Systems maps Mental Capital and Wellbeing Project
This report has been produced as part of the UK Government’s Foresight Project, Mental Capital and Wellbeing. The views expressed do not represent the policy of any Government or organisation.
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Mental Capital and Wellbeing: Making the most of ourselves in the 21st century
Systems maps
This report is intended for:
This report should be cited as:
Policy makers and a wide range of professionals and researchers whose interests relate to mental capital and wellbeing.
Foresight Mental Capital and Wellbeing Project (2008). Systems maps. The Government Office for Science, London
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The Government Office for Science would like to thank the firm shiftN which led the systems work within the Foresight Project on Mental Capital and Wellbeing, and also the many experts and stakeholders from the UK and around the world who contributed to this work.
The Foresight Programme is run by the UK Government Office for Science under the direction of the Chief Scientific Adviser to HM Government. Foresight strengthens strategic policy-making in government by embedding a futures approach.
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Systems maps
Contents 1. Introduction
2
2. Catalogue of diagrams
2
Appendix A: Structure of the Project reports and supporting papers
15
1
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Systems maps
1 Introduction This report provides a catalogue of important systems diagrams that have been produced within the Foresight Project on Mental Capital1 and Wellbeing2. Some of these diagrams also appear in particular Project reports3. This report is not intended as a stand alone document. Rather, it should be read in conjunction with the final Project report, which describes the Project and its key findings, and the following reports which synthesise the science and evidence base: ●●
Mental capital through life: Future challenges;
●●
Learning through life: Future challenges;
●●
Mental health: Future challenges;
●●
Wellbeing and work: Future challenges; and
●●
Learning difficulties: Future challenges
The interested reader can also obtain detailed information on these diagrams in a report that has been produced by the firm shiftN, which undertook the systems work for the Project. In particular, that report details how the various diagrams were built up from their component parts, and provides other explanatory information. That contractual report can be obtained via www.foresight.gov.uk. The production of the diagrams and their use within the Project The systems diagrams mostly detail the many factors that affect aspects of mental capital and wellbeing. They were used within the Project to gain a clearer understanding of the complex interactions and interrelationships of these factors. Their production involved extensive consultation with leading experts. However, the systems that they seek to capture visually are extremely complex, and therefore the detail which the diagrams contain is inevitably controversial: for example, some readers may argue for the inclusion of other factors, or for different linkages. Nevertheless, whilst the diagrams do not purport to be definitive, it is hoped that others will find them useful.
1 “Mental capital” refers to the totality of an individual’s cognitive and emotional resources, including their cognitive capability, flexibility and efficiency of learning, emotional intelligence (e.g. empathy and social cognition), and resilience in the face of stress. The extent of an individual’s resources reflects his/her basic endowment (genes and early biological programming), and their experiences and education, which take place throughout the lifecourse. 2 “Wellbeing” throughout this report refers to “mental wellbeing”. Mental wellbeing is a dynamic state in which the individual is able to develop their potential, work productively and creatively, build strong and positive relationships with others, and contribute to their community. It is enhanced when an individual is able to fulfil their personal and social goals and achieve a sense of purpose in society. 3 See Appendix A for a list of the Project reports..
2 Catalogue of diagrams
The following table lists the systems diagrams that are reproduced here, together with a brief description. Page
Systems diagram
3
Mental capital through life – conceptual overview The trajectory of mental capital through life, detailing some of the many factors that influence mental capital and how they are connected across the lifecourse
4
Learning through life – conceptual overview A visualisation of the issues associated with learning through life
5
Disposition to learn – influence diagram A diagram of the many factors that interact to affect disposition to learn
6
Learning difficulties – conceptual overview A visualisation of the many factors that affect learning difficulties
7
Functional literacy – influence diagram A diagram of the causal factors that drive the development of functional literacy
8
Functional numeracy – influence diagram A diagram of the causal factors that affect the development of functional numeracy
9
Executive function – influence diagram A diagram showing the causal factors involved the development of executive function
10
Mental health – conceptual overview A visualisation of the principal factors that affect mental health and mental ill-health, and their inter-relationships
11
Stigma associated with mental ill-health – influence diagram A diagram of the many factors affecting the stigmatisation of, and discrimination against, people with mental illness
12
Stigma associated with mental ill-health – actors An illustration of some of the people and settings that can influence stigma and discrimination
13
Wellbeing at work – conceptual overview A visualisation of the factors that affect wellbeing at work and the associated positive and negative outcomes of healthy versus unhealthy workplace environments
14
Stress at work – influence diagram A diagram of the many factors that interact to affect stress at work
2
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Systems maps
)PNF 'BNJMZ FOWJSPONFOU
School environment
Age Gender Ethnicity Immigration status
Social valuation of parenting
Learning environment
Knowledge, attitudes and aspirations towards: Parenting Education Health behaviours
Early stress exposure
Early home experiences
Childhood trauma
Early school experiences
Social attitudes towards drugs and alcohol
‘Self-controlled’ Peer resistance Drug and alcohol abuse ‘Impulsivity’
n i n g l e a r
n g l o e f L i
Transport Housing Living conditions
Parenting skills Positive parenting style Parental modelling
Permissive environments .JOJNJTBUJPO PG SJTL UBLJOH .FEJB BOE FOUFSUBJONFOU JOøVFODFT Smart motivation
Social valuation of teachers and education
Education Employment Income Occupational status Social status
8PSL FOWJSPONFOU
.FEJB *OGPSNBUJPO environments
Socioeconomic gradient
Cu l t u re
Mental Capital People
T r a n s p o r t
Built environment and housing
Executive function
Organising managing and controlling behaviour
Self-esteem and emotional cognition
St re ss
Anxiety Depression
Stigmatisation Feelings of shame Hopelessness Victim mentality Lack of control Loss of self-confidence Low expectations
Competence Confidence Character Caring
Social maladjustment Anti-social behaviour
Functional literacy and numeracy
Disposition to learn
Social exclusion
Social engagement
Social cognition
8PSL MJGF balance
Socio-economic status
Teen pregnancy Smoking
Cognitive resilience and coping skills
Cognitive reserve
Physical activity .FOUBM BDUJWJUZ Social stimulation .FEJDBUJPO PS Dietary interventions
Active coping strategies
?
