Article Text

Download PDFPDF

What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey
  1. Laurie A Manwell1,2,
  2. Skye P Barbic1,3,
  3. Karen Roberts1,
  4. Zachary Durisko1,
  5. Cheolsoon Lee1,4,
  6. Emma Ware1,
  7. Kwame McKenzie1
  1. 1Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, University of Western, London, Ontario, Canada
  3. 3Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
  1. Correspondence to Dr Laurie A Manwell; lauriemanwell{at}


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?

Design and participants 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.

  • mental illness
  • social determinants of health
  • human rights
  • agency
  • primary health care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.