How to Make Societies Thrive? Coordinating Approaches to Promote Well-being and Mental Health

1. Applying a well-being lens to mental health

Abstract

Good mental health is a vital part of people’s well-being, and a range of government departments, beyond health, can contribute to and benefit from addressing the upstream determinants of mental health. This overview chapter sets out the different elements of the “well-being lens” that this report employs to inform mental health strategies. First, the OECD Well-being Framework is used to systematically review how people’s economic, social, relational, civic and environmental experiences shape and are, in turn, shaped by their mental health. Second, based on this evidence, examples of co-benefits, or policy interventions that can jointly improve both mental health and other well-being outcomes, are identified. Third, selected mental health initiatives across OECD countries are reviewed to highlight different elements of an effective policy ecosystem that supports collaboration across stakeholders.

1.1. Mental health is a topical and cross-cutting issue

Mental health plays a central role in people’s lives and is intrinsically tied to many other aspects of people’s wider well-being. The importance of mental health to the ability of individuals – and societies – to thrive is not a new insight: OECD research estimates that half the population will experience some form of mental health condition at least once over their lifetime, and that the economic costs of this amount to at least 4% of annual GDP (OECD, 2021[1]). Still, the necessity of good mental health, and the costs of ill-health, have only been further underscored by the COVID-19 pandemic, which exacerbated pre-existing vulnerabilities and exposed new risk factors for mental health, as the population dealt with not only the direct health impacts of the virus, but also financial insecurity, job loss, disruptions to education and increased social isolation. Data from 15 OECD countries reveal that over a quarter of the population showed symptoms indicating risk for major depressive disorder in 2020 and 2021; for those countries with comparable pre-pandemic data, the share of the population at risk for depression more than doubled (OECD, 2021[1]).

Momentum has also been building in recent years to shift the conversation away from the sole prevention of mental ill-health and onto the promotion of positive mental health, or high levels of emotional and psychological well-being (OECD, 2023[2]). Indeed, good mental health can boost people’s resilience to stress, help them realise their goals and actively contribute to their communities. Positive mental health is increasingly being recognised as a policy target in its own right by health and other government agencies across the OECD, be it through the development of regularly monitored indicators of population positive mental health, dedicated guidance on how to improve it, or funding mechanisms that explicitly target resilience factors for mental health promotion.

Evidence on the powerful ways in which people’s economic, social, relational and environmental living conditions interact with mental health makes it clear that effective mental health promotion, prevention and treatment strategies need to involve government sectors beyond health. Renewed calls for collaborative “health in all policies” approaches that systematically integrate and articulate (mental) health considerations into policy making across sectors have been growing. For instance, at the European level, following steers from the European Parliament and the outcomes of the Conference on the Future of Europe, in June 2022 the European Commission launched the “Healthier Together” initiative to reduce the burden of non-communicable diseases, including mental health, by taking a “health in all policies” approach. This was followed in 2023 by the new “A comprehensive approach to mental health” strategy, which factors mental health considerations into EU and national policies (European Commission, 2022[3]; European Commission, 2023[4]). The OECD has also long been calling for a society-wide response to mental health, including in the 2015 OECD Council Recommendation on Integrated Mental Health, Skills and Work Policy (OECD, 2015[5]), and surrounding workstreams (Box 1.1). Additionally, the 2021 OECD COVID-19 and Well-being: Life in the Pandemic report included, among its policy recommendations, a cross-government focus on mental health promotion and prevention (OECD, 2021[6]).

Box 1.1. Integrated approaches to mental health policy at the OECD

This report builds on existing work at the OECD in mental health policy, and in particular, long-standing calls for integrated approaches to mental health promotion. The 2012 publication, Sick on the Job? Myths and Realities about Mental Health and Work, underscored the cost of mental ill-health to not only individuals, but to employers and the economy more broadly, demonstrating that policy makers should place greater emphasis on integrating those experiencing mental ill-health back into the workplace, and on supporting them once there (OECD, 2012[7]). Ten dedicated country reviews of mental health and work policies, conducted between 2013 and 2018, underscored the broader education, health, welfare and labour market policy challenges arising from mental ill-health (OECD, n.d.[8]). This work was further built upon in Fit Mind, Fit Job: From Evidence to Practice in Mental Health and Work, which expands the evidence base on the social and economic costs of mental ill-health and calls for integrated policy responses (OECD, 2015[9]).