Parents
Teachers
.FOUPST BOE role models
Friends Peers
Maternal diet Tobacco use Alcohol use Drug abuse
Friends Peers
Co-workers S Friends Community Learning Attention Executive function Episodic and working memory
The onset of substance use coincides with a critical maturation period of the neural substrates that are affected by alcohol and other drugs of abuse
Pregnant mother Cytokines Glucocorticoids Oxidative stress Nutritional deficit
Nutrition
Nutrition quality Sleep
Exe
rci
se
Nutr
iti
on
Reward circuits and dopamine Slee
p
Exercise
Nu
trition
Genetic vulnerability to addictive behavior
Sle
ep
Exerc
ise
i Nutrit
on
Sleep
Biology
Synaptic refinement and myelination
Foetal programming
Early development
Low birth weight Central adipocytes Cerebral structure Epigenetic changes
Rapid weight gain Innate immunity Brain development
Childhood Obesity Inflammation Response to stress
Low
Immune system setting
High
Neuroendocrine response
School Prenatal Early-childhood (0-4) Parental responsibility for creating the foundations for success
Child (5-12) Primary education builds knowledge, skills, and a learner identity
A c q u i s i t i o n
7838-DIUS-Foresight System Maps.indd 3
Understanding of lifecourse factors Attitudes and expectations towards ageing Ageism and social marginalisation Under-investment in older people
8BTUF PG .FOUBM $BQJUBM
.BUFSOBM care
Genetic endowment
8PSLJOH MPOHFS
Age-related cognitive and physical challenges
Chronic illness
Peer influence
.BUFSOBM bonding
Community and home environment
t .BOBHFSJBM TUZMF t 1BSUJDJQBUJPO BOE DPOUSPM t̓+PC JOTFDVSJUZ t 4LJMM VUJMJTBUJPO BOE WBSJFUZ t̓8PSLMPBE BOE XPSLQMBDF t *EFOUJUZ 4UBUVT 3PMF Life events: t 4PDJBM SFMBUJPOTIJQT Becoming a parent t̓)PVST 4DIFEVMF Death of a parent t $PNNVUJOH Divorce Death of a spouse Unemployment Financial pressures Illness
Adolescent A dynamic and critical transition to adulthood
Ex
Spouse Children Family
ocial support
Technological interventions Early assessment and treatment of age-related disorders Cognitive training Pharmacological cognitive enhancement Stem cells in neural regeneration and adult neurogenesis Assistive technologies Cognitive prosthetics
Cardiovascular disease Stroke Diabetes Rheumatoid arthritis Cancer Respiratory disease Nu
tri
tion
Sle
ep
Exercis
e
HPA axis and SNS activation Glucocorticoid overexposure
C h r o n i c i n fl a m m a t i o n n-3 polyunsaturated fatty acids, folic acid, WJUBNJO & BOE DPHOJUJWF GVODUJPO
Nutrition Lifestyle Socio-economic status Genes
4PDJBM TVQQPSUT
St re ss
ercise
Living longer:
?
Adult
Obesity Chronic inflammation Negative mental outlook Poor sense of control Heightened response to stress
Later life
Accelerated ageing Chronic diseases Cognitive decline
Nutrition Bioscience
Environments
Mental capital through life – conceptual overview
Sleep
se
Nut
rit
ion
Brain atrophy and white matter lesions Accumulated damage to cells and tissues
Retirement
Adult
Older adults
. B J O U F O B O D F
rci
Genomics .FUBCPMPNJDT Transcriptomics Proteomics
Work Coping with the many opportunities and stresses of adult life
Exe
Dealing actively with the challenges of ageing; using resources largely built earlier in life
D e c l i n e
3
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Systems maps
Learning through life – conceptual overview Economic environment
Future work Individualisation/personalisation Decentralisation – personal judgment Constant/rapid change Networked information societies Knowledge work
Required new competencies
Teacher training and professional development Developing the theoretical basis for new: Tools – technologies Techniques and processes Environments
Self awareness and self assessment Progressive independent thinking Adaptability/flexibility Ability to manage complexity Teamwork Communication Techno-mathematical literacy
Reflective practitioners:
Designing and testing new approaches Researching, experimenting, innovating Sharing ideas
Able to support?
