Mental health is a social good. It supports overall population health, strengthens community ties, and enables economic and social participation.
Despite common cultural narratives about how mental health is an individual— or even private— matter, positive mental health is critical in helping communities and populations experience vitality in every life domain.
But how do we cultivate mental health in ways that are effective? How do we ensure that initiatives and programs are actually improving mental health in meaningful ways?
And how do we uphold human dignity and integrity in the process?
The field of mental health needs social innovation.
These days, our understanding of mental health is expanding beyond clinical associations with mental illness or ill-health, toward a vision of experiencing life in an active, whole, and engaged way.
And the reality is that generations before us have asked these deep questions. Even if the term “mental health” is relatively new in human history, people have explored what it means to live “the good life” for millenia.
And for good reason: life as a human being or human tribe has always been fraught with hardship. Together with our families and communities, and across wisdom traditions, we’ve asked what it looks like to experience meaning and purpose in the presence of pain.
This fundamental question demands continued curiosity and creativity— and social innovation offers tools and practices to bring that creativity to bear.
4 pillars of social innovation in mental health
As we (re)expand our vision of collective mental health beyond an illness/treatment framework, we seek to create initiatives and programs that are not only ameliorative but transformative.
The following four practices are central to our method here at Brio as we work with local partners and stakeholders to create lasting change in the field of mental health and all the life domains that it touches.
1. Human-centered and community-centered design for mental health
Human-centered design is a popular approach to creating products that meet users’ needs— so how does it work for mental health?
We start with inviting community members, partners, and stakeholders to share about their lived experiences and deeply held values. While mental health may feel like a worthy end in itself, what we’re really hoping for is to help people live in greater alignment with what matters to them, to do what they care most about. Cultivating mental health is a way to do that.
So centering a program on the experiences and values of a given community or population means understanding what meaning and vitality actually look like to them. There are many ways to seek these insights beyond traditional interviews, including expressive art, games, storytelling, and other approaches to interaction. But at the end of the day, we ask questions along these lines:
What does it look like to live a good life in your community?
What barriers seem to get in the way?
When you think about the past week or month, what has felt worthwhile to you?
When done well, participants’ perspectives can inform the language, stories, examples, and activities that are utilized in the program design. Further engagement and participant-centering can occur as an initial outline is created.
When sharing program drafts with participants, we invite them to name not only what excites them but also what they would add or change. Are there other ways they would tell a story or explain an idea that makes more sense?
This kind of input can be gathered in the creation phase, during a pilot, and even as the program is up and running. There is always room for increasing the alignment and improving engagement as a result.
Participants’ experiences and values are the point.
In the social sector, there is a misconception about the purpose of community engagement in program creation and implementation: to make a program more “acceptable”. For Brio, the role of human-centered and community-centered design is not simply to make a bitter pill more palatable by wrapping it in what tastes good to a participant.
If the transformation that becomes available through positive mental health and wellbeing is not, ultimately, what participants want for their lives, then we’ve failed.
Helping participants cultivate the inner postures and strengths that move them toward what matters to them is precisely the point of these programs— and the impact we seek is centered on that.
In our most successful programs, community members share that it has helped them live in ways they’ve wanted to for a long time, or supported them in becoming the kinds of people they want to be. In other words, they experience more freedom.
2. Integrating evidence-informed knowledge and practice
Here’s the reason we are so obsessed with values: they are chosen qualities that individuals and communities can seek to embody in nearly every circumstance they encounter. And values-aligned living— the kind of living that brings meaning and vitality— is the ultimate goal of positive mental health.
Values are intrinsically rewarding, offering deeper and more enduring motivation than external incentives and punishments. Some of the values our partners and their community members choose most frequently include: love, courage, justice, compassion, solidarity, and ownership. These qualities are not an endpoint but an ongoing invitation to ever-deeper engagement.
More specifically, we at Brio have chosen to center the programs we design on the framework known as Acceptance and Commitment Training, or ACT (pronounced “act”)— a proven transdiagnostic behavioral approach to improving mental health by helping people shift their inner mental processes, connect with their chosen values, and take committed action.