These publications helped to pave the way for the 2015 OECD Recommendation of the Council on Integrated Mental Health, Skills and Work Policy (OECD, 2015[5]). The Council Recommendation, adopted by all OECD member states, acknowledges that the costs of mental ill-health are wide-ranging, and that the promotion of good mental health involves agencies beyond the health sector. It endorses a set of policy guidelines to better integrate mental health considerations into (physical) health, education, employment and social service systems. In 2021, Fitter Minds, Fitter Jobs: From Awareness to Change in Integrated Mental Health, Skills and Work Policies reviewed progress achieved in the policy areas covered by the Recommendation five years after its adoption (OECD, 2021[10]).

OECD work has also underscored the importance of broad and multi-sectoral efforts towards strengthening care and services for mental health conditions, in particular in Making Mental Health Count: The Social and Economic Costs of Neglecting Mental Health Care (Hewlett and Moran, 2014[11]) and A New Benchmark for Mental Health Systems: Tackling the Social and Economic Costs of Mental Ill-Health. The latter publication develops a comprehensive framework for understanding countries’ mental health performance, focusing on accessible, high-quality and person-centred services, good prevention and promotion, an integrated and multi-sectoral approach, strong governance and leadership, and a focus on innovation (OECD, 2021[1]). This work demonstrates that enduring weaknesses in mental health care provision in OECD countries have direct and indirect economic costs, in terms of years lived in ill-health, as well as productivity losses. The Benchmarking publication includes a series of indicators which have been used to assess countries’ mental health system performance, and can be used in years to come to their track progress and policy impacts. Going forward, as part of the workstream on best practices in public health, the OECD is also assessing the effectiveness, efficiency and potential for transferability of candidate best practice and promising practices in mental health promotion and prevention, for publication in 2024.¹

Note: 1. This work covers multiple types of interventions including suicide prevention, improving mental health literacy, making mental health services more easily accessible, actions based in schools and workplaces, and those targeting front-line players such as school teachers, nurses and midwives.

1.2. Moving from mental health in all policies to mental health for all policies

How to Make Societies Thrive? Coordinating Approaches to Promote Well-being and Mental Health is the second of two reports that form a broader project on well-being and mental health. The first report, Measuring Population Mental Health, provided recommendations to data producers on how to collect population mental health outcomes, both for ill-health and positive mental health, in an internationally comparable way (OECD, 2021[12]). How to Make Societies Thrive?, on the other hand, highlights the wide-ranging drivers of mental health, underscoring the important roles that different sectors – beyond health – play in this field. Indeed, previous “health in all policies” approaches have often not met their full potential and integration with other sectors remains limited and often not implemented at scale. This is partly because the asymmetry built into the “health in all policies” concept makes coalition-building difficult: it has often focused on improving outcomes for the health sector, thereby seeming to imply that other sectors must adjust their priorities accordingly (McLaren, 2022[13]; Greer et al., 2023[14]; Lundberg, 2020[15]).

Box 1.2. The OECD Well-being Framework

The OECD Well-being Framework is a broad outcome-focused tool to measure human and societal conditions and assess whether life as a whole is getting better for people living in OECD countries. It includes both current well-being in the “here and now”, which focuses on living conditions and inequalities at the individual, household and community levels, and systemic resources needed to sustain well-being in the future.

The Well-being Framework underpins the OECD How’s Life? report series and a wide range of other work related to well-being (OECD, 2020[16]). Since its launch in 2011, more than two-thirds of OECD countries have developed some form of national framework or strategic plan with a multidimensional well-being focus (OECD, 2023[17]).

Figure 1.1. The OECD Well-being Framework

Source: OECD (2020[16]), How’s Life? 2020: Measuring Well-being, OECD Publishing, Paris, https://doi.org/10.1787/23089679.