Structure of the educational system: Funding Governance Organisational structure Quality enhancement Built infrastructure Curriculum Pedagogy Assessment/standards Staff selection and skills Staff relations/promotion
Autonomy
Empowerment
Subjective opportunity structure
Quality of instruction
Attitudes Aspirations Autonomy Motivation Curiosity Beliefs Values
Enthusiastic and skilled teachers
Affective and behavioural
Teachers
Mentors Caregivers
Inequalities in participation:
Education Income Genes Occupational status Family size
Parental involvement
School-age Learner
Attitudes Aspirations Beliefs Values Talent
(Dispositional)
Psychological Parents
Ethnicity
Influencing skills
Qualifications
Home/family environment
Participation in maths and science
• An instructor-led, contentbased intervention, leading to desired changes in behaviour • A self-directed, work-based process, leading to increased adaptive capacity
Science and engineering of new learning technologies
Threat
Adult learner Work related
Formal
• Supporting, accelerating and directing learning interventions that meet organisational needs and are appropriate to the learner and the context
Vulnerability of older workers?
Te c h n o l o g y
vs. Non work related
On-the-job vs. training
Off-the-job training
vs. Informal
Access
Discrimination
Broadband Mobile ICT – Phone, PDA, MP3, Pocket PCs Games, Simulations, Virtual worlds Semantic Web – search and aggregate Personalised information environments
Techno-mathematical literacy Converging
Social inclusion inequalities
Stratification Transition regimes:
Low-skilled
Universalistic Employment-centred Liberal Sub-protective
Social class Ethnicity Region Older Unemployed Migrant Weak qualifications
Employability
of adults in the UK don’t have the equivalent of a basic school-leaving certificate
Opportunity
Autonomy and selfdirection
Shift in role for trainers and organisations
Transport Time Cost Direct/indirect Opportunity cost Institutional barriers
Utilities Manufacturing Construction
Capabilities
Gap
Demands
High-skilled
2x the participation in adult learning
Worker supply
Trending up Trending down
2004: 3.2 million unqualified jobs 2020: only 600,000 such jobs may be left
Learning trajectories Preschool
Sense of control Sense of purpose
Training
Technical skills
The knowledge, skills, competencies and other attributes embodied in individuals that are relevant to the economic activity
Managers
Trainers
Structural
Learning identity established ~ Age 16
Substantial gaps in cognitive development and learning styles are already in evidence
Cognitive Skills
Barriers to continued education
Family structures Migration and demographic change Cultural dynamics and diversity
1/3
Prenatal through early Childhood
Regulation Licence to practice Qualifications Vendor-based qualifications Professional organisations Unions
Learning
Multiple social disadvantage
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Alcohol Drugs Underage sex
Motivation
Early home experiences
Social gradient
~Age 3
Skills move us up the value chain
Social capital Pro-social behaviour Social inclusion and cohesion Citizenship Human capital
Service work Knowledge work
Understanding and support
The importance of skills
Risky behaviours
Learning trajectories
Age Social Class Place Sex Parental education Ethnicity First language Family structure Religious background Learning difficulties Type of school attended Housing tenure Health/disability Criminal activity
The wider benefits of learning + Mental health + Physical health – Crime
A healthy competitive workforce
Workplace environment
Future culture Social networks
Reflexive and social skills
Early school experiences
Marginalisation Disempowerment Stratification Inequality of access Social exclusion
Future society
Responsibility Flexibility Remote/informal learning Negotiate ever-changing demands
Knowledge and skills
Education managers
?
Individual learning
Learning environment
Environmental sustainability
Fragmentation
‘Externalities’
Hyper-competition Offshoring Downsizing Outsourcing Mergers Restructuring Constant change Intensification of work
Worker requirements
Open teaching – learning communities
Worldwide production and financial markets Global flow of information Networking across cultures Migration
Offshoring
Future learning
Leavers Primary school
Secondary school
Finishers Postsecondary school
Qualitative shift
Lifelong learners Working longer
Work
Training
Retraining
Retirement 4
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Systems maps
Disposition to learn – influence diagram
Mental Capital and Wellbeing
Citizenship
Family functioning
Social cohesion
Ability to make and maintain social relationships
Standards focused education
Quality of provision Teaching skills
Access to social networks
Peer learning Supportive schooling environment
Informisation of society
Decentralisation and individualisation of society
Practiceoriented learning environment
Early school experience
Access to cultural institutions
Exposure to multimedia
Opportunities for informal learning
Access to mentors
Preponderance of informal over formal learning opportunities
Social skills
Parent’s education level
Social class
Self-concept Executive function Intrinsic motivation
Disposition to Learn
Access to training opportunities
Variety of formal education offerings
Participation in post-compulsory education
Academic and technical qualifications
Participation in skilled employment
Cognitive skills
Ethnicity, culture, religion Quality of location
Willingness to negotiate “barriers” to learning
Degree to which formal learning is part of subjective opportunity structure
Economic growth and productivity
Perceived benefits of training by employers
Informal learning
Parental valuation of learning
Wider benefits of learning
Informal workplace learning
Mentoring skills: Authority, Compassion, Personal interest
Inertia of conventional learning institutions
Access to online learning
Discrimination based on qualifications Extrinsic motivations
Perceived net economic benefits from learning
Effectiveness and equitability of labour market transition regimes
Gender
Age (birth cohort)
Generational Feedback Loops 5
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Systems maps
Learning difficulties – conceptual overview
Cognitive skills are cumulative; success builds upon success. Thus early abilities - or their lack contribute heavily to future success or failure.
