What Is the Mental Health Continuum Model?

Mental Health ContinuumWhen a person behaves oddly or deviates from the societal standards of normality, we might describe them in many ways: depressed, anxious, moody, suicidal, and so on.

But how often do categorize the mentally healthy people as happy, very happy, or well balanced?

Mental health researchers across the world agree that mental illness is often overindulged in our society, whereas mental health gets less attention than it should. Gordon Allport (1937) suggested that mental health and illness are not two independent constructs, but rather two poles of a linear sequence and keep moving throughout our lifetimes.

According to Allport, a fully developed and well-functioning individual manifests the following features:

  • A variety of interests and the zeal to pursue them
  • The ability to accomplish daily responsibilities, including self-care
  • A mature insight into their internal and external worlds

According to Allport’s model, failure to perceive or exhibit any of the three qualities indicate a deviation from optimal functioning and would mark a shift from the “healthy” end of the continuum to the “unwell” end of it. This article is a short exploration of the mental health continuum model which studies the human psyche and psychological disturbances as a unified concept (Frisch et al., 1992).

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What Is the Mental Health Continuum? (Definition)

The mental health continuum describes a range of states, with mental health and mental illness at the two extreme ends. Depending on the internal and external faculties of a person at any time, they can lie at one point of the continuum and shift position as their situation improves or deteriorates.

There are distinct markers within the mental health continuum:

The healthy point

People who lie at this point are generally satisfied and happy in their lives. They are emotionally well-balanced, stable, and goal-oriented.

The problem point

This is the mid-range of the continuum. People who lie at this point may show some distress and inability to cope, but are capable of performing daily life functions.

The disorder point

People at this point of the continuum are unable to cope with stress and exhibit significant changes in their thoughts, behavior, and actions.

Mental Health Continuum Model

How is it used?

The mental health continuum model projects the human mind on a linear perspective. It can help practitioners recognize specific behavioral patterns that may need attention and suggests ways of dealing with adversities.

The mental health continuum is widely used to:

  • Identify the underlying causes of impairment in daily life functions
  • Gather information about the different mental health states of a person over time
  • Indicate when it would be ideal to seek professional assistance to restore mental balance
  • Recognize symptoms of psychological disorders

As a reliable self-help tool for professionals at work, the mental health continuum model is a popular choice among leaders and managers of leading organizations today. As a part of organizational psychology, the continuum helps to:

  • Identify sources of stress among employees at all levels
  • Encourage employees to grow a healthy mindset that can help them overcome distress
  • Maintain a positive growth mindset among leaders, supervisors, and others in the company.
  • Understand how to identify mental health symptoms.
  • Learn how to deal with psychological crises effectively and not allow them to jeopardize wellbeing.

The Short and Long-Form Models Explained

The long and short forms of the mental health continuum (MHC) are self-assessed questionnaires with items that indicate the person’s current level of psychological functioning.

The items in both versions are categorized into three scales:

  • Positive emotional wellbeing
  • Psychological wellbeing
  • Social wellbeing

The long-form version consists of 40 items that assess subjective wellbeing. The short-form is an abridged version and consists of 14 items in total (Keyes, 2009):

  • Three statements representing emotional wellbeing.
  • Six representing the six dimensions of Ryff’s (1989) model of psychological wellbeing
  • Five representing Keyes’s (1998) model of social wellbeing.

Both tests have high validity and internal consistency reliability, making its usefulness unquestionable for assessing mental health. The long and short forms of the mental health continuum are useful for understanding mental health disorders and their impact on our daily lives (Keyes & Simoes, 2012).

Studies including people with generalized anxiety and panic disorders revealed that encouraging participants to take the assessments positively impacted the prognosis and reduced the risk of premature mortality (Keyes et al., 2010).

The forms are successfully used across different healthcare, academic sectors today. Below are brief illustrations of the two mental health continuum forms. You can learn more about them from the links below.

Mental Health Continuum Long Form – (MHC-LF; Keyes, 2002)

How strongly do you agree or disagree with each of the following statements, on a scale of one to seven?