The OECD Well-being Framework takes a multidimensional approach to measuring the outcomes that matter for people, the planet and future generations (Box 1.2). Drawing on this Framework as a conceptual basis, Chapters 2-4 of this report systematically review how people’s economic, social, relational, civic and environmental experiences shape and are, in turn, shaped by their mental health.1 This evidence is used to outline examples of policy interventions that can jointly improve both mental health and other well-being outcomes in order to make the case that integrating mental health considerations can also benefit the goals of other sectors and government’s broader policy goals. The multidimensional nature of the OECD Well-being Framework also allows for building on the current areas of the Council Recommendation on Integrated Mental Health, Work and Skills Policy to expand its focus so as to encompass both positive components of mental health as well as additional dimensions, including economic insecurity, social connections, housing, work-life balance and the environment. Many of these concerns are directly relevant to current challenges faced by governments, such as climate change, the cost-of-living crisis and the future of work.

Implementing and sustaining such co-benefits or “win-win” policies requires resources, incentives and working arrangements that enable all relevant stakeholders to contribute to tackling the upstream determinants of mental health. Chapter 5 hence reviews selected mental health initiatives across OECD countries to illustrate how policy makers have been aligning action across government agencies; redesigning policy formulation to address the joint factors influencing mental health; refocusing efforts towards the promotion of positive mental health; and connecting with societal stakeholders beyond government, including those with lived experience, youth, civil society and researchers.

Mapping the relationship between mental health and other well-being outcomes

This report takes three thematic clusters of the dimensions within the OECD Well-being Framework to analyse how outcomes in each intersect with mental health: the material conditions that shape people’s economic options (i.e. income and wealth, work and job quality, housing, economic capital) (Chapter 2); the quality-of-life factors that encompass what people know and can do, and how healthy their places of living and the environment are (i.e. knowledge and skills, health, human capital, environmental quality and natural capital/climate change) (Chapter 3); and community relations that include how safe, connected and engaged people are, and how and with whom they spend their time (i.e. safety, work-life balance, social connections, civic engagement, social capital) (Chapter 4).

For each dimension, the following steps are systematically applied:

• using cross-sectional microdata for several OECD countries, associations between outcomes in a specific well-being dimension and both mental ill-health and positive health are determined;

• a literature review, relying on systematic reviews and meta-analyses whenever possible, is used to unpack the causal mechanisms underlying these associations, and help understand which policy levers might be used to target them;

• examples of existing policy interventions that have a demonstrated ability to improve both mental health and outcomes in a specific (or multiple) well-being dimension(s) are outlined, drawing on existing country practice and OECD work when relevant.

Microdata analysis for European OECD countries shows that, regardless of whether considering risk for mental distress (Figure 1.2, Panel A), or low levels of positive mental health (Panel B) – people with worse mental health outcomes fare far worse in every domain of the OECD Well-being Framework. For instance, compared to the general population, those at risk of mental distress are nearly twice as likely to be at the bottom of the income distribution, to be unemployed, or to be dissatisfied with the safety and availability of green spaces in their neighbourhoods. They are also more than twice as likely be unhappy with how they spend their time and to report low trust in other people, and their risk for feeling lonely is more than four times higher. Conversely, protective well-being factors – including being financially secure, being in good physical health, living in a safe and clean-living environment, and having healthy social relationships – can provide resilience against poor mental health outcomes. Multiple regression analysis suggests that each well-being area remains a significant independent protective factor against mental distress even when controlling for other well-being outcomes, a range of demographic factors and country context (i.e., country fixed effects) (Table 1.1).2

Figure 1.2. Poor mental health and deprivations in other well-being outcomes go hand-in-hand

Note: In Panel A, risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool. In Panel B, positive mental health is defined using the World Health Organization-5 (WHO-5) tool. Refer to the Reader’s Guide for full details of each mental health survey tool, for how each well-being deprivation is defined and for which countries are included in each OECD average. Exact question phrasing varies across questionnaires, therefore please reference the Reader’s Guide for the specifics of question formulation.

Source: Panel A: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living Conditions (EU-SILC) (n.d.[18]), (database), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living-conditions; Panel B: OECD calculations based on the 2016 European Quality of Life Surveys (EQLS) (Eurofound, n.d.[19]) (database), https://www.eurofound.europa.eu/surveys/european-quality-of-life-surveys.