Accruing Mental Capital
Mental capital and wellbeing – core features
c
Sy
b
i ol
i sk
Generational feedforward
Knowledge, beliefs, and skills
Auditory processing Visual processing Visuo-spatial Motor systems
Parents
Teachers
Education level and involvement
Training level
Home / Family environment
School environment
Sensory Specific Language Impairment
Learning environments
Dyscalculia Dyslexia Deafness / Hearing impairment
lls
Selfconcept
So
ci
al
Self-efficacy Self-esteem Non-cognitive skills
Executive function Self-monitoring Self-reflection Self-control
sk
il
ls
m
Feedback / Amplification
Attitudes Aspirations Beliefs Values Talents
Early capability makes later learning more efficient and increases the complexity of what can be learned
Theory of Mind Social perception Social knowledge Communication skills
Social cognition
Cognition Attention Reasoning Problem solving Learning Language Memory
ADHD
Positive trajectory Learning performance
Learning trajectories
and Social performance
Negative trajectory
Autism spectrum
Eating disorders
Basic intellectual functioning Cognitive flexibility and resilience Cognitive reserve Optimism Active coping style Self-esteem and self-efficacy Social engagement Social inclusion Employability
Lifecourse
Delinquency School failure Depression Mental ill-health Criminality Substance abuse Teen pregnancy
ASB/CD
Depression
Emotion
Mental capital and associated outcomes:
Mental Capital
Motivation
Feedback / Amplification
Gene–environment interaction
Mental Capital Period of highly plastic brain development
Very early detection age 0-2
Early detection age 3-4
Early interventions age 3-7
Possible with future advances in neural and genetic science and technology
Genetic disposition
6
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Systems maps
Functional literacy – influence diagram
Schools
School resources, structure, and environment Degree of personalisation of learning assessment
Age of Assessment
Presence of other sibling with LD
Family
Level of mastery of English by parents Parent reading with children Parental valuation of literacy
Ability of schools to deal with special needs
Delay between identifying and intervening
Time spent watching TV Print exposure via family
Exposure to text-based multimedia
SLI
Speech perception
Genes
Gender
Mother’s educational level
Availability of accessible texts
Individual’s print exposure
Phonology
Stigmatising
Teacher knowledge and beliefs re: learning difficulties
Learner Identity identity Self-Esteem Self-esteem Self-Efficacy Self-efficacy Metacognitive skills
Ability to decode
Parental aspirations and expectations
Academic achievement
Functional Literacy
Aural language skills
Ability to comprehend
Phonological similarity of parents to English
Oral language skills
Fit of reading curriculum
Teacher training
Teacher knowledge of the reading process
Disposition to read
Dyslexia
Deafness
Social class
Teacher ability to identify learning difficulties
Aggressive behaviour
Delinquency Working memory
Visual and auditory attention
School expulsion g (IQ)
ADHD
Generational feedback loops 7
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Systems maps
Functional numeracy – influence diagram
Family
Disposition for number Number experiences
Individual’s number exposure
Parent playing number games with children
Learning number facts
Spatial cognition
Learning algorithms
Schools
Stigmatising
Teacher knowledge and beliefs re: learning difficulties
Learner identity Self-esteem Self-efficacy
Parental aspirations and expectations
Metacognitive skills
Dyscalculia
Academic achievement Number sense (magnitude representation)
Genes
Functional Numeracy Counting
Ability to compute approximate quantity Ability to compute exact quantity
Mother’s educational level
Oral language skills
Working memory
ADHD
Visual and auditory attention
Aggressive behaviour
Delinquency
School expulsion
g (IQ)
Generational feedback loops
7838-DIUS-Foresight System Maps.indd 8
Teacher training
Teacher knowledge of the number development process
Fit of number curriculum
Number line
Parental valuation of numeracy
Social class
Teacher ability to identify learning difficulties
Ability of schools to deal with special needs
Exposure to number-based multimedia
Presence of other sibling with LD Parents mastery of numbers
Degree of personalisation of learning assessment
Age of assessment
Delay between identifying and intervening
School resources, structure, and environment
8
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Systems maps
Executive function – influence diagram
Schools D i ffi c u l t i e s
ASB/CD
Depression
Eating disorders
School exclusion
ADHD
(about aggressive Parent and challenging knowledge behaviour etc.)
