Mental health has become a central trope of the Zeitgeist. As with the recent collective interest in optimizing physical health and longevity, people want to know how to get happier.
Body and mind are intricately connected, of course, despite our tendency to treat them as two separate riches to safeguard. When it comes to tending our bodies, we are inundated with advice on what to eat, how to move, when to rest. If we are trying to get stronger, reach a number on a scale, or alter key blood values, there is some or other well-paved road that leads to our goals.
But when it comes to our minds, things are less straightforward. To begin with, we don’t even have a comprehensive picture of the very thing we are trying to improve—a construct that goes by many names: flourishing, mental well-being, mental health, quality of life. Poignantly, the field of happiness is fraught with intricacies and ambiguities that create challenges as much for the happiness-seekers as for the researchers and policy-makers seeking to implement interventions.
A recent study set out to address the fragmentation that dominates in well-being research by creating a preliminary taxonomy of the dimensions that make up positive mental health. The study used the Delphi consensus method—a structured technique for tapping into collective intelligence. This method is used across various fields to reach a consensus among a panel of experts through multiple rounds of questionnaires. After each round, panel members receive feedback summarizing the group’s results and adjust their answers until they reach a consensus. Among the advantages of this “forecasting tool” are the anonymity of the experts, the iterative process, controlled feedback, and stability (or response consistency) of the consensus.
The study included a pool of 122 experts living across 26 countries—all distinguished scholars from various disciplines, including psychology, sociology, philosophy, economics, and medicine. The experts were presented with 26 possible dimensions of positive mental health (together with their definitions and two representative items each), which were selected from established research. On a scale of 1 (“irrelevant”) to 4 (“essential”), they were asked to assess how important each dimension was for positive mental health. The experts needed to reach more than 75 percent agreement or disagreement on whether to retain or dismiss a given dimension. If a dimension did not reach consensus after two rounds, it was removed from the study.
After three rounds of voting, a consensus on 19 dimensions was reached. Importantly, six of those dimensions received overwhelming support with more than 90 percent agreement as either “essential” or “important” for positive mental health.
The 6 dimensions of positive mental health:
- Meaning and purpose
- Life satisfaction
- Self-acceptance
- Connection
- Autonomy
- Happiness
As the authors of the study note, these dimensions echo findings from existing models of well-being. For example, the subjective well-being framework posits the three core components of well-being to be “life satisfaction,” “frequent positive affect,” and “infrequent negative affect;” self-determination theory proposes that well-being hinges upon satisfying the core psychological needs of “autonomy,” “competence,” and “relatedness;” and the six-factor model of psychological well-being includes the components of “purpose,” “self-acceptance,” “autonomy,” “environmental mastery,” “personal growth,” and “relationships.”
The experts raised a number of challenges in conceptualizing well-being.
A driver or an outcome?
When asked to determine whether each dimension was a driver or an outcome of positive mental health, the experts found it difficult to distinguish, given how closely the two are intertwined. The authors bring the example of “autonomy.” A sense of autonomy can contribute to happiness (making it a driver), which can, in turn, increase the person’s life satisfaction, which then can feed back into autonomy (making it an outcome). Nevertheless, the most commonly identified outcomes of positive mental health were the dimensions of “happiness” and “life satisfaction,” while the dimensions most often seen as drivers were “sense of safety” and “autonomy.”
Well-being is multifaceted
Well-being is inherently complex, which makes it challenging to study. Despite various taxonomies suggested over the years, distilling the concept into clear and distinct categories has proven difficult. For example, a recent large-scale study with participants from 29 countries found that 11 well-being indicators, such as “purpose in life” and “personal growth,” belonged to multiple clusters. The authors concluded that the various domains of this multidimensional construct have “fuzzy boundaries” with overlapping components.
WEIRD cultural bias
The experts pointed out the dominant WEIRD (Western, educated, industrialized, rich, Democratic) bias in psychological research, which extends to well-being studies as well. To arrive at a more comprehensive and inclusive understanding of human flourishing, it is important to incorporate diverse cultural and linguistic perspectives into all emerging frameworks of well-being. For instance, the experts raised the possibility of including dimensions from non-Western cultures, such as the Japanese ikigai (i.e., a reason for waking up in the morning).
Happiness Essential Reads
Finally, based on the recommendations from the experts, the authors of the study reached the following definition of positive mental health:
“Positive mental health is a personal and subjective experience, where we are content with our lives, feel good, function well, and view ourselves favourably. Our level of positive mental health can vary over time, and is influenced by the way we adapt to the problems and opportunities we face. It’s impacted by many factors such as our environment, life experiences, cultural background, biology, and behaviours. Many people have some level of positive mental health, and we can improve it by taking action using a variety of means, even when we experience a mental health condition.”
As research progresses, more nuanced maps of well-being will undoubtedly emerge. In the meantime, perhaps we can take these dimensions as valuable signposts to guide our attention and effort toward living healthier, happier lives.
