cheaper than randomised trials, and we can scale-up and spread proven actions.
Treatment gap is the gap between the number of people who have a mental disorder (1 in 4 of us) and how many receive treatment (fewer than 1 in 4).
Work and workplace: We know not having a job or working in an unsupportive workplace can damage mental health. Meaningful work, adequately paid, with reasonable adjustments are key, as are evidenced PMH workplace interventions to support people in their work. It’s also important to acknowledge the impact that voluntary/unpaid work can have on our mental health.
Inequalities may include forms of exclusion based on age, gender, disability, race/ethnicity, gender identity, sexuality, social class and others. Social determinants are the ‘causes of the causes’ of poor mental and physical health.
Life expectancy: In the UK, people’s average lifespan had started to fall before COVID-19. More years were lost among the most deprived and people with mental disorders and/or learning disabilities. PMH can reverse this loss of life.
Obesogenic environment: We walk less, look at screens more, eat more ultra-processed food, and our children are targeted by adverts for unhealthy food. One in three children now leave primary school overweight or obese.
Recovery: The definition and use of this term in public mental health has been debated, but it can be thought of living beyond a mental health condition to live a full, productive and meaningful life. Friends, family, carers and loved ones form a ‘triangle of care’ between the service user and service staff.
Urban, rural and the in-between places: Where we live has a strong influence on mental health. PMH gathers data to plan place-based evidenced interventions.
XX chromosomes: Our genes can lead to some mental disorders. Structural discrimination means that women carry more risks than men of some mental disorders. See the Royal College of Psychiatrists’ Position Statement on supporting transgender and gender-diverse people.