SLI
Self-esteem Self-efficacy
Autism
Teacher knowledge
School resources to deal with child’s needs
Emotional regulation
Inhibitory control
Presence of other sibling with LD
Language Attentional flexibility
Genes
Executive Function
Cognitive regulation
Academic achievement
Social cognition
MAOA genotype
Teacher training Action regulation
Working memory
Socioeconomic stressors
Caretaking style
Mother’s education
Sibling aggression
Family
Stigmatising
Metacognitive skills
Deafness
Age
Teacher style
Auditory processing skills
Cognition Oral arts, storytelling, poetry etc.
Sociodramatic pretend play
Music and arts
Curriculum
9
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Systems maps
Mental health – conceptual overview
Mental Health Wellbeing Physical health Knowledge Quality of relationships Sexual satisfaction Use of services Productivity Public safety
Community cohesion: Intergenerational advantage
Healthcare
Trust Reciprocity Participation Informal social control A sense of citizenship and participation in society A sense of belonging to family, school, workplace and community A culture of cooperation and tolerance between individuals, institutions and diverse groups in society
Diagnosis Treatment Primary care
Mental health professionals
Service use
Public awareness
Sup pporting g facto fa to tors o
Community groups
Preva l ence
Social Networks
ACORN Classifi cation:
Prevalence of mental disorders among adults in Great Britain by ACORN® Wealthy achievers
Housing quality Access to open spaces Access to transport Access to community resources
5.8
Urban prosperity
9.5 % of 5-15 year olds Ability to deal with thoughts & feelings Life-management skills Emotional resilience Ability to cope with stressful circumstances
Spouse Children Extended family
Friends
Social supports Positive Learner Identity
Exercise Nutrition Sleep
Gainful Employment
Parenting
Education
Employment
Home/Family environment
School environment
Work environment
Parent(s)
8.2
Moderate means
Managers Co-workers Customers
Teachers
14.6 0%
5%
10%
15%
Socioeconomic gradient Chronic social adversity: Unemployment Poverty Illiteracy Child labour Violence Lack of social supports
Lone-parent families Larger families Punishment strategies Family discord Marital breakdown Divorce/Remarriage Local authority care
Poor scholastic performance hence to unrewarding employment or unemployment
Managerial style Participation and control Job insecurity Skill utilization and variety Workload and workplace Identity / Status / Role Social relationships Hours / schedule
Diagnosis and treatment
Lack of referral Avoidance of treatment Inadequate treatment Ineffective treatment Repeat consultation
Intergenerational burden Family/Caregiver burden
Structural level
Social exclusion Poor educational levels Unemployment Low income Poor housing Lack of social networks Neighbourhood deprivation Discrimination Perceptions of discrimination People diagnosed with a significant mental illness are among the most ‘excluded’ in society
9% mixed anxiety –depression 5% anxiety 3% depression 2% phobias 1% OCD 1% panic disorder
Poor coping skills Low self esteem
Stressful life events: threats to health interpersonal problems unemployment job insecurity debt Lifetime stressors: sexual abuse expulsion from school bullying running away from home institutional care in childhood
Genes Childhood maltreatment Social stresses and life events Socio-demographic
Psychosis
People with personality disorders are at increased risk of developing other serious mental health problems Some personality disorders are associated with an increased risk of violence and suicide, aggravated by comorbid alcohol abuse
Personality disorders 4%
Other mental disorders
7% Alcohol 3% Drugs 32% Tobacco
Individual Resources supply ‘friction’ at the fulcrum between the Supporting Factors and Risk Factors
32% Neurosis, psychosis, personality disorder Substance abuse Hazardous alcohol consumption Alcohol dependency Alcohol and anti-social personality disorder
Violence 12%
Dementia
Age Genetic background Medical history Lifestyle
5% of people over 65
Risk i sk facc tors fa
20% of people over 80
0%
5%
10%
15%
20%
Migration and mental health
Mental ill-health
Populations most at risk of social exclusion:
Co m m u n i t y l e v e l
16.4% total
Addictions
Social stigma
Women Racial and ethnic minority groups Refugees Sex workers People living with disabilities Addicts
Women, aged between 35 and 54 Separated or divorced Living as a one person family unit Lone parent No formal educational qualification Predicted IQ of less than 90 Social class V Tenants of subsidized housing Live in an urban area One or more physical complaints
Common mental disorders in adults 16-64
0.5% of the adult population
Substance abuse and addiction Smoking
Unemployment
Life events Bereavement Severe trauma Severe illness Job loss Violence
Work stress
Psychological factors
Genes Immunity Physical trauma Endocrine response
11.7
Hard pressed
I ndi v i d u a l res ou u rrces
Physical factors
7.4
Comfortably off
Characteristics of the child Characteristics of the family Family functioning characteristics Stressful life events Neighbourhood characteristics
Mental disorders in children
Family burden
Living conditions
Mental health problems in children and young adults often have serious adverse effects in adulthood, including: Anti-social behaviour Criminality Relationship difficulties Substance misuse General impacts on quality of life R is k Fac to r s
Chronically ill Homeless Long-term unemployed Early school leavers Older people living on pensions
Individual level
Higher incidence rates of all clinically relevant psychotic disorders have been observed in several immigrant groups and their descendants
