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Mental health is an emerging health policy priority globally. The emphasis on closing the treatment gap in psychiatric services is now being complemented by an increasing focus on prevention and health promotion. The purpose of this paper is to describe the programmes and delivery of public mental health in England led by Public Health England (PHE), an arms-length body of the Department of Health and Social Care.

This technical paper outlines the general approach PHE has taken in delivering national work in public mental health and describes several key areas of work: children and young people, suicide prevention, workplace and workforce, strategic engagement with stakeholders, data and information and evidence synthesis.

A description of the various programmes and guidance documents that PHE have produced are described and referenced, which form a substantial body of work in public mental health.

The outputs from PHE may assist in informing the approach to public mental health that other government agencies could consider adopting. The resources described and signposted within this technical paper are publicly available for readers.

England is one of a small group of countries that have a track record in delivering public mental health at a national level. This paper gives a unique and detailed insight into this work.

The purpose of this paper is to investigate the overall campaign reach and impact of the ABCs of Mental Health in Denmark; a secondary objective is to investigate how mental health-promoting beliefs and actions are associated with good mental health.

A questionnaire was administered to two representative cross-sectional samples of the Danish population (1,508 respondents in 2019; 1,507 respondents in 2021) via an online survey. The data were subsequently pooled together into one sample consisting of 3,015 respondents. In addition to questions pertaining to campaign reach and impact, the questionnaire also included a validated scale for mental well-being and questions about beliefs and actions in regard to enhancing mental health.

About 7.6% had been reached by the campaign (familiar with ABC name or messages), or 11.9% when also counting familiarity with campaign slogans. Among these, respondents reported (proportions in parentheses) that the campaign had 1) made them reflect on their mental health (74.2%), talk to friends and family about mental health (35.5%), given them new knowledge about what they can do to enhance mental health (78.4%), or take action to enhance their own mental health (16.2%). An internal well-being locus of control and proactive behaviours towards enhancing mental health are shown to be associated with higher mean scores on mental well-being, lower odds of low mental well-being and higher odds of higher mental well-being.

An internal well-being locus of control and proactive behaviours towards enhancing mental health are suggested to both prevent low levels of mental well-being and promoting high levels of mental well-being. The results indicate that the ABCs of Mental Health campaign may be implemented to promote such beliefs and actions universally throughout the population.

The purpose of this paper is to describe the mental health issues among teachers globally and to investigate the significant factors that specifically impact the mental health of school teachers in Okinawa, Japan.

This cross-sectional study examined depression, anxiety, stress, self-esteem and resiliency among 174 teachers from seven schools in Okinawa, Japan. The study questionnaire consisted of four parts, including demographic data, Depression, Anxiety, and Stress scale (DASS-42), Rosenberg Self-Esteem Scale (RSE), and Connor-Davidson Resiliency Scale (CD-RISC). Multiple regression analyses were performed to identify predictors of mental health variables.

Of the 174 teachers, 111 were females (64%) and 60 were males (35%). Average age of participants was 41.65 (SD = 10.07). Average number of years being a teacher was 15.50 (SD = 9.88). There was a significant gender difference in the level of self-esteem. Significant differences in anxiety were found among varying grade levels taught. Regression analyses indicated that resiliency and self-esteem significantly predicted depression, anxiety and stress among school teachers in Okinawa.

This is the first study among school teachers in Okinawa that examined the impact of resiliency and self-esteem on their mental health. To reduce psychological distress common within the teaching profession, social and environmental support should be provided within the school to better foster the successful promotion of teacher resiliency and self-esteem.

The purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.

A postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.

Three interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.

Karen women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.

This paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.

Public health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.

This research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

This study aims to assess the knowledge and attitudes toward recovering citizenship (RC)/5 Rs and mental illness of people aged ≥18 years in Hong Kong using a telephone survey approach.

A questionnaire comprised the Mental Health Knowledge Schedule (MAKS), Short Form-Community Attitudes Toward Mental Illness (SF-CAMI) and questions on attitudes toward RC/5 Rs, was administered on the phone.

A total of 1,009 respondents completed the telephone survey. A high mean score of MAKS (4.37 ± 1.08) was found with 68%–94% answering the knowledge items correctly. The mean score of SF-CAMI was 46.50 ± 8.74 with the most positive attitude toward fear and exclusion. Approximately half had heard about a similar concept of RC and 79%–94.3% agreed with people in recovery to possess the 5 Rs. Those with greater knowledge or more positive toward mental illness, or knowing someone in recovery were more supportive toward 5 Rs. Those aged 18–44 years, attained a post-secondary education, were employed, and received a monthly income of US$3,861–6,434 were significantly more positive toward 5 Rs.