As a framework, ACT seeks to cultivate psychological flexibility, which has been proven across thousands of studies to support individuals in a wide range of contexts. As a construct, psychological flexibility encapsulates the ability to actively engage the full range of the human experience while choosing to take action toward one’s chosen values.
Values-aligned living is for everyone, not just those experiencing suffering.
As a psychological intervention, ACT has some of the best evidence that exists. ACT can and has been used to treat a range of mental health concerns amongst diverse populations. But the reason we use it goes beyond the strength of this evidence.
First, the idea of psychological flexibility resonates deeply with our partners and their communities. Across the board, people agree that life in marginalized communities can be very stressful and sometimes excruciating— and the goal of a mental health initiative is not simply to “feel better” about it.
Psychological flexibility does not demand that people change their thoughts and feelings, which none of us can fully control. Instead, it invites us to change how we respond to our thoughts and feelings, especially the painful ones, so that we can orient ourselves toward values-aligned action, no matter how small.
This kind of freedom and agency is vital for everyone in a community— not just those who may be experiencing a health concern or condition. Participants have named how it has helped them react to their anger calmly, instead of hurting those around them. They have shared how they decided to try something new that was once scary to them. They have advocated for themselves and for each other more courageously as their personal and communal values have become clarified in the process.
Second, the psychological flexibility skills not only help those who may be experiencing a mental health condition, but also reduce the risk of developing a condition. A person’s ability to respond more flexibly to life’s challenges is directly connected to the way those challenges impact their lives.
As mental health promotion seeks to improve the inner capacities of everyone, cultivating psychological flexibility can offer all community members a meaningful opportunity to improve their lives. Because values-aligned living is an ongoing journey, we can always identify some area of life in which we’d like to experience more vitality.
And finally, while ACT offers specific skills validated by research and evidence, community members get to choose the values they want to orient toward. ACT is simply a vehicle to help them go where they want to go.
3. Telling stories and making choices that support liberation
If ACT is the evidence-based framework that anchors the skills we hope to cultivate in the mental health design process, then liberation psychology offers a posture with which to co-create desired outcomes.
It is critical to center participant voice not just in the design process but throughout the program. The liberation psychology concept of testimonios speaks directly to the importance of telling one’s experience as part of the freedom process.
In multiple settings, we have heard from participants whose greatest wellbeing concern was that their voices were not heard by governments, multilaterals, NGOs, and others that claimed to care about them. Most often, they would receive multi-hour trainings in which they were not allowed to speak at all. What they appreciated most was the space to talk about their experiences and know that they were heard— to give language to their inner world and learn that they were not alone.
Of course, allowing participants to speak can seem like a baseline program standard that almost needs not be named. But the shift we make is recognizing and upholding the value of community voices simply as they are— not just for the design process, not for impact reports, not in the service of anyone but themselves. Sometimes our voices are instrumental— a means to a desired end. Other times, our voices are the end in itself.
The role of storytelling in strengthening psychological skills
As creatures with the capacity for meta-cognition (knowing that you know), we have the immense ability not only to witness the world around us through our senses, but to interpret that world. This ability to story-tell our lives reflects— and perpetuates— a human desire for a sense of coherence. We want our world and our lives to make sense.
Furthermore, our ability to craft stories about ourselves can lead to both empowerment and entanglement, liberation and oppression. Here’s an example: If we had a poor experience with a particular teacher who was unkind to us, we might have a story in our minds about being incapable of learning.
Over time, that story can exert power over our lives, influencing what we believe is possible for us. It can have strong ramifications if we are deeply entangled with the story: we become afraid of following our curiosities, we choose not to go to graduate school, or we stay stuck in a job or role at home because we’re convinced there are no other options for us.