R e cove r y Freedom from abuse, stigma and discrimination Access to resources Work and employment Housing Personal relationships Social participation
Suffering, disability and mortality Loss of economic productivity Low academic achievement Absenteeism - inability to work Presenteeism - low productivity Unwanted pregnancy Accidents and errors Unhealthy lifestyles Persistence of personality traits Risky behaviours that handicap in the work place Failure to seek treatment and care for oneself Crime Suicide Impaired parenting skills in later life; with consequences for deprivation of their own children
Trending up Trending down
Outcomes
10
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Systems maps
Stigma associated with mental ill-health – influence diagram
Empowerment Knowledge about antidiscrimination laws
Access to legal resources
Legal
Anti discrimination laws
Inclusion
Awareness of human rights
Legal action
Cognition
Opportunityseeking
Source power
Target power
knowledge
Social networks / support
Indicating behaviour or diagnosis
Help-seeking
Knowledge about MI
Belief in internal locus of control
knowledge Socioeconomic opportunities
Disclosure of diagnosis
Practical / functional concerns
Pathological / Impaired behaviour
Socioeconomic status
Mental Ill-health
Physical ill-health
Denial or degradation of service or benefits
Discrimination
Social mistreatment
Discouragement / Learned helplessness
Separating / Out-grouping
Knowledge and skills for interacting with PWMI
Stress
Subtle social discrimination
Poor health service
Prejudice
Belief that it couldn’t happen to me Belief in internal locus of control
Status loss / Dehumanization
Universal norms
Belief that different is bad
Self-concept / Self-esteem
Unemployment
Fear of mistreatment
Fear of losing control
Poor housing Quantity and quality of personal relationships Perception of discrimination
Positive cause Dependent and/or bi-valued cause Negative cause
Denial of control / responsibility Nondiscriminatory behaviour
Person with mental illness
Association of MI with violence
Fear (anxiety) of having MI
Culture
Anger / Resentment
Comfort / Relief / Anxiety shielding Structural discrimination
Target
Shame
Fear (anxiety) of harm from PWMI
Natural altruism
Distaste / Disgust
Loss of socioeconomic opportunities
Emotion
Natural xenophobia
Compassion
Social discomfort
Shame
Anger / Resentment
Organisational norms and rules
Social norms/ideals
Stress
Loss of confidence Low self-esteem
Fear (anxiety) of having MI
Cultural Stereotypes
?
Perception of kinds not continua
Medication side-effects
Discrimination
Knowledge about MI Myths about MI
Negative stereotyping
Health behaviours Self-concept / Self-esteem
Ignorance
Labelling
Anticipated discrimination
Belief that discrimination is bad
Personal relationship with PWMI
Non-normative appearance & social behaviour
Anticipated discrimination
Selfcompassion
Cognition
Emotion
Source
MI: Mental illness PWMI: Person with Mental illness
Other
11
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Systems maps
Stigma associated with mental ill-health – actors
Individual
Local
National
Legislative
Map of the “Other” people with potential for discriminatory behaviour
Leg al
Government officials
Lawyers
Courts – Criminal justice system
Ministers and legislators
Prison staff
Prisons
House of Commons
Police
Law enforcement
M edia
Editors Producers Journalists
Phys ic al h ealth c are
GPs Nurses
M ental h ealth c are
Psychologists Therapists Counsellors
S o c ial Care
Counsellors Social workers
Fin an c ial
Financial professions
Speaker’s bureau
Media companies
Celebrities
Health providers
Psychiatrists Mental health providers
Physical place
where discrimination happens
Local mental health support and advocacy groups
Occupational support
Insurance companies
Discrimination Professional societies
Customers / Public Person with mental illness
Wor k Other
Educ ation Hous in g Transport
Managers
Co-workers
Teachers
Primary education
Vocational training
Further school
Professional programs
Housing quality Local Access to open spaces housing authorities Access to transport Access to community resources
Landlords
Housing Authorities
Ar ts, Culture, S p o r ts, R ec reat i on
Commun it y
Community volunteers
Social Networks Community groups
National mental health support and advocacy groups
Parenting Per s on al
Parents
Friends
Family Burden Spouse - Children
Social Supports
Extended family 12
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Systems maps
Wellbeing at work – conceptual overview
Economic environment
Global
Workplace environment
Deregulation
of the labour market
Governance
Participation and control
Age Discrimination Act
Lack of participation in decision-making Lack of control over work methods, workplace, work schedule
Country Ageing workforce Immigration
Region
Organisation
Managerial competence Selection, Training, Feedback, Reward and Punishment
Regulatory environment
Career development Boring, monotonous tasks Lack of variety in the job Under utilisation of skills and abilities Unpleasant, aversive tasks
Discrimination (age, race, sex) Lack of promotion potential Under- or over-promotion Work of “low social value” Unfair performance evaluation
Managers
Workload and workplace
Regulations and directives
Identity / Status / Role
Organisation-focused stress management Active involvement Careful analysis of specific problems Quality implementation Focused on: Early diagnosis Empowerment Effective delegation Better people management Flexible work arrangements Job redesign
Techno-stress
Perception of stress Coping abilities Affective style Locus of control
Constant change
tis
f
io ac t
n
Sophistication and Customers demands
Str
ess
Reverse causation?
