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Purpose Workplace and study environments generally provide opportunities for social connectedness, however, not all individuals in such settings are equally well connected. It is possible that potential mental health benefits of participation in social leisure activities may be greater for individuals that lack social connectedness through a workplace or study environment. This study aims to examine if the association between social leisure activities and mental health is moderated by the degree of social connectedness at work/school. Design/methodology/approach Data stem from 2,406 adults (age range 16-64 years old) from The Danish Mental Health and Well-Being Survey 2016. Validated scales were used to measure mental well-being and depression/anxiety symptoms. Multivariable linear regression analyses were conducted. Findings Participation in social leisure activities (i.e. participation in community/social groups such as a sports association, art club, book club, running group, card game club, cultural or political group) was positively associated with mental well-being and negatively associated with depression/anxiety symptoms. The associations were stronger among individuals feeling less socially connected at work/school and strongest among individuals that were unemployed or not enrolled in education. Originality/value Mental health promotion strategies may focus on promoting social leisure activities especially among unemployed or otherwise socially isolated groups, as well as among individuals that are not well connected at their workplace or school. Workplaces and schools may also monitor employee/student social connectedness and potentially intervene accordingly.

Action learning is a promising approach for building mental health promotion (MHP) capacity. The aim of this study is to explore how action learning processes can strengthen MHP capacity within and across organizations in a community setting. We applied an embedded case study design and a realist evaluation framework to explore key combinations of mechanisms and contextual factors that generated the emergent MHP capacity outcomes of an action learning program, i.e. context-mechanism-outcome-configurations (CMO-configurations). Data consisted of 18 semi-structured face-to-face interviews, 10 telephone interviews, two group interviews, observations, and documents. Interviewees (n = 21) were participants and management employees. Our analytical provision of CMO-configurations provides insights into how contextual factors, such as participant motivation, organizational support, and existing task descriptions, in combination with certain program mechanisms, such as legitimization of specific agendas, learning-by-doing, and collaborations across organizational boundaries, explain the identified outcomes. Outcomes ranged across implementation of MHP initiatives, personal development among participants, and relational and collaborative development. Taken together, our results strengthen the notion that mechanisms of action learning hold the potential to build MHP capacity on an individual, organizational, and community level. This study, also, illustrates that realist evaluation offers a relevant methodology for investigating the underlying workings of capacity building programs.

The need for strengthening intersectoral mental health promotion (MHP), together with prevention and treatment, is widely acknowledged. However, what roles are involved in intersectoral MHP and the interrelatedness of these roles have received limited attention in the existing literature. Therefore, the aim of this study is, first, to develop a practice-oriented taxonomy of roles within intersectoral MHP practices and, secondly, to investigate interactions across roles within the implementation of MHP practices. We conducted secondary analyses on data from a study (conducted between 2019 and 2021) evaluating MHP efforts within a Danish partnership. Data included 17 interviews, 10 telephone interviews, two group interviews, observational data, and documents. Analytical processes were inspired by the approach of Template Analysis and drew on results of prior evaluations of the partnership and literature on MHP. We propose a taxonomy consisting of five roles: 1) decision-maker; 2) MHP specialist; 3) MHP co-ordinator; 4) MHP practitioner; and 5) end user. Furthermore, applying these roles in a case study of the implementation of MHP practices in a Danish community setting, we elucidate and exemplify the interactions and interrelatedness across roles. The proposed taxonomy extends the current evidence-base for MHP by offering a language that can be used to clarify roles and functions within MHP practices across sectors and professions. It is, to our knowledge, the first of its kind specifically for MHP. Overall, our results add to the literature on MHP and facilitate a greater understanding of the intersectoral actions of MHP, which is relevant for strengthening practices and capacity building within MHP. Research on the transferability of the taxonomy and which competences are needed to successfully master the five identified roles is warranted. The need for strengthening intersectoral mental health promotion (MHP), together with prevention and treatment, is widely acknowledged. However, what roles are involved in intersectoral MHP and the interrelatedness of these roles have received limited attention in the existing literature. Therefore, the aim of this study is, first, to develop a practice-oriented taxonomy of roles within intersectoral MHP practices and, secondly, to investigate interactions across roles within the implementation of MHP practices. We conducted secondary analyses on data from a study (conducted between 2019 and 2021) evaluating MHP efforts within a Danish partnership. Data included 17 interviews, 10 telephone interviews, two group interviews, observational data, and documents. Analytical processes were inspired by the approach of Template Analysis and drew on results of prior evaluations of the partnership and literature on MHP. We propose a taxonomy consisting of five roles: 1) decision-maker; 2) MHP specialist; 3) MHP co-ordinator; 4) MHP practitioner; and 5) end user. Furthermore, applying these roles in a case study of the implementation of MHP practices in a Danish community setting, we elucidate and exemplify the interactions and interrelatedness across roles. The proposed taxonomy extends the current evidence-base for MHP by offering a language that can be used to clarify roles and functions within MHP practices across sectors and professions. It is, to our knowledge, the first of its kind specifically for MHP. Overall, our results add to the literature on MHP and facilitate a greater understanding of the intersectoral actions of MHP, which is relevant for strengthening practices and capacity building within MHP. Research on the transferability of the taxonomy and which competences are needed to successfully master the five identified roles is warranted.

