Some focus group participants said they have enough knowledge and personal empowerment to protect their own mental health. However, some argued that it is not possible to control the onset of a mental illness regardless of the level of knowledge or personal empowerment. Several thought that the ability to monitor and protect mental health requires a high level of insight and self-awareness, which may increase with age and life experience. Many agreed that people would be unlikely to seek information unless directly affected by the issue, and therefore knowledge and capacity to self-monitor would be higher in those who have experience with mental health problems.
Canadians appear to have good knowledge of prevention strategies and many of the strategies they recommended, such as social support, physical exercise and stress reduction, are indeed protective factors. Footnote 121 The focus group participants who attributed mental illness to genetic causes exhibited more pessimism about prevention. This is similar to other research findings showing that biomedical perspectives are associated with increased pessimism about treatment outcomes. Footnote 122 Such perspectives may also reduce the sense of personal empowerment for health promotion, if people feel that preventing mental health problems is futile. Footnote 123 This calls for careful construction of key messages for educational initiatives about mental health problems and prevention strategies.
Mental health and physical health are closely associated and each influences the other. Footnote 124 Many chronic diseases are associated with a higher prevalence of depression including diabetes, cardiovascular disease and arthritis Footnote 125 Depression is a risk factor in itself for physical health problems, such as heart disease Footnote 126 and it is associated with poorer prognosis and higher risk of all-cause mortality from chronic disease. Footnote 127 Research suggests it may also be an independent risk factor for all-cause mortality in older persons. Footnote 128 Prolonged stress can lead to depression Footnote 129 as well as to physical health problems, such as suppressed immune function, autoimmune disorders, heart disease, diabetes and obesity. Footnote 130 These effects occur along a social gradient, as persons of higher social status normally have more control over life events including work, and therefore experience less chronic stress. Footnote 131 The mechanisms by which stress and depression lead to physical illness appear to be related to damage to the body from prolonged exposure to stress hormones. Footnote 132
Return to note 121 Stephens et al, 2000; WHO, 2004b
Return to note 122 Read and Law, 1999; Martin et al, 2000; Walker and Read, 2002; Lauber et al 2004; Phelan et al, 2006
Return to note 123 Read and Law, 1999; Harris, 2001
Return to note 124 WHO, 2004b
Return to note 125 Kivimaki et al, 2003
Return to note 126 Abas, 2002
Return to note 127 Kivimaki et al, 2003
Return to note 128 Schulz et al, 2000
Return to note 129 Adelson, 2005
Return to note 130 Johnston-Brooks et al, 1998; Egede, 2005; NIH, 2002; Boscarino, 2004; Chandola et al, 2006
Return to note 131 Evans et al, 1994; Chandola et al, 2006
Return to note 132 Johnston-Brooks et al, 1998; NIH, 2002; Abas, 2002; Boscarino, 2004;Chandola et al, 2006