In the previous chapters, we have seen that there is an association between mental health problems and social exclusion across all the domains that have been examined (material, productivity, social, political and health). This differs across the range of disorders and is influenced by the person's socioeconomic and social identity group. It is clear that mental health problems are a significant risk factor for poor economic, health and social outcomes, however the direction of causality is often difficult to establish. Nevertheless, it would appear that the causal pathways can operate in both directions and that mental health problems can be both a cause and consequence of exclusion. This emerging complexity of the causal relationships requires further exploration and in this chapter we shall try to build a descriptive model of exclusion and mental health problems. We will explore further the relationship between mental health problems and exclusion and examine some of the main drivers, but first it is necessary to introduce the related topic of mental health and well-being.

Mental health and well-being

There is a growing literature on mental health and well-being (psychological well-being or positive mental health) which focuses on people's strengths in contrast to their deficits. This echoes the long-standing literature on health, as opposed to ill health or disease, which in the 20th century was encapsulated by the World Health Organization's (WHO) definition of health as:

Essentially, mental well-being is about people's lives going well (Huppert, 2008) and is concerned not only with a positive subjective state (emotion and cognition), but also with social functioning and interaction and the ability to deal with adversity and painful emotions.