Statlink

Table 1.1. Multiple regression results for protective well-being factors against the risk of mental distress

	Dependent variable: MHI-5 score from 0 (most at risk for mental distress) to 100 (least at risk)
											All domains
Financially secure (no difficulty making ends meet)	9.57*** (0.58)										3.92*** (0.27)
Employed		4.43*** (0.58)									1.41*** (0.23)
Spend less than 40% of household income on housing costs			6.18*** (0.41)								0.78** (0.34)
Good general health				14.62*** (0.56)							9.12*** (0.44)
High (tertiary and above) education					3.13*** (0.30)						0.04 (0.24)
Live in area free of pollution, grime or other environmental problems caused by traffic or industry						4.46*** (0.39)					1.53*** (0.38)
Live in an area free of crime, violence or vandalism							5.44*** (0.31)				1.78*** (0.16)
Satisfied with time use								11.64*** (0.45)			7.11*** (0.29)
Rarely or never lonely									19.95*** (1.03)		15.54*** (0.95)
Have trust in others										8.31*** (0.37)	3.36*** (0.16)
Controls	YES	YES	YES	YES	YES	YES	YES	YES	YES	YES	YES
Country Fixed Effects (FE)	YES	YES	YES	YES	YES	YES	YES	YES	YES	YES	YES
Observations	333 257	333 257	333 257	333 257	333 257	333 257	333 257	333 257	333 257	333 257	333 257
R2	0.09	0.05	0.05	0.15	0.04	0.04	0.05	0.11	0.22	0.08	0.34

Note: Controls include sex, age and age-squared. Standard errors are displayed in parentheses and are clustered at the country level. Refer to the Reader’s Guide for full details of indicator definitions. While high education is not significant in the model with all controls, having only primary education remains a significant predictor of mental distress in an alternative model using well-being risk factors.

Source: OECD calculations based on the 2018 European Union Statistics on Income and Living Conditions (EU-SILC) (n.d.[18]), (database), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living-conditions.

Identifying co-benefits for mental health and well-being

Building on the evidence of these interlinkages, Chapters 2-4 each conclude with examples of “win-win” policies that can promote better mental health at the same time as supporting better outcomes in other domains of well-being. A short description of these, along with the government agencies that may be involved in their implementation, is shown in Table 1.2. The policy examples draw from existing OECD research where relevant, including the reports covered in Box 1.1, but also pull in external evidence and new examples for previously under-explored areas of intervention, for example, relating to the environment, social connections, work-life balance and civic engagement. Importantly, these are not policy recommendations that are ranked in terms of either importance or size of expected impacts. Rather, they serve to provide instructive examples for which evidence (on mental health impacts, or very probable pathways) exists, and to spur further policy action in agencies not necessarily involved in mental health promotion thus far.

Many of the more known practices for such “win-win” policies are in the realm of people’s material conditions. For instance, a range of social benefits, including direct monetary schemes – cash transfers, debt relief, pensions – or in-kind social assistance or social insurance schemes – health care, unemployment or workers’ compensation benefits, maternity care – that can help recipients escape the cycle of poverty can have a positive impact on mental health outcomes. Despite the positive effects of social benefits, many individuals with mental health conditions do not apply for benefits available to them. While some of this may be due to stigma, a lot is attributable to complex application processes, long and involved eligibility assessments, or falling through the cracks of the system if working in the gig or informal economy. Policy makers can use lessons from behavioural economics to systematically assess social protection programmes to reduce the cognitive burden of accessing them and to build fault tolerance into them. Other examples of policies that several OECD countries have piloted and that have been found to both improve employment outcomes (including likelihood of being employed, productivity, job satisfaction and retention) and mental health include integrating mental health service provision into unemployment services, as well as guidance, regulation and financial incentives to encourage employers to prioritise mental flourishing at work. In the area of housing conditions, Housing First policies have shown promise to get those in need into homes right away, without preconditions, not only to diminish homelessness, but also to alleviate symptoms of mental distress.

