What Is the Mental Health Continuum Model?

When 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.

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.

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

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.

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,’ and there are theories—such as PERMA—dedicated to helping people move from one end of the continuum to the other.

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.

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.

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 five positive psychology tools for free.