New Scale Measures Mental Health Promoting Behaviour

Nearly one in three adults in the Danish population score high on the stress scale, and more than one in ten feels lonely. This is shown by the large survey The National Health Profile 2025. There is good reason to pay attention to the mental health of the Danish population - and now researchers, municipalities, and others working with well-being and mental health promotion have a new tool at their disposal.

Researchers from the University of Copenhagen, together with colleagues from Denmark and Australia, have developed a new scale that can measure the extent to which people engage in behaviours that can benefit their mental health.

Act Belong Commit

The scale was developed and validated as part of the research project the ABCs of Mental Health. This initiative is the first research-based universal mental health promotion initiative that focuses on informing people about how their behaviour can improve or maintain good mental health, as well as supporting professionals in municipalities, associations and other organisations in creating supportive environments that enable as many people as possible to Act Belong and Commit.

These three research-based core messages - Act Belong Commit - are inspired by the Australian initiative of the same name and have spread to Denmark and several other countries. In Denmark, the initiative is led by researchers at the University of Copenhagen, Department of Psychology, who are responsible for the research and have translated and adapted the original messages.

• Act - Do something: Keep physically, mentally and spiritually active. For example, go for a walk, read a book, or set aside time for relaxation and reflection.
• Belong - Do something with someone: Develop a strong sense of identity and belonging by keeping up family relationships and friendships. This could be starting a social dining club, participating in community activities and inviting others to do so, talking to a neighbour, or engaging with colleagues.
• Commit - Do something meaningful: Do things that provide meaning and purpose in life, such as taking up challenges, helping a colleague, supporting a cause, engaging in voluntary work, or going to the theatre or a concert.

In addition to being a research project at the University of Copenhagen, the ABCs of Mental Health is also a national partnership involving nearly 100 organisations, including research institutions, NGOs, municipalities and private companies.

"The idea is to establish a shared language for working with mental health and mental health promotion across disciplines and sectors. It can be applied before people become unwell and need treatment, or among those who already experience mental health problems. It is about strengthening and maintaining mental health, just as we maintain our physical health - even when we are healthy - to prevent poor health and injuries," says senior researcher Charlotte Bjerre Meilstrup.

Nine Questions

The ABCs of Mental Health aims to promote mental health by encouraging and enabling mental health promoting behaviours. It is precisely this behaviour that the researchers' new scale can measure.

The scale consists of nine questions that produce a score indicating the extent to which individuals engage in behaviours that can strengthen or maintain good mental health.

"Many tools for measuring loneliness, stress, and various symptoms of mental health challenges already exist. Here, we are interested in capturing and measuring behaviours that specifically can promote mental health," says senior researcher Line Nielsen.

The questions have been tested in a large national survey involving more than 120,000 adult Danes.

"It is a very large and unique study, and it has been fantastic for us to include our questions and carry out a statistical validation," Line Nielsen adds.

Developed for Research

The research shows a link between mental health promoting behaviour and mental health. According to the researchers, it therefore makes sense to ask about behaviour rather than only focusing on symptoms or people's own perceptions of their mental health.

The results show that individuals who engage weekly in all three types of behaviour - Act Belong and Commit - are approximately 2.5 times more likely to have good mental health compared to those who engage in only one of the three types weekly.

"Just as we can measure whether people smoke, drink, or exercise and examine how it affects their physical health, this scale allows us to gain insight into the extent to which people engage in behaviour that influences their mental health," Line Nielsen explains.

The researchers emphasise that the scale is developed for scientific purposes. It is not intended as a test for individuals to complete and receive a score indicating whether their behaviour is healthy or not.

Instead, the scale can be used as a monitoring and evaluation tool in large-scale well-being initiatives, measuring population behaviour before and after interventions. It also contributes to research on the relationships between mental health promoting behaviour and social and health outcomes, as well as improving understanding of the factors and conditions that promote or hinder such behaviour; insights that can guide public health and prevention efforts.

"In the long term, a scale like this could be included in national health surveys to monitor mental health promoting behaviour in the Danish population. It would also be relevant to further develop the scale so it can be adapted for children and young people under 18," says Charlotte Bjerre Meilstrup.

More Than Behaviour

Mental health is highly complex and is not solely about following the correct ABC behaviours.

"There are many factors that influence our mental health. Behaviour alone is not enough. Major life events and living conditions also play a significant role, and our ability to act depends to a large extent on the surroundings and structures we live in. Mental health is a dynamic process with ups and downs. But if we are thrown off balance, we may recover more quickly if we generally engage in mental health promoting behaviour," says Line Nielsen.