Its a dimension of mental health outside psychiatry and the current diagnostic system. It is the other continuum of mental health, as I understand it, and is a paradigm shift for it to be used in practice.
It is sa that it is the current mental health system and psychiatry that will be driving this new way of thinking about people's mental health. It will fall back into thinking along the psychiatric disorders continuum because that's all that psychiatrists know and where the majority of research is.
The real expertise in this area lies outside psychiatry. The world's expert on well being is most likely to be the Dalai Lama or the Bhutanese king rather than someone who's spent most of their life learning a system of disorder based on a mix of people's experiences of severe distress, society's stigmatised groups medicalised and social stigmas falsely made into illnesses (e.g homosexuality, communism, hearing voices).
I believe that the new operational definitions of well being will end up being very much like the psychiatric mental health system so much so that in a few years people will ask whether there was any point. It may even end up looking very similar to premorbidity developments in DSM-V because the people working on these definitions have been educated in the same paradigm: psychopathology.
Few of them would know the continua model of mental health that has been promoted through the last century by organisations such as the National Association for Mental Health. Mind (as its know today) still haven't realised just what a significant victory it is that the UK, French and other international governments are putting what the original meaning of mental health was on the national policy agenda. This is the paradigm that separates psychiatric diagnosis from mental health, so a person can be very 'ill' but have good mental health or well being.
Commissioners, policy makers, researchers and the general public still don't understand this. This will show in the processing through which the operational definitions are constructed such that they show strong similarities to psychopathology's system and future critics will lambast the wellbeing system for being psychiatry all over again.
This is why it is essential for their to be a wider group of people involved in the development of wellbeing. Importantly the psychiatric movement should be on a equal par with the alternative and fringe. In practice this will not happen because psychiatry has such a high regard, it is embedded as a way of thinking about mental health in too many people and few are openminded enough to quickly leap to an alternative, untested paradigm.
If this happens it is still not a failure. The change brought about to psychiatry and the perception of what is mental health may be the more significant. The continua model serves most to separate diagnosis from distress or wellbeing. It is not well understood. The discussions surrounding wellbeing will mean that the idea of individual distress will permeate into the mind's of clinicians who often consider only the academic diagnostic criteria as the be all and end all of mental health.
Wellbeing should also bring a cornucopia of new treatments. These will be humane and safer than medication though this will still remain and become a last resort. Again, this will perhaps be more important than the separation of well being and mental illness. It will mean better, safer treatments for the mentally ill alongside continued antistigma work and this will make their lives better.
Mu utmost hope is that true sages will become involved in medical mental healthcare and national policy. The factory-made sages (psychiatrists and their ilk) can only repeat what they have been taught by their common system. Those that have learnt the wisdom of life through their own journey in life have the most to offer to any movement, and most of all to one that hopes to make the word a genuinely better place.
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