  • One – Agree strongly.
  • Two – Agree somewhat.
  • Three – Agree a little.
  • Four – Neutral.
  • Five – Disagree a little.
  • Six – Disagree somewhat.
  • Seven – Disagree Strongly.
Statement Score
I like most parts of my personality.
When I look at the story of my life, I am pleased with how things have turned out so far.
Some people wander aimlessly through life, but I am not one of them
The demands of everyday life often get me down.
In many ways, I feel disappointed about my achievements in life.
Maintaining close relationships has been difficult and frustrating for me.
I live life one day at a time and don’t think about the future.
In general, I feel I am in charge of the situation in which I live.
I am good at managing the responsibilities of daily life.
I sometimes feel as if I’ve done all there is to do in life.
For me, life has been a continuous process of learning, changing, and growth.
I think it is important to have new experiences that challenge how I think about myself and the world
People would describe me as a giving person, willing to share my time with others.
I gave up trying to make big improvements or changes in my life a long time ago.
I tend to be influenced by people with strong opinions.

Access the full MHC-LF.

Mental Health Continuum Short Form – (MHC- SF; Keyes, 2009)

During the past month, how often did you feel the following on a scale of one to five?

  • One – Every day
  • Two – Almost every day
  • Three – 2/3 times a week
  • Four – About once a week
  • Five – Never
Statement Score
Happy
Interested in life
Satisfied with life
That you had something important to contribute to society.
That you belonged to a community (like a social group, or your neighborhood).
That our society is a good place or is becoming a better place, for all people.
That people are basically good.
That the way our society works makes sense to you.
That you liked most parts of your personality.
Good at managing the responsibilities of your daily life.
That you had warm and trusting relationships with others.
That you had experiences that challenged you to grow and become a better person.
Confident to think and express your own ideas and opinions.
That your life has a sense of direction or meaning to it.
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A Look at the Mental Health Continuum

We experience stress every day, and sometimes it takes a toll on our happiness and wellbeing. Many of us succeed in overcoming these daily stressors, and  our inner balance remains intact. But sometimes we might need a little support to get back on our feet.

It can be important to pay as much attention to the daily struggles as we do to more significant adversities. For example, divorce, death, and financial crisis are undoubtedly substantial stressors that can alter our mental stability. But equally potential stressors lie in daily experiences such as regular arguments with our spouse, awkward commuting hazards, an unpleasant work environment, etc.

The theory of the mental health continuum states that while identifying where we lie at the present moment, we must consider all the little things that upset us and work on minimizing them. The continuum describes different mental health conditions and their physiological effects and suggests ways to improve both.

It is important to remember that we all are capable of moving along the continuum. Being at one end does not imply that we cannot be at the other again, and vice versa.

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Languishing and Flourishing

Mental health is a state of successful performance of psychological functions, resulting in productive activities, fulfilling relationships with people, and the ability to adapt to change and cope with stress (Jahoda, 1958).

Mental illness does not mean the absence of mental health; instead it implies that the person, at present, lies at that end of the continuum.

Within the mental health continuum model, Keyes (2002) also describes the opposing states as ‘Languishing and flourishing.’

Studies on this model focused on four fundamental aspects:

  1. The prevalence of flourishing and languishing in the sample population.
  2. The association of languishing with significant depression and other mental health illnesses.
  3. The relationship between flourishing and happiness and whether one calls for the other.
  4. The understanding of mental health and mental health disorders among the general population.
Video

Illness-wellness continuum exercise – Susan Bane


The Illness–Wellness Continuum

Dr. John Travis (1972) created the Illness–Wellness Continuum, intending to inspire people rather than treat them. He formulated the continuum and a Wellness Inventory with some valuable inputs on how lifestyle modification can bring a positive shift in mindset and move us to the wellness end of the continuum.

The concept focuses on building wellbeing through responsibility, emotional control, deep insight, and mindful, holistic awareness.

The Illness–Wellness Continuum includes three key concepts of wellbeing:

  • Wellness is a process; it is always moving up and down, right, and left. Moving from one paradigm to another does not signify personal achievement or shortcoming; it is a natural process we all go through at some point in life.
  • Presence of illness does not imply the absence of wellness and vice versa. They differ in degree and do not follow an all-or-none principle.
  • At any point, we have the potential to push ourselves from illness to wellness.

