1 The Place of Wellbeing in Health Promotion and Education Agendas
Wellbeing is a complex concept. Although a universal definition of wellbeing does not exist, there is a consensus that it is a multidimensional construct that comprises psychological, social, and emotional dimensions. One frequently cited definition has been proposed by Diener (2000), who defined subjective wellbeing as people’s cognitive and affective evaluations of their lives. Life satisfaction, positive affect, and low levels of negative affect are the main components of this concept (Diener, 2000). According to the World Health Organization (WHO), wellbeing is an integral part of mental health, which is defined as ‘a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community’ (WHO, 2013b, p. 38).
Wellbeing is increasingly included in global health promotion policy agendas and strategic documents. The Health 2020 strategy (WHO, 2013a) and the Mental Health Action Plan 2013–2020 (WHO, 2013b) are good examples of the strong commitment with the promotion of wellbeing in the current health policy context. The vision statement of the Health 2020 strategy includes ‘[…] that all people are enabled and supported in achieving their full health potential and wellbeing’ (WHO, 2013a). Wellbeing has also been presented as one of the key targets and an essential pillar of successful societies (WHO, 2013a). Furthermore, wellbeing also features prominently in the Mental Health Action Plan, whose overall goal is ‘to promote mental wellbeing, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity, and disability for persons with mental disorders’ (WHO, 2013b, p. 9). Importantly, this document makes it clear that mental health policies and programmes should not only focus on persons with mental disorders but also promote the mental wellbeing of all citizens (WHO, 2013b).
In addition, both Health 2020 and the Mental Health Action Plan have underscored the importance of promoting environments that nurture health and wellbeing. This is in line with a healthy settings approach, which can be traced back to the Ottawa Charter. Health 2020 considers schools to be an example of one such healthy setting, which is defined as ‘the place or social context in which people engage in daily activities and where environmental, organisational, and personal factors interact to affect health and wellbeing’ (WHO, 2013a, p. 48). One of the clearest articulations of the important role of schools that have been inspired by the healthy settings approach is presented in Box 1.1.
Box 1.1 School as a Key Social Setting for the Promotion of Health and Wellbeing, as Described in the Health for the World’s Adolescents Report
Among all the sectors that play critical roles in adolescent health, education is key. Not only is education important in itself, but schools are also a setting where adolescents can receive skills-based health education and, sometimes, services. Furthermore, the social environment or ethos of the school can contribute positively to physical and mental health. It is in the interest of the education sector for adolescents to be healthy, because they are better able to learn and benefit from their years in school. (WHO, 2014, p. 8)
Important initiatives that have been informed by the aforementioned settings approach have been introduced in schools to promote the health of children and adolescents. A notable example of such initiatives is the Health Promoting Schools framework. However, these interventions have primarily aimed to promote healthy lifestyles and prevent risk behaviours and bullying (Langford et al., 2014). Thus, a more holistic approach towards the promotion of wellbeing is essential.
With regard to educational policy agendas, the Europe Cooperation Framework in Education and Training (ET 2020) states that education is an investment in human capital that is key for ‘promoting personal fulfilment, social cohesion, and active citizenship’ (Council of the European Union, 2009). However, the four strategic objectives that have been established within this framework do not explicitly mention wellbeing. Wellbeing is mentioned twice in the 2015 ET 2020 Joint Report ‘New priorities for European cooperation in education and training’ (Council of the European Union and European Commission, 2015). First, wellbeing is mentioned in the description of one of the new priority areas, but it is not elaborated upon when this priority is developed into concrete issues that necessitate cooperation. Second, measures to support the wellbeing of students are recommended as part of early school leaving policies; however, the aim is reducing early school leaving (rather than supporting wellbeing). Although the mentions of wellbeing in ET 2020 can be regarded as a step in the right direction, these references are quite peripheral when compared with the aforementioned health policy documents.
Encouragingly, there have been a few less timid mentions of wellbeing in the discussion of cooperation areas for creating better schools. Specifically, it has been contended that diverse forms of school violence undermine students’ wellbeing, and wellbeing has been explicitly mentioned as an important prerequisite for learning to occur (European Commission, 2017). The importance of taking assessments of factors such as school climate and learners’ wellbeing into consideration has also been underscored. A perusal of the successive reports of the Programme for International Student Assessment (PISA) indicates that there has been a gradual increase in the attention that has been paid to wellbeing. In PISA 2012, wellbeing was taken into consideration only as a prerequisite for learning (OECD, 2013). In contrast, in more recent editions of PISA (OECD, 2017, 2019), wellbeing is considered to be both a precursor of learning and an important learning outcome. Indeed, an entire volume (volume III) has been devoted to the topic of students’ wellbeing in both PISA 2015 and 2018 (OECD, 2017, 2019). Despite that, when PISA results are published, academic performance indicators continue receiving much more attention than wellbeing. Therefore, there is a need for serious advocacy efforts that can ensure that wellbeing is recognised as an important indicator of education quality, and that it receives as much attention as academic performance.
In summary, an inspection of recent policy documents suggests that wellbeing is a top health policy priority, and it is increasingly included in educational agendas. The current policy context can create opportunities for additional efforts that can promote wellbeing in schools. Nevertheless, there still is a long way to go in this area, and the following aspects require attention:
- It is important to emphasise a holistic approach, and attention to wellbeing should not merely be confined to efforts to respond to potential threats to students’ wellbeing. It is of paramount importance that those reactive measures are combined with strategies that decisively aim to actively promote wellbeing.
- The status of wellbeing needs to change. Wellbeing needs to be acknowledged as an outcome that is desirable in its own right and as an essential indicator of the quality of our educational systems.
- A more complex understanding of the associations between learning and wellbeing is needed. As discussed earlier, wellbeing is often regarded as a prerequisite for learning. Therefore, the bidirectionality of the associations between learning and wellbeing is not sufficiently acknowledged.
In addition, to ensure that the increasing acknowledgement of wellbeing in policy documents extends beyond mere tokenism, efforts to integrate health and education agendas need to be maximised. In other words, the belief that ‘the goal of mental health includes effective schooling and the goal of effective schools includes the healthy functioning of students’ (Atkins, Hoagwood, Kutash, & Seidman, 2010, p. 40) should be translated into practice. Research that provides scientific evidence that can support the process of translating policy goals into more specific actions is important and can help identify the indicators that can be used to evaluate and monitor school int...