This Conceptual Framework for Public Mental Health is a web-based tool that brings together evidence from academic research, reports, and practitioner and public consultations to map out the factors affecting mental health across all stages of a person’s life, including links to key evidence and lived experiences. It has been developed as part of the NIHR School for Public Health Research Public Mental Health Programme.
The aim of this tool is to summarise the current evidence around key factors (also known as determinants) that affect public mental health and provide information that is relevant and useful to members of the public, public health practitioners and academics across England.
The tool can be used to:
Inform policy and practice
Advance people’s knowledge of mental health and how it can be improved
Help identify further opportunities for research
The content of the Conceptual Framework for Public Mental Health was produced by bringing together findings from three sources:
Published academic literature on the determinants and frameworks of public mental health, which was comprehensively reviewed and summarised
Reports and policies identified through scoping reviews and collaborator input
Public and practitioner perspectives obtained through stakeholder involvement including mind-mapping exercises, workshops and an online survey and consultations
From these activities, a final list of determinants of public mental health was established. Additional review work then took place to define and identify key supporting literature and resources for each determinant.
The research team and advisory panel wanted to highlight the interconnection between determinants, so also focused on summarising key connections linking determinants from across the framework.
The final step was to find a way to visualise the framework in an engaging and accessible way that suited the needs of the three core audiences: academics, practitioners, and members of the general public.
A team of skilled designers worked closely with the project team to develop an interactive web-based tool with bespoke imagery that captures the determinants. User-testing sessions with representatives from the core audiences provided valuable feedback and opportunities for final improvements to be made before it was ready to launch.
Determinants are the factors or indicators that research findings suggest can have an impact on someone’s mental health. They can be risk factors, protective factors or both. Some risk and protective factors are fixed: they don’t change over time. Other risk and protective factors are considered variable and can change over time or be modified.
Risk factors are characteristics associated with a higher likelihood of negative mental health outcomes.
Protective factors are characteristics associated with a likelihood of positive mental health outcomes or that reduce a risk factor's negative impact.
Connected determinants are used to convey the interconnected, complex and cumulative nature of mental health influences.
Key literature / interventions are links through to some relevant evidence-based literature and/or interventions. Interventions are programmes or actions that can be put in place to improve mental health. This might be a new service, for example, or a change to policy or the environment.
Resources are materials, organisations or websites that provide tools, advice, support or further information.
Lived experiences are links to blogs, vlogs, and other resources that provide insights from people with lived experience of the factor impacting on their mental health.
References are the source materials used to produce the text about each determinant.
In developing the definitions and key literature, we conducted rapid literature searches. A full systematic review and quality assessment of the literature for each determinant separately has not been possible due to time constraints and the links provided should be used as examples rather than exhaustive listings. In a couple of cases, it wasn’t possible to find relevant literature, interventions, or lived experience perspectives during the rapid search process. Subject to resources, we will be updating the content of the framework as further evidence emerges. Recommendations or suggestions for inclusion in the framework can be emailed to email@example.com
Where possible open-access references have been prioritised.
Key reports may be referenced multiple times if particularly relevant to more than one determinant.
References may not always be from the most up-to-date sources. Sometimes older papers contain the most relevant information.
The Interconnectedness of factors that affect public mental health is too complex to convey in a meaningful way through this tool. We found that the evidence on the strength and direction of the links between factors and how they together influence mental health was limited and difficult to assess comprehensively. The decision was made to take a simplified approach to keep the tool accessible and user-friendly. For each determinant, up to 9 related determinants have been identified and linked to. These are listed in no particular order and do not necessarily provide the full catalogue of all interconnected determinants.
For the best experience, we recommend that visitors who primarily use their keyboard to navigate the site use Google Chrome to access the framework.
The Conceptual Framework for Public Mental Health is not a diagnostic tool and should not be used as one. It should not be assumed that the presence of any one risk factor listed in the tool is an indication of a mental health issue. The state of someone’s mental health may be determined by a combination of multiple factors and is incredibly complex. Please see the full Disclaimer for more information.
Public Mental Health programme co-leads: Judi Kidger, David Osborn, Kate Walters
Project team: Kate Walters, Jen Dykxhoorn, Becca Bayliss, Paula Moehring, Carol Brayne
Jen Dykxhoorn, Hannah Fairbrother, Laura E. Fischer, Emma Geijer-Simpson, Joe Hulin, Oli Jones, Eileen Kaner, Judi Kidger, Louise Lafortune, Caroline Lee, Michael McGrath, Dasha Nicholls, David Osborn, Mylene Petermann, Mark Petticrew, Vanessa Pinfold, Olivia Remes, Gillian Samuel, Ami Vagdama, Kate Walters
Advisors: Jude Stansfield, Cam Lugton, Ian Walker, Liam Crosby, Zoe Thomas
We would also like to thank everyone who took part in the user testing sessions.
Public Mental Health Programme (2021). Conceptual Framework for Public Mental Health: online tool. NIHR School for Public Health Research. London, UK. https://www.publicmentalhealth.co.uk/
Process paper: Dykxhoorn J, Fischer L, McGrath M, et al., (2022). Conceptualising public mental health: development of a conceptual framework for public mental health. BMC Public Health. 22:1407.
Review paper: Remes O, Petermann M, Dykxhoorn J, et al,. The determinants of public mental health: a state-of-the-art review. (In preparation).
Funding acknowledgement statement
This project is funded by / supported by the National Institute for Health Research (NIHR) School for Public Health Research (Grant Reference Number PD-SPH-2015-10025). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Different copyright restrictions apply to different components of the site.
The website is licensed under a Copyright 2021 Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License by the joint owners: University College London and the University of Cambridge. To enquire about permissions please email firstname.lastname@example.org
The copyright of individual designs and illustrations belongs to Laura E. Fischer and Bobbie Galvin and all rights are reserved to them. To enquire about permissions please email email@example.com