More recent innovations for mental health promotion that focus on policy areas that have not received as much attention for their links to mental health so far are also featured in this report. For example, social prescribing is an emerging practice in several OECD countries in which health professionals connect patients to non-health-related support provided by community organisations (e.g. debt advice and financial planning workshops, arts and sports activities, walking groups). There is positive evidence that social prescribing can both improve patient (mental) health outcomes, reduce health care usage and costs, and revitalise community organisation infrastructure. Or, the topic of social connections, despite its central importance for mental health and broader well-being, often does not have a dedicated policy home. However, since the onset of COVID-19, several OECD countries have created or are in the process of developing dedicated loneliness strategies. This report also highlights climate change as a significant emerging risk factor for mental health, and among other things argues that disaster preparedness and emergency response systems should be strengthened and include mental health services for survivors, and that mental health costs should be integrated into existing accounting approaches to the non-financial impacts of climate change. Conversely, many climate change mitigation policies, including active transportation, energy-saving measures, community environmental stewardship programmes and green urban infrastructure, have been found to also synergistically improve mental health outcomes. Many other examples of co-benefits in other policy areas can be found throughout this report, as outlined in Table 1.2.

Table 1.2. Overview of policy examples that simultaneously improve aspects of well-being and foster good mental health outcomes

Domain of well-being	Policy intervention	Relevant for agencies responsible for….
Income and wealth (Box 2.1)	Increase access to social assistance programmes, while decreasing the cognitive burden of enrolment	Social policy and service provision, financial departments responsible for debt relief and targeted inflation support measures
	Universal and unconditional schemes to improve quality of life and reduce stigma of social service use	Social policy and service provision
	Increase access to affordable mental health care through new technology and expansion of community services	Health care and social policy
Work and job quality (Box 2.2)	Integrate mental health service provision into unemployment services through Individual Placement and Support (IPS) programmes	Employment promotion, adult and continuing education, health care
	Encourage employers to prioritise mental flourishing at work	Employment and labour, corporate affairs
	Extend social protection schemes to platform workers	Social policy, employment, and labour
Housing (Box 2.3)	Housing First as strategy to tackle homelessness and help alleviate mental distress	Housing and social policy
	Integrate mental health considerations into housing design guidelines	Housing, social policy, healthcare, environment and urban planning
	Create supportive and inclusive neighbourhoods to promote connectedness and psychological well-being	Housing, social policy, health care, sports and culture, environment and urban planning, law enforcement and safety
Physical health (Box 3.1)	Better integrate physical and mental health care	Health care
Healthy behaviours and human capital (Box 3.1)	Encourage physical activity to promote good mental health	Health care, sports and culture, education, employment and labour, environment, urban planning, transport
Knowledge and skills (Box 3.2)	Promote school-based interventions for mental health prevention and promotion	Education, health care
	Incorporate social and emotional learning into curricula	Education, sports and culture
Educational attainment and human capital (Box 3.2)	Promote life-long learning	Education, including adult and continuing education, sports and culture, employment
Environmental quality (Box 3.3)	Expand options to engage in ecotherapy and green social prescribing	Health care, environment and conservation, urban planning, conservation
	Increase access to and availability of green spaces	Urban planning, environment, transport, sports and culture
Climate change and natural capital (Box 3.3)	Strengthen response to climate disasters and foster resilience	Emergency response, health care, social policy, environment, housing, urban planning
	Highlight the mental health costs of climate change, and the benefits of climate action, in environmental accounting and cost-benefit analyses	Budgeting, health care, environment, urban planning, transport, housing, social policy
Safety (Box 4.1)	Improve neighborhood safety and resulting time-space inequalities (variation in the ability to use the neighborhood space fully and at all times for mental health protecting activities such as sport and socialising)	Urban planning, transport law enforcement, social policy, healthcare, environment
	Address intimate partner violence and improve support for survivors	Law enforcement, justice, social policy, health care, statistics, education
	Tackle the roots of discrimination and racism	Justice, health care, education, employment and labour
Work-life balance (Box 4.2)	Promote work-life balance for all groups	Employment and labour, corporate conduct, transport, urban design
	Reduce the unpaid work gender gap	Employment and labour, taxation, family policy, social policy
	Recognise the value of unpaid work	Statistics, economy, social policy, education
Social connections and social capital (Box 4.3)	Make improving social connectedness an explicit policy priority	Central government target setting, social policy, local development
	Expand support for existing social connection interventions, for example, into existing community and government service structures (e.g. social prescribing) or by increasing opportunities for social contact (e.g. creating public civic and green spaces)	Urban planning, health care, social policy, housing, education, sports and culture
	Strengthen the evidence base on effective and scalable interventions for different population groups	Social policy, healthcare, family and youth policy, sports and culture, education
Civic engagement (Box 4.4)	Ease participation and representation in politics of those with lived experience of mental ill-health	(Civic) education, parliaments, voting and participation
	Address political stress, or concerns about polarisation, as an emerging mental health risk factor	Health care, education, sports and culture, urban planning

Note: For more in-depth explorations of each topic area, with detailed references, refer to the policy boxes found throughout Chapters 2, 3 and 4. An extended, more detailed version of this overview table can be found in the accompanying StatLink below.

