If you had to have an illness in your lifetime, and could choose

which one, which of the following would you choose?

CancerMental Illness

The Debate

Insel and Scolnick 2006

“All current medical treatments for mental illnesses are palliative,

none are even proposed as cures.”

George Albee2006

“Public health teaches us that no mass disease or disorder has ever been controlled or eliminated

through individual treatment”

Self-Acceptance

Positive Relations with Others

Environmental Mastery

Purpose in Life

Autonomy

Personal Growth

Social Coherence

Social Contribution

Social Growth

Social Integration

Social Acceptance

Positive Functioning Positive Feeling

Social Well-BeingPsychological Well-Being

Satisfaction

Happiness

Family Tree of Mental Health

Emotional Well-Being

Interest in Life

I Me We Us

Self-Acceptance

Positive Relations

Environmental Mastery

Purpose in Life

Autonomy

Personal Growth

Social Contribution

Social Acceptance

Social Integration

Social Actualization

Social Coherence

Social Well-BeingPsychological Well-Being

Avowed Quality of Life

Positive Affect

Structure of Well-Being

Emotional Well-Being

Mental Health Continuum

• Flourishing

“almost every day” or “every day”

1 emotional well-being + 6 positive functioning

• Moderate

• Languishing

“never” or “once or twice” 1 emotional well-being + 6 positive

functioning

15

20

25

30

35

40

35 42 44 45 46 47 48 50 51 53 56 57 59 60 61 62 63

Prevalence of Flourishing on Campus

r = −.66 p = .001

The Two Continua Model ©2010 CLM Keyes and the Winnipeg Regional Health Authority

Implication 1:

Absence MI ≠ Presence MH

74.5

25.5

05

1015202530354045505560657075808590

Screens Positive on PHQ Free of Mental Illness

Implication 1US College Students (2007; n = 5,750)

0.82.8

16.927.6

5.8

46

05

1015202530354045505560657075808590

Screens Positive on PHQ Free of Mental Illness

Flourishing

Moderate

Languishing

Implication 1US College Students (2007; n = 5,750)

Implication 2:

Level of Mental Health Matters

Implication 2(Keyes et al, in press)

15.4

3.9

1.3

0

5

10

15

20

25

30

35

40

Languishing Moderate Flourishing

Mental Health (Categorical Diagnosis)

% R

ep

ort

ing

Su

icid

alit

y

Free of PHQ Diagnoses

Implication 2(Keyes et al, in press)

28.3

18.1

7.0

15.4

3.9

1.3

0

5

10

15

20

25

30

35

40

Languishing Moderate Flourishing

Mental Health (Categorical Diagnosis)

% R

ep

ort

ing

Su

icid

alit

y Screened Positive on PHQ

Free of PHQ Diagnoses

Implication 3:

Absence of MH ≈ Presence of MI

Implication 3

28.3

18.1

7.0

15.4

3.9

1.3

0

5

10

15

20

25

30

35

40

Languishing Moderate Flourishing

Mental Health (Categorical Diagnosis)

% R

ep

ort

ing

Su

icid

alit

y Screened Positive for aMental Illness

No Mental Illness

Absence of Positive

Implication 3

28.3

18.1

7.0

15.4

3.9

1.3

0

5

10

15

20

25

30

35

40

Languishing Moderate Flourishing

Mental Health (Categorical Diagnosis)

% R

ep

ort

ing

Su

icid

alit

y Screened Positive for aMental Illness

No Mental Illness

Absence of Positive

Implication 4: Health Is More Serious

6.6

8.2

3.4

4.4

3.7

1 1

0

1

2

3

4

5

6

7

8

9

10

StayedLanguishing

Declined toLanguishing

Improved toModerate

Stayed Moderate Declined toModerate

Improved toFlourishing

StayedFlourishing

Implication 4: Health Is More Serious

6.6

8.2

3.4

4.4

3.7

1 1

5

0

1

2

3

4

5

6

7

8

9

10

StayedLanguishing

Declined toLanguishing

Improved toModerate

StayedModerate

Declined toModerate

Improved toFlourishing

StayedFlourishing

Any MentalIllness 1995

17.5% Any Mental illness in 2005 (52% incidence)

7.8%

35.5%

4.7%

6.5%

3.9%

18.5%

3.9% 6.5%+ = 10.4%

4.8% = 48.1%35.5% 7.8%+ +

= 58.5%

Can We Promote It?