title: What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey.
abstract: OBJECTIVE
  Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health?
  
  
  METHODS
  50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience.
  
  
  RESULTS
  46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented.
  
  
  CONCLUSIONS
  Answers to the question, 'What are the core concepts of mental health?' are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations.
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, University of Western, London, Ontario, Canada.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Manwell
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Skye P
authors.initials: SP
authors.lastname: Barbic
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Roberts
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Durisko
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea.
authors.forename: Cheolsoon
authors.initials: C
authors.lastname: Lee
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Emma
authors.initials: E
authors.lastname: Ware
authors.affiliation: Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kwame
authors.initials: K
authors.lastname: McKenzie
mesh_terms: D032921:Consensus; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health / Q000145:classification*; D036301:Qualitative Research
keywords: MENTAL HEALTH; agency; human rights; mental illness; primary health care; social determinants of health