Reflections on Public Health : principles for a person-centred promotion of mental and physical health

Main Article Content

Wolfgang Rutz


Recent public health data, especially those generated in countries in dramatic societal transition and collected in the WHO European “Health for all” database, show clearly that physical and mental health are indivisibly linked and exist in continuous interaction. The parallelism of societal stress and figures of premature mortality show that individual health is interrelated to public health. Therefore, health promotion has to address healthcare at both the individual as well as at the aggregate level. Public health development over years and clarified by health surveys in especially eastern European countries in dramatic societal transition and the  collected research evidence  on the psychosocial determinants of health presented by the World Health Organisation have identified the determinants of health as including a sense of existential cohesion, social connectedness and significance, self governance and the absence of helplessness, as well as individual dignity and integrity. In order to promote culturally and individually these determinants of health, a person-centred approach is demanded, both on an individual level as well as aggregated on a societal level with a focus on at-risk populations. Concrete strategies have to be developed in order to address these identified health determinants differently in different stressful and potentially pathogenic individual or societal environments. Even at-risk populations have to be supported differently, e.g. immigrants, elderly,  males in one type of society, females in another, adolescents, mentally vulnerable or  unemployed persons. Thus, a person-centred way of salutogenic and health promoting action is of incontrovertible significance. A person-centred and societally-engaged psychiatry has here an important role to play – as a pool of expertise and a knowledge base for impact awareness and consequence analysis provided to and needed by political and other decision makers in a society. A person-centred individual psychiatry and an aggregated societal and community focused mental health approach to health promotion appears here to be a human right.

Article Details

Third Geneva Conference on Person-centred Medicine: Institutional, Primary Care and Public Health Perspectives
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. 


WHO (2001). Mental Health: New Understanding, New Hope. The World Health Report. Geneva.

Rutz, W. (2001). Mental Health in Europe. Diversities, possibilities, shortcomings, challenges. The WHO perspective. European Archives of Psychiatry and Clinical Neuroscience 251 (Supplement 2), 113-115.

Mezzich, J.E. (2007). Psychiatry for the Person: Articulating Medicine’s Science and Humanism. World Psychiatry 6, 1-3.

Rutz, W. (2006). Social psychiatry and public mental health – present situation and future objectives. Time for rethinking and renaissance? Acta Psychiatrica Scandanavica 113 (Supplement 429), 95-100.

Rutz, W. (2005). Seelische Gesundheit, Stigma und Ausgrenzung aus Europäischer Perspektive. In: Stigma – Diskriminierung – Bewältigung. (eds. Gaebel, W., Möller, H-J. & Roessler, W.) Stuttgart: Kohlhammer.

WHO Office for Europe (2002, 2004). The Athens Declaration on Mental Health, Stigma and Man made Disaster, Copenhagen.

WHO Office for Europe (1999). Health for All in the 20th century. “The solid Facts” Copenhagen.

DeMarinis, V. (2003). Pastoral Care – existential health and existential epidemiology. A Swedish postmodern case study. Stockholm: Verbum.

Wilkinson, R. (2010). The Spirit level. London: Penguin Group.

Värnik, A. (2010). "Gender, Age and Suicide”. Lecture hold at The International Conference on Social and Primary Health Determinants of Suicide in Eastern Europe. Tallinn, Estonia.

Amering, M. & Schmolke, M. (2007). Recovery – Das Ende der Unheilbarkeit. Psychiatrie-Verlag, Bonn.

Melder, C. A. (2011). The epidemiology of lost meaning. A study in psychology of religion and existential public health in a Swedish context. In Swedish. Acta Universitatis Upsaliensis. Psychologia et sociologia religionum. 25, 305.

WHO Office for Europe (2003). WHO Regional Committee. Conference Paper: Mental Health in Europe. Copenhagen.

Eisenberg, L. (2007). “Psychiatry and Human Rights. Putting the Good of the Patient first”. Juan Jose Lopez-Ibor Award Acceptance Speech. World Congress of Psychiatry. Prague, Czech Republic.

Marmot, M. (2005). Public Health, Social Determinants of Health, Inequalities. Lancet 365 (9464), 1099-1104.