Purpose The purpose of this paper is to investigate the overall campaign reach and impact of the ABCs of Mental Health in Denmark; a secondary objective is to investigate how mental health-promoting beliefs and actions are associated with good mental health. Design/methodology/approach A questionnaire was administered to two representative cross-sectional samples of the Danish population (1,508 respondents in 2019; 1,507 respondents in 2021) via an online survey. The data were subsequently pooled together into one sample consisting of 3,015 respondents. In addition to questions pertaining to campaign reach and impact, the questionnaire also included a validated scale for mental well-being and questions about beliefs and actions in regard to enhancing mental health. Findings About 7.6% had been reached by the campaign (familiar with ABC name or messages), or 11.9% when also counting familiarity with campaign slogans. Among these, respondents reported (proportions in parentheses) that the campaign had 1) made them reflect on their mental health (74.2%), talk to friends and family about mental health (35.5%), given them new knowledge about what they can do to enhance mental health (78.4%), or take action to enhance their own mental health (16.2%). An internal well-being locus of control and proactive behaviours towards enhancing mental health are shown to be associated with higher mean scores on mental well-being, lower odds of low mental well-being and higher odds of higher mental well-being. Originality/value An internal well-being locus of control and proactive behaviours towards enhancing mental health are suggested to both prevent low levels of mental well-being and promoting high levels of mental well-being. The results indicate that the ABCs of Mental Health campaign may be implemented to promote such beliefs and actions universally throughout the population.

Background Escalating healthcare expenditures highlight the need to identify modifiable predictors of the use and costs of healthcare and sickness benefit transfers. We conducted a prospective analysis on Danish data to determine the costs associated with flourishing as compared to the below threshold level of flourishing. Methods We used data from a 2016 Danish survey of 3508 adults, which was linked to Danish register data. Flourishing was assessed with a validated psychological well-being scale. A two-part regression model was used to predict 2017 costs while adjusting for 2016 costs, demographic variables, and health status, including psychiatric morbidity and health behaviours. Costs are expressed in USD PPP. Results Applying criteria from prior literature, the prevalence of flourishing in Denmark (measured in 2016) was 34.7%. Flourishing was associated with significantly lower healthcare costs ($-687.7, 95% CI = $-1295.0, $-80.4) and sickness benefit transfers ($-297.8, 95% CI = $-551.5, $-44.0) per person in 2017, as compared to the below threshold level of flourishing. Extrapolated to the Danish population (4.1 M people aged 16+ years), flourishing was associated with lower healthcare costs and sickness benefit transfers amounting to $-1.2bn (95% CI = $-2.3 bn, $-149.0 M). Conclusions Flourishing is associated with considerably lower health-related government expenditure. Substantial reductions could potentially be achieved by increasing the number of people who are flourishing in the population.

Background: Previous research has suggested that social disconnectedness experienced at school is linked to mental health problems, however, more research is needed to investigate (1) whether the accumulation of various types of social disconnectedness is associated with risk for mental health problems, and (2) whether loneliness is a mechanism that explains these associations.Methods: Using data from the Danish National Youth Study 2019 (UNG19), nation-wide cross-sectional data from 29,086 high school students in Denmark were analyzed to assess associations between social disconnectedness experienced at school (lack of classmate support, lack of teacher support, lack of class social cohesion, and not being part of the school community) and various mental health outcomes, as well as the mediating role of loneliness for each type of disconnectedness. Multilevel regression analyses were conducted to assess the associations.Results: Descriptive analyses suggest that 27.5% of Danish high school students experience at least one type of social disconnectedness at school. Each type of social disconnectedness was positively associated with mental health problems (depression symptoms, anxiety symptoms, stress, sleep problems, suicidal ideation, non-suicidal self-injury, eating disorder, body dissatisfaction, and low self-esteem) and negatively associated with mental well-being. In all cases, loneliness significantly mediated the associations. We found a clear dose-response pattern, where each addition in types of social disconnectedness was associated with (1) stronger negative coefficients with mental well-being and (2) stronger positive coefficients with mental health problems.Conclusion: Our results add to a large evidence-base suggesting that mental health problems among adolescents may be prevented by promoting social connectedness at school. More specifically, fostering social connectedness at school may prevent loneliness, which in turn may promote mental well-being and prevent mental health problems during the developmental stages of adolescence. It is important to note that focusing on single indicators of school social connectedness/disconnectedness would appear to be insufficient. Implications for practices within school settings to enhance social connectedness are discussed.