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The Be You Mental Health Continuum (incl. PDF)

Be You is an initiative of Beyond Blue, an organization dedicated to providing mental health and volunteering services. The Be You mental health continuum tool traces specific signs and symptoms of mental disorders from an early stage.

Be You is a favorite choice among educators, childcare workers, and mental health practitioners, as it:

  • Provides an opportunity to give accessible training and evidence-based information to students and parents about learning difficulties and overall academic performance.
  • Helps them understand the best ways to deal with children coming from demanding and stressful surroundings.
  • Organize mental health records in an accessible directory format.
  • Spreads awareness of mental health and wellbeing among parents.
  • Provides consultations and support services to children with a learning disability.

The Be You continuum can trace and distinguish mild, moderate, and severe symptoms of mental illness, making it easy for professionals to plan intervention strategies. It is a noble initiative bringing together schools, childcare, medical services, and the mental health sector, with the unified aim of promoting wellbeing and happiness among children.

You can learn more about the Be You mental health continuum and download the PDF.

A Take-Home Message

Mental wellbeing can begin with a strong relationship with the self. Healthy and happy people tend to feel safe with themselves. Acknowledging the presence of any tension, worries, or overwhelming emotions can go a long way in developing a deeper and more meaningful connection to the self.

The key takeaway of the concept of the mental health continuum is that human minds are always moving. We have the potential to drive ourselves from one end of the continuum to the other.

The transformation that happens during this shift can change our mindset and fill us with positive life energy. So, let us use the continuum to get to know ourselves, listen to ourselves, and push ourselves toward a happier and more content life.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free.

References

  • Allport, G. W. (1937). Personality: A psychological interpretation. Holt.
  • Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the Quality of Life Inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment4(1), 92-101.
  • Jahoda, M. (1958). Joint commission on mental health and illness monograph series: Vol. 1. Current concepts of positive mental health. Basic Books.
  • Keyes, C. L. M. (1998). Social well-being. Social Psychology Quarterly, 61(2), 121-140.
  • Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222.
  • Keyes, C. L. M. (2009). Brief description of the mental health continuum short fort (MHC-SF). Author. Retrieved from https://peplab.web.unc.edu/wp-content/uploads/sites/18901/2018/11/MHC-SFoverview.pdf
  • Keyes, C. L. M., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health100(12), 2366-2371.
  • Keyes, C. L. M., & Simoes, E. J. (2012). To flourish or not: Positive mental health and all-cause mortality. American Journal of Public Health102(11), 2164-2172.
  • Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology57(6), 1069-1081.
  • Travis, J. W. (1972). The wellness/illness continuum. Author.

Comments

What our readers think

  1. Krisie Stanley

    I enjoyed reading this article! It helped me better understand the mental health.

    Reply
  2. raja katkam

    good one

    Reply
  3. shivani shah

    I feel wary of the whole concept of positive psychology movement sensing something toxic under its facade. Human beings do not exist on a linear scale, they are all over the map. I like the way the autism movement has begun to talk about functioning in a much more nuanced way especially as it does not link to negative or positive values. There are so many people across history who have contributed so much to humanity without necessarily being particularly “normal”.

    Reply
  4. Shamsul Islam

    It will help to make my future better life.

    Reply
  5. Sarah Ngoma

    The whole article has been an eye opener on what mental health and mental illness is. i have been able to place myself and those around me.

    Reply
  6. Laura

    I feel wary of the whole concept of positive psychology movement sensing something toxic under its facade. Human beings do not exist on a linear scale, they are all over the map. I like the way the autism movement has begun to talk about functioning in a much more nuanced way especially as it does not link to negative or positive values. There are so many people across history who have contributed so much to humanity without necessarily being particularly “normal”.

    Reply
  7. Mbongeni Zondi

    Very interesting read. It puts the concept into perspective in a very simple and precise way. Easy to grasp and understand.

    Thank you very much

    Reply
  8. Kris

    Talk about an ethnocentric and privileged way to approach those you claim to want to help. This model is so white middle class that it should be tossed in the bin immediately.

    Reply
    • Natalie

      Hi Kris,

      I’m genuinely curious about your comment – do you mind elaborating a little – if you have moment – on the ways in which it is ethnocentric and middle class?

      Reply

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