"We often look for pathology by associating the terrible things that people have been through with the inevitability of being mentally ill... but there’s a difference between distress and having a disorder."

Dr. Clare Pain

Promotion and prevention should consider individuals within the context of multiple levels of nested systems—an ecological framework—that affect an individual’s life (Brofenbrenner, 1977; Centers for Disease Control and Prevention, 2022). The individual is at the center, with the other systems and agents working around them to help determine and model behaviour, understanding and development (Brofenbrenner, 1977; Strader et al., 2000; Centers for Disease Control and Prevention, 2022).

Individual wellness

Microsystem

Macrosystem

Ecosystem

Mesosystem

These patterns can operate directly or indirectly to influence mental health development, understanding and outcomes (Brofenbrenner, 1977). As a result, working with the individual alone to promote well-being and prevent mental health problems and illnesses may be insufficient.

Health care systems and leaders emphasize early intervention as a means to reduce health care costs and improve treatment maintenance and recovery. It is therefore important to factor in the macro, meso and micro systems that affect individuals’ lives. One potential way to support early intervention at a level beyond that of the individual is by developing communities and establishing community partnerships.

It is important to recognize that community engagement is a process, not a program (Centre for Addiction and Mental Health [CAMH], 2015; National Collaborating Centre for Determinants of Health [NCCDH], 2013). The participation of program developers and community members in assessing, planning, implementing and evaluating solutions affects the community itself (CAMH, 2015; National Institute for Health and Care Excellence [NICE], 2016; Winnipeg Regional Health Authority [WRHA], 2017).