Person-centered public health promotion: an overview and a plea

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Wolfgang Rutz


The Definition of Health of the World Health Organisation (WHO) has traditionally focused on individual health as a human right, defined not only by the absence of symptoms, disorder and disease, but also including a state of continuous and balanced mental- and physical wellbeing [1]. Today, increasingly holistic approaches in medicine are concerned to integrate physical, mental, psychosocial and existential factors and to focus additionally on salutogenesis and resilience, even on happiness [2]. Over the last few decades, the WHO has summarized the global research evidence on mental health and mental wellbeing and has identified the following determinants of health as necessary for the maintenance of health and the avoidance of illness [3]: (i) a state of control: not to be helpless, to be in charge of and execute mastery in one’s own life; (ii) a sense of existential cohesion and meaning:  to experience an individual context of meaning and sense and to find individual and feasible ways to live according to this experience; (iii) a feeling of social connectedness: to feel socially connected and related, to experience the feeling of being needed and to be supported by others when needing help, to have someone to care for and  to be cared for by and (iv) a feeling of “caseness” - being a person and identity of one’s own:  this involves feelings of integrity, identity, dignity, being respected and the absence of alienation. It is here that person-centred public health and community approaches, focussing on regions or populations at risk, have to investigate and elucidate these four dimensions for each person or population at risk.In this article, the often complex patterns of specific vulnerabilities will be described, specific assets and strengths as well as specific etiological causalities analyzed and some different individual salutogenic or pathogenic health causalities and consequences  in different populations discussed, in order to elucidate an underlying basis for actions and interventions on a demographic level.

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Author Biography

Wolfgang Rutz, University for Applied Sciences of Coburg (Germany); Public and International Mental Health, Karolinska Institutet, Stockholm

Dr Rutz is Professor of Social Psychiatry at the University for Applied Sciences of Coburg (Germany) as well as Senior Advisor for Public and International Mental Health, based in Stockholm. He is chairman of the International Advisory Committee of the German network on Suicide Prevention and Vice Chairman of the World Psychiatric Organisations (WPA) Section for Psychiatry and Policy. Dr Rutz is Member of the Board of the Swedish Social Psychiatric Forum and head of its international secretariat as well as member of the board of the Swedish Family Association of Suicide Prevention (SPES) and its scientific advisor. 1976 to 1998 Director of the Mental Health and Psychiatric Services in the County of Gotland, Sweden. During this time Dr Rutz headed the professional and structural development of the mental health services on Gotland towards deinstitutionalisation, professionalisation and community based mental health to become one of the model organisations both in Sweden and internationally. He acquired his Doctorate of Philosophy at the University of Linköping, Sweden, with a dissertation about the “Gotland Study”on suicide prevention by the involvement and education of General Practitioners.During the 90s he became Vice Chairman of the Swedish Psychiatric Assocoation and President of the Swedish Society for Biological Psychiatry.From 1998 to 2005 Dr Rutz was recruited as WHO European Regional Advisor for Mental Health and Director of WHO's European Program for Mental Health at its European office in Copenhagen.After his retirement from WHO and United Nations he was Head of the Department for Psychiatry and Health Promotion at the Academic University Clinic of Uppsala from 2005 to 2009. 


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