Universal mental health program: An extension of life skills education to promote child mental health.

Sir,

Prof. Shastri, in his Presidential address[1] has eloquently and aptly described the current challenges in child mental health and suggested strategies to counter these challenges. We, however, believe that mental health professionals not only have a role in early intervention, but also in prevention of mental illness. As mental health has been defined as ‘a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between the realities of the self and people, and that of the environment,’[2] promotion of this harmony could go a long way in prevention of mental illness, which has been aptly demonstrated by many controlled studies.[3] Yet, even as mental health professionals, we are often accused of always discussing mental health but doing nothing to promote it, instead remaining preoccupied only with mental illness.[4]

One of the methods by which promotion of child mental health can lead to prevention of mental illness is by the promotion of ‘Life Skills Education for Psychosocial Competence’ thereby promoting mental health, as a whole.[5]This is a program designed by the World Health Organization (WHO), the rationale for which is the imparting of life skills education in order to improve individual psychosocial competence (PSC), given that most people in this world have average intelligence, although they may differ vastly and widely in their self-image and self-esteem and in being successful in education, work or relationship. However, one would need to first understand what psychosocial competence is and how life skills education can help in improving it.

Psychosocial competence is a person's ability to deal effectively with the demands and challenges of everyday life. It is a person's ability to maintain a state of mental well-being and demonstrate this in an adaptive and positive behavior, while interacting with others and his / her culture and environment. PSC has an important role to play in the promotion of health in its broadest sense; which includes physical, mental, and social well being. The most direct interventions for promotion of PSC are those that enhance the individuals′ coping resources, and personal and social competencies. PSC also encourages peoples to live happily in co-existence with their surroundings.

Life Skills, being skills of adaptive and positive behaviors, enable individuals to enhance psychosocial competence. The nature and definition of life skills are likely to differ across different cultures and societies. Life skills are innumerable; however, analysis of life skills suggests that there are core set of skills, which are the heart of skills-based initiatives for the promotion of mental health and well being. These core life skills are Decision making, Problem solving, Creative thinking, Critical thinking, Effective communication, Interpersonal relationship skills, Self-awareness, Empathy, Coping with emotions, and Coping with stress.

Life skills enable individuals to translate knowledge, attitudes, and values into actual abilities — that is, ‘what to do and how to do it’. Life skills are skills that enable individuals to behave in a healthy manner, given the desire to do so and given the scope and opportunity to do so. Life skills improve the perceptions of self-efficacy, self-confidence, and self-esteem. Therefore, life skills play an important role in the promotion of mental well-being. The promotion of mental well-being contributes to our motivation to look after ourselves and others, the prevention of mental disorders, and of health, as well as behavior problems.

Currently, life skills education is being practiced in a few schools around the world, the scope of which needs to be expanded, by introducing them to more numbers and for different age groups. Schools should be targeted and teaching of life skills should be introduced in schools at a young age, before negative patterns of behavior and interaction become the norm.

COMMENTARY

We believe that if WHO promotes life skills education as a part of a ‘Universal Mental Health Program (UMHP)’ and urges its member nations to include life skills education programs in their respective national mental health programs (NMHPs), it would go a long way in not just promoting child mental health, but mental health as a whole.

Once life skills education is included and executed as a part of UMHP, it may follow in the footsteps of the successful WHO-UNICEF Universal Immunization Program (UIP), which may be beneficial in improving the quality of life and mental well-being. Mental health professionals should be encouraged to participate actively in the planning and execution of the aforesaid ‘Universal Mental Health Program,’ rather than only treating mental illness.