ABSTRACT
Mental health promotion initiatives may be targeted towards different social units e g. a local community or neighbourhood. It is then of crucial importance to identify those stressors which adversely impinge up mental health if we are to develop effective promotion/prevention programmes.
Social disintegration i.e. the fragmentation of social networks, apathy, lack of social interaction and leadership and feelings of powerlessness and pessimism is conducive to a state of poor mental health. Social disintegration may have a number of causes including rapid social change, high migration rates, poor economic conditions and cultural/social conflicts but whatever the individual causes we need to acknowledge their inter-dependence and cumulative effect.
This paper describes three projects which illustrate how social disintegration contributed to poor mental health in different communities and then discusses how effective interventions were implemented to bring about improved mental health status in the populations under review.
Examples 1 and 2, the Stirling County and the Eastlake studies are based upon mental health promotion intervention programmes. The third project relates to the analyses of the development of the social environment in different neighbourhoods in Oslo. This is not an intervention project but a study that discusses how mental health may be improved when the social environment itself is subject to improvement - ‘a delayed community development’.
The special nature of these programmes is that they combine features of the community development with epidemiological research, thus making it possible to assess the effect of social change on mental health, in terms of the 62level of change in the prevalence of mental health problems. Such validation is essential if mental health initiatives are to be stringently evaluated.
