The relationship between mental health and wellbeing is a complex, and fascinating, issue in our work at the Centre. Surprisingly, in 2018, we still don’t really understand the fundamental interconnections. Few would argue against the need to offer much better mental health services, but the idea that ‘human misery’ is, in part, ‘caused by mental illness’ is a little more controversial. One group of psychologists commented that “… people suffer when bad things happen to them. [It is] obvious that ‘mental illness’ will predict ‘misery’ … These two terms relate to the same experiences”.
DIFFERENT PATHWAYS FOR WELLBEING AND MENTAL HEALTH
In 2013, we found that there were different pathways for poor wellbeing, anxiety, and depression. Low levels of subjective wellbeing were associated with social isolation and low levels of adaptive coping. Alternately, mental health problems were associated with negative life events and rumination. This is consistent with the idea that mental health and wellbeing lie on ‘two continua’: that it’s possible to have high levels of wellbeing (with appropriate support) even if we experience specific mental health problems.
That specific mental health problems and subjective wellbeing might have different causal mechanisms, and different mediating psychological processes is interesting and important. It makes the topic more complex, and that’s before we consider the different trajectories and causal factors that might apply to community, rather than individual, wellbeing.
FLUID RELATIONSHIP BETWEEN WELLBEING AND MENTAL HEALTH
It seems too simplistic to suggest that our wellbeing and our mental health are merely two opposing poles of a single continuum. It’s clearly possible to have low levels of wellbeing without experiencing mental health problems. But it is also easy to see how our wellbeing can be threatened by mental health issues, especially if we don’t have appropriate help. This implies that the relationship may be asymmetrical (a technical statistical challenge for researchers). This may mean that the relationships are different for different kinds of challenges, whether that is different threats to our wellbeing (loneliness or poverty, perhaps) or different mental health problems (depression, hearing voices, self-harm, for example).
NEW CITIZEN SCIENCE PROJECT ON WELLBEING
In collaboration with the University of Liverpool, Dr Sara Tai at the University of Manchester and BBC’s Tomorrow’s World, we have launched a ‘citizen science’ research project to investigate these questions.
As many thousands of people – including you – can complete our survey, we should be able to tease out at least some of these relationships. It will give us a better understanding of social factors such as income; employment and loneliness; our family history of mental health problems; the events that happen to us, both in our childhood and in recent months; and the ways in which we make sense of, understand, and respond to those events.
Importantly, we hope to be able to collect data at two time points. This allows us to predict both wellbeing and mental health – anxiety and depression – over a six-week period, much more powerful in scientific terms.
Sampling and representation in the survey
This kind of research is complex. And a little controversial. For example, our research uses crowd-sourced data from an entirely unrepresentative group of people with uncertain motivation accessing the website, without any kind of purposive or stratified sampling. This is very different from the careful, epidemiologically rigorous, approach used by organisations such as the Office for National Statistics, although we are using the standard methodology recommended for the measurement of wellbeing.
I have to confess to being a pragmatist – one of the joys of working with the Centre is that it is about bringing the best available evidence to bear for policy makers. It’s focussed on quality, but also on practicality. When we get the opportunity to reach out to large numbers of people, we should grasp it. Even when the sampling is non-random, it allows us to explore statistical relationships between many different inter-related factors with much greater precision that would be possible with more carefully-controlled, but smaller, samples.
Here, we are not attempting to map or survey wellbeing or mental health across the UK population, nor to draw conclusions about epidemiology or prevalence (issues for which, admittedly, our methodology would be weak). And we should always be aware of the limitations and weaknesses of our research methodologies.
What we should be able to say, with more detail, how social and environmental issues affect our mental health and wellbeing, how the ways in which we think about, understand and react to these events influence their impact, and a little more about the complex relationship between wellbeing and mental health.
Without doubt, our research will lead to even more questions and discussion (possibly even disagreement)… but that’s a good thing!