Promotion and prevention

Mental health in later life is promoted and protected by a range of factors. Protective personal attributes include positive self-esteem, self-efficacy, resilience and mastery. The positive psychological benefits of taking part in exercise is well established, especially in a group. There is a vast literature on the mental health benefits of social relationships, social networks and social participation. It is the quality rather than the quantity of relationships that is protective; having a confidante is especially important. Membership of an accepting faith community, having a meaningful occupation and a reasonable income are also protective. For people living with dementia important factors are social and family relationships; effective communication; and involvement in decisions. How older people protect their mental health is underexplored. Most older people regard prevention and promotion as conjoined; the two fields intersect. Risks and protective factors can be conceptualised as located in the individual, community and national/societal domains. In order for policy to engage meaningfully with preventing mental ill health in later life, it needs to address risks in all three domains and tackle the social determinants of health inequalities. Many risks to mental health in later life are a product of, and are embedded in, the lifecourse.