Mood contagion
Wo rk s ati s fac ti o n Co-workers
Low support
Li fe s ati s fac ti o n Elderly dependents
Inflexible work hours Long hours Mandatory overtime Unpredictable hours Rotating shift schedules
Relationships Belonging Fulfilment Wellbeing Flourishing
Dual earner couples
Young dependents
Negative Wellbeing: Nervousness Irritability Anxiety Depression Hostility Fatigue Sleep problems Poor nutrition Substance abuse Lack of exercise
Burnout Low morale Helplessness Alienation Job dissatisfaction Work-family conflict Absenteeism High turnover Early retirement
Commuting
Parents and Partner extended family
Working Time regulations
Work
Children
Social Supports
The current structure of work is often at odds with people’s needs and aspirations
Friends
£
Micro-economic costs
£
Medical and employee liability Employee Assistance programmes Health and lifestyle programmes
Community groups
Nutrition Exercise Sleep
Absenteeism Presenteeism (80% of lost productive hours?) Sick leave Early retirement Turnover costs Resistance to change Interpersonal conflict Violence Damage to equipment Grievances, disputes and compensation Decreased productivity – due to accidents and errors Decreased performance and productivity Decreased quality of products or client service Loss of company reputation Loss of intellectual capital
Prevalence: 30-39% of the workforce
Active leisure Active ageing Work-family conflict
Macro-economic costs
(and unemployment is positively dangerous)
Leisure options – access and cost of
Hours / Schedule
£
Organisational stress outcomes:
Individual
Social – Spatial – Temporal
Physical health consequences Environmental consequences Wellbeing consequences: Reduce depression and anxiety Produce positive moods Enhance self-esteem and self-concept Facilitate social interaction Increase general psychological wellbeing and life satisfaction Improve cognitive functioning
Person-focused stress management Relaxation techniques Progressive muscle relaxation Meditation / Mindfulness Biofeedback Cognitive behavioural skills training 1. Identify triggers 2. Analyse stress response 3. Modify response Specific training Assertiveness Conflict resolution Problem solving Time management Anger management
Health circles Participatory Action research
Home / Family / Community / Leisure
Work–life balance
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Excitement Challenge Creativity Identity Meaning
Stress = High demands + Low support + Individual susceptibility
ICT: Information / Communications Technology
Diversity
Social support and relationships
Sa
Individual susceptibility
Technology
Lack of support from supervisor Lack of support from co-workers Isolated or solitary work Inadequate conflict resolution Bullying, harassment, violence Fear of bullying Perceived safety
Positive Wellbeing:
I n d i v id idual rre e s o ur u ces ce es es
Power
High demands
Ambiguity about one’s role Conflicting roles in the job Responsibility for people Boundary roles (customer contact)
A happy workforce is a productive and competitive workforce?
Hyper-competition Constant change Intensification of work Mergers Restructuring Offshoring Downsizing Outsourcing
Job Insecurity
Work conten t Too much or too little work Understaffing Time/Deadline pressures Inadequate tools or equipment Machine-pacing of work Physical environment
Economic outcomes
Service work Knowledge work
Organisation climate Skill utilisation and variety
Worldwide production and financial markets Global flow of information Networking across cultures
Demographic shifts Compassion Trust Respect Mutual support Participation Delegation Communication Role clarity Conflict management Performance appraisal Enhance worker potential Manage by praise and reward
Managerial style
Environmental sustainability
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Systems maps
Stress at work – influence diagram
Access to career counseling
Availability of meta-skills (networking)
Gender/Agebased limitations to acquire skills
Ability to self-manage career
Employee’s commitment to learning
Employability
Speed of habituation
Ability to retool business model
Peer pressure to consume Household spending level
Ability to satisfice
Gap between ability and time available to consume
Pressure to move into knowledgeintensive markets
Female labour participation
Pressure for profits
Number of dual earner families
Pressure to differentiate
Viability of work-life balance
Work-family conflicts
Time to spend within family
Number of people putting in more than 48hr weeks
Level of environmental stress
Perceptions of opportunities for optimal experiences in daily life
Ability to opt out of continuous fast-paced work
Work intensification Absenteeism
Quality of social relationships
Spread of flexible work arrangements
Perceived control over work context
Desire for part-time work Employee desire for flexibility (when? where?)
