A Review Study of the Concept of Mental Health

The paper addresses the global mental health crisis and the widening treatment gap, particularly in low- and middle-income countries where most individuals with severe mental disorders receive no treatment. Despite extensive discourse linking mental disorders with other chronic diseases, there is substantial confusion and lack of consensus about the meaning of mental health and mental illness. Historically, scholars have highlighted the vagueness of the term mental health (for example, Jahoda) and debated standards of normality and functionality (for example, Kraepelin, Freud, Menninger). Contemporary definitions, including that of WHO, often frame mental health as a state of well-being enabling individuals to realize abilities, cope with stress, work productively, and contribute to community. The research question guiding this review is: What is mental health? The purpose is to clarify the meaning and understanding of the concept for policy and practice.

The review synthesizes theoretical arguments, literature reviews, and empirical studies addressing definitions and understandings of mental health and/or mental illness. Definitions ranged from prescriptive to descriptive, and some defined mental health by what it is not. Fields influenced conclusions: sociological work emphasized social determinants and context; medical and legal domains often aligned with diagnostic frameworks (for example, ICD-10) and equated mental health with mental disorder categories. Many studies referenced WHO’s definition, while others promoted positive mental health, well-being, resilience, or community-level mental health. Geographic context shaped perspectives (for example, historic US debates, positive mental health in Canada and Australia, global WHO framing). Several legislative analyses found that “Mental Health Acts” tended to define mental disorder rather than mental health itself. The review also notes alternative conceptualizations grounded in traditional beliefs and community healing practices (for example, attributions to ancestors, witchcraft, or pollution in some African contexts) and shows that mental health literacy varies by culture and context. Overall, the literature evidences a lack of operationalized, measurable definitions and ongoing conceptual ambiguity.

Systematic review principles were applied to answer the question: What is mental health? Inclusion criteria required studies, reports, or papers to include an explanation of the meaning or a definition of mental health and/or mental illness. Searches (English only) spanned academic databases, websites, libraries, and archives, including: Web of Science, Psychiatry Online, Semantic Scholar, WHO website/publications, WebMed Central, Scopus, Medline, PsycINFO, Social Science Citation Index, International Bibliography of the Social Sciences (IBSS), SciELO, JSTOR, EBSCOhost, African Index Medicus, AccessMedicine, BioMed Central, PubMed, Biomedical and Life Science Collection, PsycNET, Sociological Abstracts, ScienceDirect, Science Online, SciFinder Scholar, LexisNexis, Psychodessey, ResearchGate, and Google Scholar. Search strings used internationally recognized terminology: "mental health" OR "mental illness" OR "mental disorder" OR "psychosocial wellbeing" OR "psychosocial functioning" with inclusion terms such as definition, understanding, literacy, meaning, or clarification. Reference lists and a Lancet Commission article were hand-searched; local and international experts were consulted. Screening identified over 6,500 records; 450 full texts were obtained; 26 papers met inclusion criteria. Documents were critically evaluated for their ability to answer the review question, and strengths and limitations were integrated into summaries of findings.

• Large conceptual variability: Definitions of mental health ranged from prescriptive models to brief descriptors; some defined mental health negatively (by what it is not).
• Dominant models: Two broad approaches dominated—medical (equating mental health with presence/absence of diagnosable disorder) and psychosocial/positive mental health (well-being, functioning, resilience, community contribution).
• Interchangeability and ambiguity: Mental health is frequently used interchangeably with mental illness/disorder in research, policy, and practice, creating confusion. Related terms (for example, psychosocial well-being, positive mental health, mental ill-health, psychosocial support) are inconsistently defined and rarely operationalized.
• Social determinants: Strong evidence links mental health levels to socio-economic stressors (poverty, low education), gender discrimination, social exclusion, violence exposure, human rights violations, and biological/psychological predispositions.
• Empirical scope: Initial screening >6,500 records; 450 full-texts; 26 included studies, primarily theoretical or review papers with some empirical methods (surveys, interviews, focus groups, surveillance data) and legal analyses.
• Geographic/contextual influences: Early debates (1950s–1970s) largely US-based; positive mental health embraced in Canada and Australia; global framing aligns with WHO; legal definitions often focus on disorder, not health.
• Implications: Lack of consensus impedes measurement, epidemiology, policy, and implementation. There is a need for standardized, context-sensitive definitions to guide policy and legislation and to distinguish mental health from mental illness while acknowledging their continuum and overlap.

The findings address the research question by demonstrating that no single, universally accepted definition of mental health exists. Instead, competing paradigms (medical versus psychosocial/positive) and diverse cultural, social, and legal contexts shape understandings. This ambiguity leads to the conflation of mental health with mental illness, complicating epidemiological assessments, service planning, and policy development. The evidence underscores the importance of conceptualizing mental health as more than the absence of disease, recognizing social determinants and cultural context, and promoting positive mental health. Standardizing definitions—while allowing for contextual specificity—would improve clarity in research, comparability across studies, and alignment of policy, legislation, and implementation. Furthermore, incorporating traditional and community perspectives can enhance mental health literacy and culturally congruent interventions.

Using systematic review methods, the paper evaluated definitions of mental health to clarify the concept and inform policy and practice. The review concludes there is no consensus definition; mental health is frequently conflated with mental illness/disorder, and many related terms lack concise definitions. While the medical model remains influential, there is increasing recognition of mental health as a broader social construct beyond disease. Mental health is a generic term encompassing degrees of health and illness; everyone has a level of mental health at all times, while mental illness may be absent. Poor mental health and mental illness are not mutually exclusive and can co-occur along a continuum. The long history of theorizing and the social construction of these concepts explain variability across contexts. The authors recommend that national mental health policies address not only disorders but also the broader promotion of mental health, include standardized and context-relevant definitions, and mainstream mental health promotion across sectors through multi-sectoral approaches.

The term mental health was often used interchangeably with mental illness/disorder in included studies, complicating conceptual clarity. The review focused on mental health as a holistic concept (including psychosocial wellbeing) rather than on specific mental illnesses or disorders. Although the search was global, most included papers originated from North America, reflecting limited evidence from other regions specifically addressing the concept of mental health. Searches were performed in English only.