Purpose – Within the framework of Health Promoting Schools Up is an intervention using a whole school approach aimed at promoting mental health by strengthening social and emotional competence among schoolchildren. Social and emotional competence is an integral part of many school-based mental health interventions but only a minority of interventions measure changes in competences. The purpose of this paper is to present the intervention Up and document changes in social and emotional competence among schoolchildren before and after the intervention. Design/methodology/approach –Up consists of four components: education and activities for schoolchildren; development of staff skills; involvement of parents; and initiatives in everyday life at school. Up was implemented in two Danish schools in 2010-2011. Social and emotional competence was measured among 11-15-year old schoolchildren before (response rate 96.2 per cent, n=589) and after (response rate 83.9 per cent, n=532) the intervention. Findings – Changes in level of social competence were assessed by the prevalence of a high level of social and emotional competence before (33.3 per cent) and after (40.8 per cent) the intervention (p-value=0.01). Research limitations/implications –Up provides valuable experiences for adapting evidence-based mental health promotion to the Danish school system which is characterized by democracy, autonomy and inclusion. Future research should study the implementation and effect of Up in larger scale studies. Practical implications – The comprehensive description of Up serves as important information for policymakers and practitioners working with mental health promotion. Originality/value – The whole school approach intervention Up has the potential to promote social and emotional competence and reduce socioeconomic differences in social and emotional competence among schoolchildren.

OBJECTIVES: This study examined the relationship between trustful communication with parents and frequency of emotional symptoms in schoolchildren and whether this relationship was modified by the family's socio-economic position.METHODS: Pooled data (n = 15,646) from the Danish Health Behaviour in School-aged Children surveys 2002, 2006 and 2010 were analysed by multilevel multivariable logistic regression.RESULTS: 8 % of all schoolchildren reported emotional symptoms almost daily. Odds ratio for daily symptoms was 2.1 (1.8-2.4) for children without trustful communication with parents compared to children with trustful communication. This association appears unaffected by family occupational class. A substantial socio-economic gradient in emotional symptoms persisted, independent of parent-child communication.CONCLUSIONS: Trustful communication with parents might have a fundamental importance, regardless of socio-economic position.

We investigated school children’s intentions to participate or not to participate in physicalactivities. The empirical material is a six month field study with participant observationand qualitative interviews in a Danish seven grade class. The article’s theoretical standpointis social practice theory and critical psychology.Almost all school children are physically active, especially in their leisure time. Duringschool hours we do not see the exact same picture. For the participants it is of key importanceto socialize with friends, to participate and to avoid social exclusion, but not tobe physically active. The article illustrates how the school context is a contributor to thepatterning of physical activity and physical inactivity.

Formål: Formålet med Projekt Optur er at udvikle, implementere og evaluere en skolebaseret intervention, der skal fremme psykisk trivsel og reducere social ulighed i psykisk trivsel blandt børn og unge. Metode: Projekt Optur bygger på internationale erfaringer med at fremme psykisk trivsel gennem interventioner i skolen og anlægger et såkaldt ”whole school approach”, hvor både elever, lærere, forældre, skoleledelse og skolesundhedspersonale inddrages og aktiveres. Projektet har fire indsatsområder; 1) Undervisning og aktiviteter for elever med det formål at styrke elevernes viden og handlekompetence i forhold til psykisk trivsel, 2) Kursus og vejledning for lærere for at opkvalificere lærerne til at gennemføre Projekt Optur, 3) Involvering af forældre i arbejdet med at fremme den psykiske trivsel blandt eleverne og 4) Strukturelle tiltag (skolesundhedspolitik, trivselscafe osv.) for at skabe et trivselsfremmende skolemiljø. Design: Projekt Optur er i 2009 afprøvet som pilotprojekt på én skole. I skoleåret 2010/2011 gennemføres projektet i to udgaver; en udgave hvor skolen får hjælp til at gennemføre interventionen og en anden udgave, hvor skolen selv står for implementeringen. Formålet er at undersøge, i hvor høj grad skoler selv kan gennemføre Projekt Optur uden proceshjælp. Resultater: Erfaringer fra pilotprojektet viser, at det er muligt at igangsætte og implementere en skolebaseret intervention, der har til formål at fremme psykisk trivsel blandt børn og unge. Skolen tog godt imod Projekt Optur, og lærere og ledelse vurderede, at projektet kan være med til at opfylde kravet til folkeskolen om at arbejde med elevernes alsidige udvikling og trivsel. De første analyser af evalueringen tyder endvidere på positive effekter i forhold til elevernes udbytte af projektet og fremme af elevernes psykiske trivsel. Konklusion: Det er lykkedes at udvikle en intervention, der ser ud til at kunne fremme psykisk trivsel og som er anvendelig i danske skoler.