Job insecurity
Discrimination and harassment
Number of type II violent incidents
Bullying
Stres s at wo rk
Number of type III violent incidents at work
Immigration
Cultural diversity of work environment
Understaffing
Prevalence of “face time” ethos
Commuting time
Outsourcing
Worker flexibility
Teamwork
Globalisation
Spread of labour markets
Downsizing Spread of performance management
Overtime work
Time spent on physical exercise
Spread of commodity/ financial markets
Pressure to maximise productivity
Pressure to reduce costs
Ability to use lunch break entitlements
Time and energy to participate in non-work activities
Physical health and fitness
Spread of ICT
Flow rate of information
Speed of margin erosion
Competitive pressure
Health & safety incidents
Ability to use holiday entitlements
Caring responsibilites
Cross-over of work-family conflicts
Role of knowledge in value creation
Scope for automation of tasks
Consumer sophistication Womens’ aspirations
Cost and time to build up competence
Shareholder expectations
Exposure to commercial messages
Need for income
Scope of reward systems
Willingness to invest in employee skills
Willingness to recruit highly educated workforce
Employee turnover
People’s desire and ability to consume
Ageing of society
Exposure to training
Income inequality People’s decision horizon
Number of older workers
Resistance to change
Ability to use technology to achieve goals
Intellectual stimulus Personal consideration
Desire to reduce stress
Quality of management
Quality of physical work environment
Customer relationship and loyalty
Fit with personal ambitions
Ability to deal with stress Perceived negative career impacts of flexible work arrangements
Employee relationship and loyalty
Quality of relationships Organisational support for flexible work arrangements
Relaxation and cognitive behavioural skills
Task content and variety
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Systems maps
Appendix A: Structure of the Project reports and supporting papers
Mental capital through life: Future challenges SR-E1: Neuroscience of
education
SR-E17: Nutrition, cognitive
wellbeing and socioeconomic status
SR-E2: Human reward SR-E3: Neuroeconomics SR-E4: Cognitive reserve
SR-E18: Nutrition and
cognitive health
SR-E20: Effect of chronic
Mental Capital and Wellbeing: Making the most of ourselves in the 21st century Final Project Report
Learning through life: Future challenges
Mental health: Future challenges
Wellbeing and work: Future challenges
Learning difficulties: Future challenges
Cross-Project papers
SR-A2: Learning at work
SR-B1: Genetics and
SR-C1: Workplace stress
SR-D1: Specific language
SR-X2: Science of wellbeing
SR-A3: Skills
social factors
SR-A4: Participation in
SR-B2: Mental health
SR-A5: Evidence-informed
SR-B3: Positive mental health
learning
of older people
principles from the SR-B4: Mental disorders SR-E5: The adolescent brain stress on cognitive Teaching and Learning in the young function through life SR-E6: Behavioural economics Research Programme SR-B5: Prisoners SR-E21: Depression and its toll SR-A7: Estimating the effects SR-E7: Resilience SR-B6: The homeless on mental capital of learning SR-E8: Adolescent drug users SR-B7: Children in local SR-E22: Fitness and cognitive SR-A9: Self-regulation and SR-E9: Pharmacological authority care training executive function cognitive SR-B8: The costs of mental SR-E24: Effects of exercise on SR-A10: Lifelong learning enhancement disorders cognitive function and across the world SR-E10: Stem cells in neural mental capital SR-B9: Serious and enduring regeneration and SR-A11: Non-cognitive skills mental illness SR-E25: Technology solutions neurogenesis SR-A12: F uture technology to prevent waste of SR-B10: Personality disorders SR-E11: Early detection for learning mental capital of mild cognitive SR-B11: Violence SR-E27: Housing as a impairment and SR-B12: Ageing determinant of Alzheimer’s disease: SR-B13: Migrants mental capital An example using the CANTAB PAL SR-B14: Substance abuse SR-E29: Cognitive neural SR-E12: Anxiety disorders
SR-E13: Neurocognition and
social cognition in adult drug users
SR-E14: Normal cognitive
ageing
SR-E15: Social cognition in
teenagers – inclusion
SR-E16: HPA axis, stress, and
sleep and mood disturbance
prosthetics
SR-E31: Cellular and molecular
logic of neural circuit assembly
SR-B15: Depression
impairment
SR-C2: Mental wellbeing at
work and productivity SR-D2: Dyslexia
SR-C3: Management style
and mental wellbeing at work
SR-C4: Flexible working
arrangements and wellbeing
SR-C6: Stress management
and wellbeing
SR-C7: Working longer SR-C8: Leisure: the next
25 years
SR-C9: Training in the
workplace
SR-C10: Careers SR-C11: Violence at work
wellbeing
SR-X5: Neural circuit
SR-D4: Dyscalculia
DR-1: ICT as a driver of
SR-D5: Deafness SR-D7: Genetics and
diagnosis of learning difficulty
SR-C5: New technology and
wellbeing at work
SR-X3: Neurobiology of
SR-D3: Adult learning
disabilities
S1: Systems maps
assembly change
DR-2: Physical environment
and wellbeing
ER-1: Ethics
SR-D8: Conduct disorder
and anti-social behaviour
SR-D9: Social cognition and
school exclusion
SR-D10: Autism and autism
spectrum disorders
SR-D11: Attention Deficit
Hyperactivity Disorder
SR-D12: New technologies and
interventions
SR-D13: Trajectories of
development and learning difficulties
SR-D14: Early neural markers
of learning difficulty
SR-D15: Childhood depression SR-D16: Eating disorders
Note 1: Some reference numbers were assigned to topics; however, the reports/papers were not subsequently commissioned. Note 2: The Project commissioned some additional “discussion papers” as referred to in the text of the final report. These will be made available through www.foresight.gov.uk in due course.
15
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All the reports and papers produced by the Foresight Mental Capital and Wellbeing Project may be downloaded from the Foresight website (www.foresight.gov.uk). Requests for hard copies may be made through this website.
Printed in the UK on recycled paper with a minimum HMSO score of 75 First published October 2008. The Government Office for Science. Š Crown copyright. URN 118-08-Fo/b.
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