A socio-ecological framework for mental health and well-being

Welcome to the second issue of 2017. The papers in this issue cover the full spectrum of mental health promotion, prevention and intervention which I trust will be of interest to you. Without specifically intending to, many of the papers in this issue denote different elements of a socio-ecological model, which recognises the dynamic interrelatedness among personal and environmental factors, including the family, school, community and mental health agencies. Within such a framework, even if not used explicitly, is a repeated recommendation across the papers presented here, for collaboration and coordination across sectors including mental health, education and the broader community.

In the first instance the bi-directional influence of family and an individual’s mental health is highlighted across several of the papers, within a recovery framework. As argued elsewhere (Reupert, Maybery, Cox, & Scott Stokes, 2015) relational recovery for any given individual may involve various familial roles such as being a parent, partner or looking after aged parents. Assuming these roles may promote identity as someone who is more than their illness and simultaneously provide various connections to others, both in their family and outside of it. For example, being a parent provides an important way of connecting to children and may also afford opportunities to connect with other parents.

In this issue, Price-Robertson, Obradovic, and Morgan (2017) challenge the notion of individualism implicit in many recovery models. They do this by focusing on social interactions and roles as the medium through which personal transformation takes place. In their model, recovery processes are disturbed within an interpersonal network, rather than residing within one individual. Awram, Hancock, and Honey (2017) also explore notions of family recovery, by investigating how mothers living with a mental illness balance the demands of mothering and mental health recovery. The intimate intersection between mothering and recovery found in this study highlights various targets of recovery for mothers with mental illness for clinicians to consider. It would be of interest to ascertain whether and how such ‘balancing’ might resonate for fathers with mental health issues (Reupert & Maybery, 2009).

Fletcher et al. (2017) and Isobel, Pretty, and Meehan (2017) further demonstrate that the treatment of those with mental health issues within services should not and indeed cannot exist in a vacuum. Instead, by investigating a mobile phone-optimised, SMS-based, informative and interactive telephone-linked support system for new fathers (Fletcher et al., 2017) and a child-focused program delivered by adult mental health services to the children of clients of the service (Isobel et al., 2017), both studies conclude with recommendations for how services might support the various interactions between individuals (within and outside of the family) and agencies when supporting clients and their families.

Many of the other papers in this issue describe the multiple community and societal forces that impact on mental health prevention, promotion and intervention. From the perspective of service providers, Platell, Cook, and Martin (2017) identified the barriers and enablers faced by young people when accessing mental health services. How services might listen to and interact with young people, the service environment and organisational policy all influenced the ways in which young people might navigate (or not) they help they need. One of the several recommendations generated from their study was for schools to play a role in the promotion and early intervention of young people’s well-being. As indicated by Platell et al. (2017), schools are opportunistic, non-stigmatising places to identify and intervene with at risk young people and promote general well-being. Dove and Costello’s (2017) study substantiate this claim by providing preliminary support for a mindfulness program in schools in the promotion of children’s well-being.

In an acute mental health care setting in Sri Lanka, Meehan, de Alwis, and Stedman (2017) identified predicators of aggression in adults. They found that ratings on the Brief Psychiatric Rating Scale was the strongest predictor of aggression following admission. The use of structured risk assessments for monitoring the risk of aggression in clients 72 hours post-admission is supported by their study. The other paper in this issue comes from Bond, Jorm, Kelly, Kitchener, and Mason (2017), who conducted a Delphi study with a panel of experts to provide advice on delivering sensitive and appropriate mental health first aid to a lesbian, gay, bisexual, transgender, intersex and queer or questioning (LGBTIQ) person. These guidelines aim to increase support, and decrease stigma and discrimination towards LGBTIQ people who are experiencing mental health problems. Thus, the papers in this issue draw on multiple, intersecting levels across and between individuals, families, organisations and the community.

Many of the authors of this issue have produced video abstracts of their papers, which allow readers to hear the first author explain more about his or her study. These videos are available at the journal website and I would encourage readers to access these along with a full copy of these respective papers. Thank you for your continued support of the journal and I look forward to reading more of your work and celebrating the diversity that this journal showcases.