Marge Kulev Tartu Psychiatric Clinic Mental health nurse-specialist Health promotion as a part of health policy and salutogenesis as a model of health promotion Marge Kulev Tartu Psychiatric Clinic Mental health nurse-specialist

The concept and development of health promotion Health promotion is the process of enabling people to increase control over factors, that influence their health, and improve their health, to live active and productive life (WHO, 1986). The formal beginning in Canada in 1970-ies. Paying attention to “positive health”.

Health promotion and politics Ottawa Charter (1986): health promotion is not only a part of health care field, it reaches also into politics. Health promoting politics is a combination of different approaches (legislation, financial measures, taxation and organizational changes). Using politics one can influence almost all dimensions of health (e.g. employment rate and working conditions, availability of education, physical, social and psychological environment etc).

Salutogenesis as a model of health promotion Salutogenesis – genesis of health. Aaron Antonovsky (1923 – 1994) – relationships between stress, health and well-being. Coping recourses are crucial for health in difficult situations. Focusing on maintaining and strengthening health, not on that, what is causing disease (pathogenesis).

The model of health continuum; core concepts of salutogenesis Health is not a dichotomous variable (healthy/unhealthy), but a continuum: Healthy disease Health is an unstable, active and dynamic state, not a stable balance state. The sense of coherence (SOC): - comprehensibility; - manageability; - meaningfulness. General resistance resourses (GRR). Appropriate challanges.

An example of promoting mental health Applied group therapy program based on salutogenic principles in Norway (2005) for people with mental health problems. Langeland, E., Riise, T., Hanestad, B.R., Nortvedt, M.W., Kristoffersen, K., & Wahl, A.K. (2006). The effect of salutogenic treatment principles on coping with mental health problems – a randomised controlled trial. Patient Education and Counseling, 62, 212 – 219.

An example of promoting mental health The aim of the program was to help people find their coping resources and ability to use them. Group therapy helped to improve coping skills of people with mental health problems in recovery phase.