Stories like these are powerful. They can be like a heavy brick we discover one day at the bottom of our bag— one weighing us down and draining our energy, that we did not even know was there. Once discovered and acknowledged, we can decide if we want to keep carrying the burden of this story and allowing it to take vitality away from us. Or, we can decide to do something new with it.
This process is known as “de-ideologizing” in liberation psychology, but there are elements of this in ACT as well. The practice of discovering our self-stories and self-concepts allow us to recognize their presence and actively choose how we want to respond. Maybe the teacher really was unkind to us, or that we really did do poorly in school. But do the stories we created about those events have to control us? If we could tell a new story, what would that be?
And finally, stories help us to touch the deeper truths of our inner worlds with new language. Many traditional forms of storytelling involve metaphor and myth, drawn from nature and everyday life. This practice of storytelling across many cultures can be leveraged in the cultivation of new mental processes: to describe what is happening within us in a way that is indirect, but still true.
In many of our programs, we use metaphors to describe our mental and emotional experiences— a stream with fallen leaves, a bus with passengers, a night filled with stars. The meaning of these stories is open to interpretation, so that participants can make it work for their own experiences. What the stories describe are new mental processes that help to build psychological flexibility, and create shared language for these new processes so that liberation can be experienced by all.
4. Building skills and practices that lead to meaningful collective action
Much has been written about the value that mental health can bring at the individual, communal, and population levels. Yet what if we told you that mental health is indeed not the endgame of our work, but a means to a greater end?
Social innovation begins with the premise that something about our society is not working— at least, not for everyone— and seeks to make it better. Applying this posture to mental health is to recognize the problematic assumption that mental health is restricted to helping people “feel better,” or at least feel less bad.
Let’s be clear: feeling better is not a bad aim. In fact, it might be one of the most natural human impulses. But mental health as we define it doesn’t stop there. It asks the question, now that we are less alarmed or drained by our own psychological suffering, what becomes possible for us? What can we do with our new-found energy?
This is not a revolutionary concept. Many evidence-based behavioral interventions, or even behavior change schemes, seek precisely to help people not just improve how they feel, but how they act: to quit smoking, to start exercising, to actively work toward important goals.
The difference between these self-improvement programs and a social-innovation-infused approach to mental health is that the latter fosters a vision of what communal good is made possible by the healing and hope that mental health can bring.
One critical practice of harnessing the power of mental health is to help participants connect their values with tangible actions. These are actions that may represent a small shift for them— so small in fact, that only they notice, but significant nonetheless. It is the significance of a one-degree-shift when traveling a long distance: the further you go, the greater difference it makes.
Again, these new steps toward liberation need not be revolutionary (although they often can be). Frequently, it begins with a single choice or perspective change that an individual or group can make toward the things that matter to them.
And then, they are invited to repeat those actions again and again and again. New patterns of behavior are created and we adjust to them. What started as something scary becomes normal. Then we find the next shift we want to make, and try that for a while. And it goes on.
So what does this look like, and why does it matter?
It looks like teachers showing compassion to students in government schools.
It looks like refugee women demanding justice for police abuse.
It looks like children finding it easier to pause a fun game to help a hurt friend.
It looks like adolescents sharing about their indigenous heritage with joy rather than shame.
It looks like families of disappeared people taking a moment to acknowledge their own need for care.
Mental health and the compounding good of our choices
It is no secret that mental illness is costly at a personal, communal, and societal level. Economists have determined the compounding cost of lost productivity to be in the trillions.
But our mental and emotional liberation is not (only) for the purposes of avoiding or recovering these costs. When we develop the agility to respond to our pain in new ways, we find freedom to do good things— things aligned with our personal and communal values.
The good things we do may not be measured in any formal way, but they ripple into our homes and communities. We can all testify to the lasting difference made by a compassionate teacher, a caring friend, or a demand for justice on our behalf. Just as pain and suffering have the power to compound, so does liberation and action toward a new reality.
The ultimate good that mental health can advance in systemically marginalized communities is the consistent, compounding, and liberatory action that ultimately changes those very systems of oppression. In fact, our shared future depends on it.