Mental health promotion and the positive concept of health: Navigating dilemmas

A prevailing view holds that the main goal of mental health promotion is to maintain and improve positive mental health, which is not merely defined by the absence of mental disorders, but by the presence of certain abilities. There are, however, challenges associated with this view that this paper aims to identify and explore. We start by highlighting three requirements for an ethically and politically justified mental health promotion scheme: (i) using a positive concept of mental health that (ii) respects the neutrality principle while (iii) not being overly permissive. Then, we argue that the WHO's positive concept of health violates (ii), and continue by exploring three philosophical accounts (i.e., Nordenfelt, 1995, 2017; Graham 2010; Wren-Lewis & Alexandrova, 2021) that could potentially provide a solution. We show that these face a dilemma of their own: they either violate (ii) or (iii), and they can rectify one issue only by violating the other. Considering the problems linked to the positive notion of health, the final section explores the alternate route of rejecting proposition (i) and instead embracing a negative concept of health. We argue that this option does not present a more advantageous solution. We conclude by highlighting the necessity for additional research to tackle the challenges we identified.