How do we create a society where our children can flourish? · 2020-04-07 · Children's Mental...
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Children's Mental Health and Well-Being: Policy and Future Directions in the Nordic Countries
Dora Gudrun Gudmundsdottir, Director, Determinants of Health and
wellbeing, Directorate of Health in Iceland
How do we create a society where our children can flourish?
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Overview
I. Indicators for public policy i. What indicators are mostly used for public policy
II. Epidemiology of mental well-being i. A conceptual framework of mental wellbeing
ii. Are the Nordic countries flourishing?
III. The focus in public policy in Iceland after the collapse of the banks
IV. Where do we need to focus to get a flourishing society?
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What you measure affects what you do...
…if you don´t measure the right thing,
you don´t do the right thing.“ Joseph Stiglitz,
2009
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GDP increases with
• Each sale of antidrepressant medication
• Each divorce pronounced
• Each prison built
• Air pollution
• Cigarette advertising
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But NOT with
„the health of our children, the quality of their education, or the joy of their play. It does not get the beauty of our poetry or the strength of our marriages......it measures everything, in short except that which makes life worthwile“
Robert Kennedy, 1968
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The focus in public policy
• Economy growth and jobs
• Health – How do we get health on the agenda: Health in all
policies?
• Mental health – How do we get mental health on the agenda?
• Happiness – Economists are more interested than mental health
specialist
• Well-being – Is it easier to get well-being on the agenda?
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Happiness, GDP, suicide and unemployment rate in Iceland 1990-2010
GDP per capita
Happiness
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Wealth and well-being
UK - GDP and Life Satisfaction 1973 - 2002
0%
20%
40%
60%
80%
100%
120%
140%
160%
180%
200%
1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001
GDP
Life Satisfaction
Source: Eurobarometer
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What should we measure?
Where do we want to have our focus?
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Shifting the Wellbeing Bell Curve of a Population
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Operational definition of flourishing Huppert & So, Soc. Indicators Research, 2011
Flourishing is the positive end of the mental health spectrum,
the opposite of the symptoms of the common mental
disorders (depression and anxiety).
Ten features of flourishing
Positive emotion Resilience
Engagement Emotional stability
Relationships Self-esteem
Meaning Optimism
Accomplishment Vitality
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0% 10% 20% 30% 40% 50% 60%
Denmark
Switzerland
Norway
Germany
Iceland
Netherlands
Finland
Sweden
Israel
Slovenia
Cyprus
Poland
Ireland
Belgium
United Kingdom
Estonia
Spain
Czech Republic
Italy
Albania
France
Lithuania
Kosovo
Slovakia
Hungary
Bulgaria
Portugal
Russian Federation
Ukraine
Percentages of Flourishing people in Europe by countries
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1
6
11
16
21
26
positiveemotions
emotionalstability
optimism selfesteem resilience vitality positiverelationships
meaning engagement competence
Denmark compared to the other European countries
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1
6
11
16
21
26
positiveemotions
emotionalstability
optimism selfesteem resilience vitality positiverelationships
meaning engagement competence
UK compared to the other European countries
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1
6
11
16
21
26
positiveemotions
emotionalstability
optimism selfesteem resilience vitality positiverelationships
meaning engagement competence
Norway compared to the other European countries
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1
6
11
16
21
26
positiveemotions
emotionalstability
optimism selfesteem resilience vitality positiverelationships
meaning engagement competence
Iceland compared to the other European countries
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1
6
11
16
21
26
positiveemotions
emotionalstability
optimism selfesteem resilience vitality positiverelationships
meaning engagement competence
Sweden compared to other European countries
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1
6
11
16
21
26
positiveemotions
emotionalstability
optimism selfesteem resilience vitality positiverelationships
meaning engagement competence
Finland compared to other European countries
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The impact of the economic crisis in Iceland
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What happens in a society where:
• Unemployment increases
• Exchange rate of the currency falls
• Income decreases
• Purchasing power decreases
• debt increases
– All in a month?
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Trust in the society 2004-2009
OCT-08
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Happiness in Iceland 2003-2012
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Adolescent´s happiness
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Time spent with parents
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At that time
• There was an opportunity to shift the focus
• Welfare, Mental Wellbeing, Equity and Social Indicators did get more attention from policy makers
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The Welfare Watch
• Watch out for the basic services provided by the state and local authorities
• Put special emphasis on assistance to vulnerable groups
• Developed social indicators • Demographics
• Inequality
• Sustainability
• Health
• Cohesion
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Iceland 2020 – a governmental policy statement
focusing on:
• Knowledge, sustainability, welfare
• those groups that risk long-term unemployment in the wake of the financial crisis.
• strengthening social participation and the active inclusion of all citizens
• Mental wellbeing where the aim is:
• To improve wellbeing and sound mental health so that the average measurements on the mental wellbeing index rise from 26,6 in 2009 to 28
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Conclusion
• Good social relationships – the quality of relationships with family and friends, along with the amount of time spent with family – predict happiness and wellbeing.
Despite the crises there was an increase in happiness among adolescents
Adolescents were spending more time with their parents
Average working hours for adults were fewer
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Planning for the future
• We need to focus on positive outcomes
– at home,
– in schools,
– in the local community and
– on national level
• We need epidemiology of mental wellbeing!
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Good mental health
• is not simply the absence of diagnosable mental health problems, although good mental health is likely to help protect against development of many such problems.
• Good mental health is characterised by a person’s ability to fulfil a number of key functions and activities, including:
• The ability to learn • The ability to feel, express and manage a range of
positive and negative emotions • The ability to form and maintain good relationships
with others • The ability to cope with and manage change and
uncertainty