BUILDING MENTAL HEALTH IN YOUNG AUSTRALIANS: A POSITIVE PSYCHOLOGICAL APPROACH

Abstract

In the last decade positive psychology has contributed significantly to the \nconceptualisation of mental health and shown that increases in positive virtues or \nstrengths are associated with better physical, psychosocial, and psychological \nfunctioning, and fewer symptoms of mental illness (Seligman & Csikszentmihalyi, \n2000; Seligman, Steen, Park, & Petersen, 2005; Seligman, 2005). It is suggested \nthat if such a positive focus is adopted early in life it can then help develop a \nyoung person’s psychological strengths, such as resilience, optimism, and hope, \nand lay the foundations of a sustained healthy life in adulthood (Licence, 2004). \nHowever, despite this knowledge, the focus of mental health in Australia appears \nto remain on the prevention or alleviation of mental illness. This thesis represents \none of the first attempts to redirect the focus of mental health in Australia away \nfrom mental illness and towards building positive resources that will enable young \nAustralians to flourish in life. The results of five independent but related studies are \npresented in three published and two submitted papers that contribute to the \nconceptualisation and promotion of mental health in young Australians. \nPaper one (study one) reports the results of a meta-analysis and indicates \nthat when compared to Cognitive Behavioural Therapy (CBT) that contains zero \nhopeful elements, CBT that contains multiple hopeful elements significantly \nreduces a young person’s level of depression compared to a control, no treatment, \nor usual care group. Although evidence was limited by the number of studies \navailable, the results suggest that the inclusion of a specific hope-focus may \nincrease the effectiveness of CBT to prevent depression in young people. Paper \ntwo (study two) reports the results of a meta-synthesis and indicates that when \npromoting mental health in young people with chronic illness, young people require a positive approach in order to bolster their sense of self, normalise the \nexperience, help them accept the situation, and help them develop the cognitive \nand future-orientated strategies they need to facilitate a sense of hope at this time. \nPapers three, four, and five report the results of three quantitative studies \nthat used data obtained in the South Australian Youth Mental Health Survey \n(SAYMHS). The SAYMHS (N = 3913; 13-17 years) collected cross-sectional \ninformation from a large sample of young South Australians from both regional and \nmetropolitan areas. The SAYMHS was undertaken specifically for this thesis. \nPaper three (study three) reports the prevalence of the four key states outlined by \nthe Complete State Model (CSM) of mental health (Keyes & Lopez, 2002), along \nwith the association of each of these states to health-risk and health-promoting \nbehaviour. It was shown that less than 50 percent of young Australians were \nflourishing in life, that flourishing in life was associated with increased health promoting \nbehaviour and floundering was associated with more health-risk \nbehaviour, and that the propensity to engage in health behaviour (positive or \nnegative) varied by gender and region. Paper four (study four) reports the results \nof a Confirmatory Factor Analysis (CFA) and indicates that hope, used as an \nexemplar of a psychological strength, is a stronger predictor of mental health than \nis mental illness, and that differences existed in the individual predictive value of \nhope’s components (Agency and Pathways scores). Paper five (study five) \nprovides Australian normative scores for the Adult Hope Scale (AHS) (Snyder et \nal., 1991) and indicates that differences in total Hope scores exist across age and \nregion, and in its component scores across age, region, and gender. \nThe current results have several implications for the development of \nstrategies to promote mental health in Australian youth. First, an explicit focus on \nhopeful strategies may be a useful way to ensure that strategies employed to \nprevent the symptoms of mental illness are effective, as successful hopeful \nthinking then also builds the resources needed to reach and sustain a state of \nflourishing in life. Second, a positive focus on hopeful strategies may facilitate the \ndevelopment and maintenance of a young person’s mental health when they are \ndiagnosed with chronic illness. Third, the prevalence of mental health in young \nAustralians has previously been overestimated, with this project demonstrating \nthat the majority are not flourishing in life and, when compared to those who are \nflourishing, young Australians who are languishing, struggling, or floundering in life \nare more likely to engage in health-risk behaviour. Fourth, hope may be a better \nfocus of efforts to promote mental health and build the resources needed to reach \nand sustain a state of flourishing in life than the prevention or alleviation of mental \nillness. Fifth, Australian clinical psychologists and other health practitioners now \nhave a way to identify young Australians who differ from the developmental norm \nin terms of the hopeful thinking to then help guide strategies to promote mental \nhealth.

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