Conceptualizing "Mental Health"

Background and Purpose: There exists a need for a conceptualization of the phrase “mental health” that is based on research and accounts for cultural variability. Only several empirical inquiries have been more than theoretical, but all efforts to date remain qualitative. Common themes that arise in the literature conceptualizing mental health include: an internal sense of well-being, autonomy, cognitive functioning, the ability to manipulate one’s environment, and a sense of belonging (Galderisi et al., 2015; Manwell et al., 2015; Garcia-Silberman, 1998; Mehrotra et al., 2013; Svirydzenka et al., 2014). Concept mapping is a mixed methodology which applies quantitative analysis to a qualitative data. This study utilized multidimensional scaling and hierarchical cluster analysis on ideas generated by participants in response to the prompt: “mental health is defined as...”

Methods: The aim of this study was to build an empirically-derived conceptualization of the term "mental health" on the basis of ideas provided by an ethnically diverse sample of lay-people and professionals. One-hundred and twenty-five participants used concept mapping software to generate 146 statements. Thirty-four percent identified as mental health professionals or peer support specialists; 10% identified as African American, 16.9% as Asian American, 18% Native American/Alaska Native, 16.9% as Latinx American, 38% as White American, 0.2% as another race, 73% female, and ages ranged from 19 – 72. Once “saturation” was achieved (no new concepts were appearing), participants were asked to sort statements into themes. Finally, multivariate statistics were applied to produce a visualization of the data.

Results: Out of the 146 statements, eight overarching themes emerged. Clusters were composed of between 4 and 27 statements, while, in terms of geography, the cluster with the highest topical coherence (bridging = 0.18) contained 26, and the two with the lowest coherence (both bridging at 0.40) contained 8 and 22, respectively. The clusters include: 1) Well-Being, 2) Balance, 3) Coping, 4) Adaptability, 5) Relational, 6) Self, 7) Lack of Mental Illness, and 8) Physical, with the “self” cluster appearing at the center.

Conclusions and Implications: Our findings are similar to those by Keyes (2007) in that people’s spontaneous definitions of “mental health” seem to be organized into categories like: absence of mental illness, well-being, and coping. Ours diverges from prior research in that it locates the concept of “self” as a central organizing feature of mental health. In concept mapping, themes that are centrally located on the visual map yielded by multidimensional scaling are essential to the meaning of the construct in question. Limitations include that it was impossible to trace thematic data once participants returned for the sorting process back to the original definitions they generated. Supplemental data collected regarding the importance or achievability of each theme could have strengthened the study. A logical follow-up might examine why the concept of “self” emerges centrally as it would help mental health practitioners and policymakers to focus their understanding of mental health in order to improve mental health interventions.