Implementing Mental Health Promotion Initiatives—Process Evaluation of the ABCs of Mental Health in Denmark

Abstract

Treatment and prevention alone are unlikely to make a significant difference in reducing the burden of poor mental health and mental illness. Therefore, mental health promotion (MHP) initiatives are advocated. In 2014, the ABCs of mental health (ABCs) partnership was established in Denmark; in the partnership, partner organisations, e.g., municipalities and NGOs, use a research-based framework for MHP, the ABC-framework, to develop and implement MHP initiatives. This paper has two aims: (1) to outline the overall characteristics of these MHP initiatives; and (2) to explore local coordinator and stakeholder perceptions of the implementation processes and the impact of the MHP initiatives. Questionnaire surveys, individual interviews and group interviews were conducted during 2017–2020. The MHP initiatives were grouped according to three strategies: building MHP capacity, campaign activities to promote mental health awareness and knowledge and establishing and promoting opportunities to engage in mentally healthy activities. The ABC-framework was positively received and viewed as providing relevant knowledge for working with MHP as well as fostering intersectoral and interprofessional collaborations. However, using a bottom-up approach to develop and implement MHP initiatives can be time-consuming and resource demanding, and it requires a deliberate balancing of local adaptability and concrete guidance when engaging stakeholders and implementers. Overall, using the ABC-framework to develop and implement MHP initiatives holds great promise for advancing and promoting MHP practice.

Twenty-One Reasons for Implementing the Act-Belong-Commit—‘ABCs of Mental Health’ Campaign

“…The adaptability of the Act-Belong-Commit domains across cultures illustrates the universality of these three domains as shown in the following examples: a pilot program in a First Nations community in Western Australia showed that the message was consistent with Indigenous people’s concepts around social and emotional wellbeing and was readily modified for a local implementation [ 48 ]; the campaign was adapted in Japan for children after the 2011 tsunami [ 49 ]; and the campaign has attracted partner organisations in the UK and USA and is being implemented in Denmark, the Faroe Islands and Norway [ 23 , 50 , 51 ].…”

“…Formative research and subsequent feedback reinforce the simplicity of the campaign messages as summed up in the campaign’s original animated television commercial: ‘Keeping mentally healthy is just as important as keeping physically healthy and it’s as simple as a-b-c, act-belong-commit’ [ 19 ]. Members of the general population consider that the campaign messages are simple to understand and simple to interpret [ 51 ].…”

“…The simplicity is also evident in the ‘do’ articulations of the three domains: do something; do something with someone; do something meaningful. Given this inherent simplicity and ease of understanding, Act-Belong-Commit helps reduce the complexity often associated with mental health and mental health promotion and offers a simple and efficient way of promoting mental health literacy in the population as well as in organisations [ 51 , 52 ].…”

“…The Act-Belong-Commit message emphasises what people can do to stay mentally healthy, not what people should not do. This positive approach appeals to both implementers [ 51 ] and the general population and appears particularly important in attracting involvement by people with an experience of mental illness [ 55 ] and those in recovery [ 56 ]. Further, the messages are broad enough to encompass a wide variety of activities to choose from, and hence people can reflect on and take action in ways relevant and appropriate to them.…”

Patient and Mental Health Care Professionals’ Perspectives on Health Promotion in Psychiatric Clinical Practice: A Focus Group Study

“…Further research into the development and evaluation of health promotion dialogue tools and activities inspired by a salutogenic approach appear warranted. In this regard, recent development and implementation of a mental health promotion initiative in Denmark applying a salutogenic oriented conceptual framework focussing on strengthening and promoting resources and protective factors, emphasised the importance of building capacity (including providing staff training) and campaign activities to promote awareness and knowledge (Hinrichsen et al, 2020). While the study was not related to promotion of health behaviour change per se, the study holds great promise and inspiration for advancing and promoting a resource oriented practice in the context of mental health care including fostering intersectoral and interprofessional collaborations and patient-professional co-creation (Hinrichsen et al, 2020).…”