ABSTRACT
This review has ranged far and wide. Probably too far. But this reflects the shift over the past 20 years in thinking about mental health, and the extent of the research accumulating on every aspect. The aim here has been to be even-handed and to consider the merits and usefulness of progress in each area – from biology and genetics to psychology, sociology and epidemiology, to the insights of those who have personal experience. What it shows is that all of these provide part of the story, and need to be incorporated into any explanation of mental ill-health, or into attempts to prevent it. Genetics, biology and life experience shape who we are. What matters to the individual can be described in terms of their lives from before conception through to adult life, and those who play the most important role are the person themselves, their parents, their wider family, close friends and sexual partners. Those in health or social services or in community support organizations can play a role in helping to strengthen the resilience of individuals, and the support available to them. But vulnerability, coping and support, not just that available through public services, are shaped, perhaps more than we realize, by decisions made – or not made – by government.