Statlink

Taking a well-being approach to mental health policy design

Successful implementation of such win-win policies needs to be supported by a broader ecosystem that provides the resources, incentives and working arrangements that enable all relevant stakeholders to contribute to the shared goal of tackling the determinants of mental health upstream. The final chapter of this report illustrates some of the challenges and opportunities associated with integrated approaches to mental health policy through a series of case studies of mental health initiatives across the OECD. In doing so, the chapter applies the characteristics of well-being policy approaches more generally to mental health.3

The nine case studies considered in Chapter 5 come from different countries across the OECD and include overarching mental health strategies, agencies focusing on mental health system oversight, or specific programmatic activities.4 Their experiences provide a useful set of preliminary insights into the different elements of policy ecosystems that can help realise well-being and mental health co-benefits, and in doing so, enlarge the evidence base on good practices in coordinated mental health policy design. General themes emerge, showing how in taking a well-being approach countries have been shifting policy practices and are trying to realign mental health action across government agencies; redesign policy formulation to address the joint determinants of mental health; refocus efforts towards the promotion of positive mental health; and reconnect with societal stakeholders beyond government, including those with lived experience, youth, civil society and research institutions (Table 1.3).

Table 1.3. How are countries realigning, redesigning, refocusing and reconnecting for better mental health outcomes?

Insights from selected mental health initiatives, per the key characteristics of well-being approaches

	Realign: Whole-of-government Approach	Redesign: Well-being determinants for prevention	Refocus: Emphasis on positive mental health	Reconnect: Building broad partnerships
Goal	Involve collaborations across multiple government departments	Policy content reflects the (joint) social, economic, environmental and relational determinants of mental health	Address both deprivations in mental health and promote human flourishing	Collaborate with people with lived experience, communities and non-governmental actors
Case study insights	● Broader multidimensional frameworks can provide the mandate for agencies to contribute to common goals ● Implementation plans that address intersectoral collaboration, alongside performance evaluation metrics, can concretely support delivery ● Successful cross-sectoral collaboration requires sufficient resources (e.g. time and financing), but can facilitate participation and relationship building ● Independent oversight agencies and funding schemes for broader well-being activities at the local level represent new models for realigning	● Each of the case studies promote some examples of interventions that target outcomes beyond mental health, in addition to those outlined in Chapters 2-4 of the report ● Mental health and broader well-being impact assessments can help agencies think about the impacts of their policies, but need to be designed in a user-friendly manner	● Publishing data on positive mental health can help to put it on the agenda ● Strategies and funding mechanisms are increasingly explicitly targeting mental health promotion	● The majority of mental health strategies have a participatory element, and ideally this continues beyond the planning stage ● Knowledge brokering is an essential part of reconnecting ● The depth of partnerships matters for impact

Source: Refer to Chapter 5 for further details.

Several cross-cutting lessons across these insights are noteworthy: first, explicitly defining mental health goals (i.e. what it is that should be improved, and who can contribute) can help different agencies and stakeholders to focus their actions. Examples of this in practice include using multidimensional frameworks to inform mental health plans and to point out interlinkages with other sectors; formulating concrete implementation plans; or defining and monitoring positive mental health. Second, intersectoral collaboration, partnership building and knowledge brokering – be it between different government agencies, different levels of government or when supporting community actors – take resources, including time, to do well. In several of the case studies, there was a conscious move away from short-term project cycles to multi-year processes, in order to allow for relationships to form and management capacity to be built and to give space for experimentation with programme design. Third, strategic grant making by a public health agency seems to be a promising approach for allocating funds for activities that target (mental) health determinants upstream, including into areas not traditionally under the remit of the health sector. And, lastly, provisions for impact evaluations should be integrated into programme design from the beginning. Close cooperation with academia, as has already been started in several of the featured initiatives, could be a promising avenue. Going forward, the approach of examining country efforts around realigning, redesigning, refocusing and reconnecting could be extended beyond the small sample of nine case studies to all OECD countries and both to the area of population mental health improvement and to other policy areas that can benefit from a coordinated well-being approach.