To the best of the authors’ knowledge, this is the first study assessing the views of RC of people in the community. The sample had a good knowledge of mental illness but recognition of recovery from mental illness and a sympathetic view toward people in recovery can be further improved. Besides promotion programs, dissemination of the concept of RC and having people in recovery take up valued roles in the community could potentially facilitate the acceptance of social inclusion and acceptance in the community.

Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being.

Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence.

A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions.

Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate.

The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas.

It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities.

The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.

Adolescent mental health is a global concern. There is an urgent need for creative, multimedia interventions reflecting adolescent culture to promote mental health literacy and well-being. This study aims to assess the impact of a film-based intervention on adolescent mental health literacy, well-being and resilience.

A pretest-posttest intervention with a multi-methods evaluation was used. A convenience sample of ten schools facilitated students aged 15–17 years to engage in an online intervention (film, post-film discussion, well-being Webinar). Participants completed surveys on well-being, resilience, stigma, mental health knowledge and help-seeking. Five teachers who facilitated the intervention participated in post-implementation interviews or provided a written submission. Analysis included paired-t-test and effect size calculation and thematic analysis.

Matched pretest-posttest data were available on 101 participants. There were significant increases in well-being, personal resilience and help-seeking attitudes for personal/emotional problems, and suicidal ideation. Participants’ free-text comments suggested the intervention was well-received, encouraging them to speak more openly about mental health. Teachers similarly endorsed the intervention, especially the focus on resilience.

Intinn shows promise in improving adolescents’ mental health literacy and well-being. Film-based interventions may encourage adolescents to seek professional help for their mental health, thus facilitating early intervention.

The current pandemic and ongoing climate risks highlight the limited capacity of various systems, including health and social ones, to respond to population-scale and long-term threats. Practices to reduce the impacts on the health and well-being of populations must evolve from a reactive mode to preventive, proactive and concerted actions beginning at individual and community levels. Experiences and lessons learned from the pandemic will help to better prevent and reduce the psychosocial impacts of floods, or other hydroclimatic risks, in a climate change context.

The present paper first describes the complexity and the challenges associated with climate change and systemic risks. It also presents some systemic frameworks of mental health determinants, and provides an overview of the different types of psychosocial impacts of disasters. Through various Quebec case studies and using lessons learned from past and recent flood-related events, recommendations are made on how to better integrate individual and community factors in disaster response.

Results highlight the fact that people who have been affected by the events are significantly more likely to have mental health problems than those not exposed to flooding. They further demonstrate the adverse and long-term effects of floods on psychological health, notably stemming from indirect stressors at the community and institutional levels. Different strategies are proposed from individual-centered to systemic approaches, in putting forward the advantages from intersectoral and multirisk researches and interventions.

The establishment of an intersectoral flood network, namely the InterSectoral Flood Network of Québec (RIISQ), is presented as an interesting avenue to foster interdisciplinary collaboration and a systemic view of flood risks. Intersectoral work is proving to be a major issue in the management of systemic risks, and should concern communities, health and mental health professionals, and the various levels of governance. As climate change is called upon to lead to more and more systemic risks, close collaboration between all the areas concerned with the management of the factors of vulnerability and exposure of populations will be necessary to respond effectively to damages and impacts (direct and indirect) linked to new meteorological and compound hazards. This means as well to better integrate the communication managers into the risk management team.

This study explores to what extent health promotion policy in practice and leadership engagement is reflected in school actors' experiences of health dialogues (HDs) and their ideas about promoting health and learning in schools.

The 93 participants consisted of 44 school nurses, 37 students in grades 4, 7 or the first year of high school and 12 teachers, who shared their experiences with HDs by writing open letters.

The qualitative content analysis resulted in four themes: Putting health on the agenda, Finding a common goal, Walking side by side and Pointing out a healthy direction. The participants' expectations of school health promotion leadership are revealed in suggestions on how the HDs can fulfill both the educational assignment and promote student health.

Based on the findings, we argue that for successful school health promotion leaders need to acknowledge the field of tension where leadership has to take place, anchor health promotion policy and administer “a Sandwich approach” – a top-down and bottom-up leadership simultaneously that facilitates school-based health promotion.

When different school actors (school nurses, teachers and students) are given a voice, a collective picture of HDs can emerge and help develop health promotion practices.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.