Defining mental health

Using clear and consistent strengths-based terms when talking about and documenting mental health and mental illness helps reduce stigma, builds trust to open conversations and encourages people to seek the help they need. In turn, this consistency improves the effectiveness of interventions with children and their families by facilitating coordinated support delivered with understanding and compassion.

This 2-minute video introduces a modern view of the mental health continuum, that highlights the distinct concepts of adult mental health and mental illness.

In this model, mental health is conceptualised as positive feelings and positive functioning going beyond merely the absence of mental illness, to be thought of as ‘flourishing’ (Iasiello et. al). Mental health and wellbeing are assets that can be drawn on to adapt to challenging situations or apply any necessary changes to meet a child’s needs. 

In contrast, languishing is a state of low mental wellbeing that may not be a diagnosable mental illness but can still affect how a person thinks, feels, and behaves. Someone who is languishing has low emotional, social, and psychological wellbeing. 

In this practice kit, the phrase ‘mental health concerns’ is used to describe situations where a person has low mental wellbeing but no formal diagnosis.
 

Children’s mental health and wellbeing are also defined along a continuum, as pictured in the graphic below: 

Refer to Children's mental health and wellbeing. 

Social and emotional wellbeing 

For Aboriginal and Torres Strait Islander peoples, social and emotional wellbeing is a multidimensional concept of health that includes and extends beyond conventional (Western) views of mental health to include connection to body, mind and emotions, Country, culture, spirituality, ancestry, family and community as essential to social and emotional wellbeing (Gee et al. (a)). 

This model highlights key broad areas (domains) of wellbeing. The authors asserted that ‘…restoring or strengthening connections to these domains will be associated with increased social and emotional wellbeing’ (Bergh et al.).
 

Stigma, shame and discrimination

There are many forms of stigma in society. Some are based on negative attitudes or beliefs; others are due to a lack of understanding or misinformation. Stigma can also come from the person themselves and is known as self-stigma (Groot et al.).

The discrimination faced by people living with mental illness often stems from a lack of understanding about mental health, which can perpetuate stigma. For example, a common misconception is that individuals with mental health challenges, such as schizophrenia, are violent. Another is the assumption that individuals with mental health challenges cannot be good parents.

This stigma, which can be deeply felt and even intergenerational, negatively impacts a person’s self-esteem, disrupts family relationships, and limits their ability to socialise, secure housing, or gain employment. The resulting lack of support or empathy leaves individuals feeling embarrassed, misunderstood, and marginalised (Groot et al.). 

Talk with children, young people and families using empathic non-judgemental approaches to build a positive working relationship, working transparently in partnership with families.

Engage in reflective discussions with senior team leaders, senior practitioners or cultural practice advisors to address the emergence of stigma stemming from unconscious bias, encouraging the exploration of personal values, beliefs, and experiences related to mental health and wellbeing, while maintaining awareness and intentionality in how these factors may shape behaviour, perceptions of others, and professional assessments.

Wellbeing

Wellbeing is a positive state experienced by individuals and societies. Similar to health, it is a resource for daily life and is determined by social, economic and environmental conditions (World Health Organisation (c)). Positive wellbeing is achieved when a person feels content, healthy, connected to others through meaningful relationships. It includes having a sense of satisfaction, resilience, and the ability to manage stress (Health and Wellbeing QLD). People can have a sense of wellbeing even if they have a physical illness or a, mental illness. 

For a child, wellbeing is supported when their needs are met across key areas: 

• physical, mental, and emotional health
• identity and cultural connections
• feeling safe, loved and valued
• engaging in learning and decision-making
• having basic material needs met (food, shelter and safety). 

Supporting and promoting the wellbeing of parents and other adults in a child’s life can have a significant positive impact on the child’s overall wellbeing and development. This is represented in The Nest, Australia’s first evidence-based framework for national child and youth wellbeing (ARACY). 

Watch this 4-minute video to see the concept of wellbeing brought to life. 

Mental health concerns 

The phrase, mental health concerns, is used to indicate where a mental illness has not been diagnosed, but a person is experiencing: 

• low mental wellbeing (significant worry and stress, signs of or expressions of distress or grief and loss)
• significant impacts of trauma and distress 
  or
• when there are signs a person may have a mental illness but has no formal diagnosis.

Emotional distress

Emotional distress refers to intense feelings or symptoms, such as nervousness, agitation, fatigue, tearfulness, or low mood. It can arise for various reasons, including reactions to challenging, social, or traumatic experiences (Zhu et al.). 

Emotional distress may be observed:

• as uncharacteristic behaviour by a child 
• within the interactions between a child and their parent as the distress from one is further distressing the other
• for a parent who is overwhelmed about what is happening for their child or family. 

Even without a formal diagnosis, emotional distress can pose real risks to a person's wellbeing and may require continued intervention and case management. 

Mental illness

A mental illness is a condition characterised by a clinically significant disturbance of thought, mood, perception or memory. A mental illness diagnosis is made in accordance with internationally accepted standards, and by those who are qualified to do so.

Use this term when a parent or child has been diagnosed with a mental illness by a medical or health professional.

Mental illness includes a wide range of conditions that affect how people feel, think and function. They include common conditions such as anxiety and depressive disorders, and less common illnesses such as schizophrenia and bipolar affective disorder.

A person’s experience of mental illness is individual, including how long they may be affected and what supports recovery for them. Sometimes a single episode can occur over a few weeks or months, and sometimes a person requires long-term support and may identify their mental illness as a psychosocial disability.

Mental illnesses can be grouped into 6 main categories (LAOP Center): 

Lived or living experience

A person with lived or living experience is someone with personal experience (either current or ongoing) of one or more of the following: 

• mental ill-health
• suicidal thoughts 
• surviving a suicide attempt 
• losing someone to suicide 
• engaging in non-suicidal self-injury
• engaging with services, supports and broader health and wellbeing sector. 

A person who has a family or household member with any of the experiences listed above also will have a lived experience. Such an experience may also be intergenerational. 

These terms help to conceptualise the continuum of experiences people have throughout their lives, acknowledging the changing nature of experiences (Queensland Mental Health Commission (a)).

Use of language

The words we choose to use matter. Language can empower, promote hope, and encourage people to seek help, or can create barriers, reinforce shame and prevent connection with families and supports. Explore what the terms the family uses and what the individual prefers us to use.  By using the terms and language they prefer demonstrates respect, fosters connection, builds rapport, and ensures they feel heard and valued in the conversation.

Research involving Australians with complex mental health issues or illness shows that stigma, shame, and discrimination can lead people to: 

• withdraw from those closest to them
• avoid relationships
• stop seeking or avoid employment
• not pursue or avoid educational opportunities
• refrain from seeking or continuing with protective supports
• participate less in the community. 

Even though engagement with Child Safety will be challenging, it can be used to create opportunities for a parent to access support needed in a compassionate and respectful environment.