References

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[1] OECD (2021), A New Benchmark for Mental Health Systems: Tackling the Social and Economic Costs of Mental Ill-Health, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/4ed890f6-en.

[6] OECD (2021), COVID-19 and Well-being: Life in the Pandemic, OECD Publishing, Paris, https://doi.org/10.1787/1e1ecb53-en.

[10] OECD (2021), Fitter Minds, Fitter Jobs: From Awareness to Change in Integrated Mental Health, Skills and Work Policies, OECD Publishing, https://doi.org/10.1787/a0815d0f-en.

[12] OECD (2021), Well-being and Mental Health – Towards an integrated policy approach, https://www.oecd.org/wise/well-being-and-mental-health.htm.

[16] OECD (2020), How’s Life? 2020: Measuring Well-being, OECD Publishing, Paris, https://doi.org/10.1787/9870c393-en.

[22] OECD (2019), Accelerating Climate Action: Refocusing Policies through a Well-being Lens, OECD Publishing, Paris, https://doi.org/10.1787/2f4c8c9a-en.

[20] OECD (2019), How’s Life in the Digital Age?: Opportunities and Risks of the Digital Transformation for People’s Well-being, OECD Publishing, Paris, https://doi.org/10.1787/9789264311800-en.

[9] OECD (2015), Fit Mind, Fit Job: From Evidence to Practice in Mental Health and Work, Mental Health and Work, OECD Publishing, Paris, https://doi.org/10.1787/9789264228283-en.

[5] OECD (2015), Recommendation of the Council on Integrated Mental Health, Skills and Work Policy, OECD Publishing, Paris, https://legalinstruments.oecd.org/en/instruments/334.

[7] OECD (2012), Sick on the Job?: Myths and Realities about Mental Health and Work, Mental Health and Work, OECD Publishing, Paris, https://doi.org/10.1787/9789264124523-en.

[23] OECD (forthcoming), Built Environment through a Well-being Lens, OECD Publishing.

[8] OECD (n.d.), Mental Health and Work, https://www.oecd.org/employment/mental-health-and-work.htm (accessed on 20 June 2023).

Notes

← 1.  Previous and ongoing examples of OECD work that apply the OECD Well-Being Framework to specific policy areas include the well-being impacts of the COVID-19 pandemic (OECD, 2021[6]), the built environment (OECD, forthcoming[23]), action on climate change (OECD, 2019[22]), transport strategies for net-zero (OECD, 2022[21]) and the opportunities and risks of the digital age (OECD, 2019[20]).

← 2.  Since the relationship between the mental health outcomes and the various well-being outcomes shown in this table is bidirectional, the regression coefficients shown in this table should not be interpreted as causal due to endogeneity. Chapters 2-4 of this report hence rely on a literature review that focuses on causal methods, as well as further analysis using a cross-lagged panel model to better understand some of the relationships. Refer to the Reader’s Guide for further details on the cross-lagged panel model.

← 3.  The OECD has previously summarised well-being policy approaches in terms of four “Rs”: realigning policy practice across government silos, redesigning policy content from a more multidimensional perspective, refocusing policies towards the outcomes that matter most to people and reconnecting people with the public institutions that serve them (OECD, 2021[6]).

← 4.  The case studies cover the Act Belong Commit Programme (Australia, Denmark, Faroe Islands, Finland, Norway), the Western Australian Mental Wellbeing Guide, the Mental Health Promotion Innovation Fund and the Positive Mental Health Surveillance Indicator Framework in Canada, Finland’s National Mental Health Strategy and Programme for Suicide Prevention 2020-30, New Zealand’s Mental Health and Wellbeing Commission (Te Hiringa Mahara), the Programme for Public Health Work in Municipalities in Norway, Sweden’s upcoming National Policy for Mental Health and Suicide Prevention, and the Public Service Boards in Wales.