Felicia Ah Huppert

Objectives: Nurses provide care for patients, often putting patients’ needs above their own and there is an urgent need to identify evidence-based ways of supporting both nurse wellbeing and patient care. We evaluated a meditation wellness and compassion intervention and a positive psychology wellness and compassion intervention. Method: We used a randomised controlled trial design (with waitlist control) enhanced by qualitative interviews and patient experience assessments with 247 nurses/midwives and 81 patients from 52 medical/surgical hospital wards. The interventions involved three full-day workshops over 4–6 weeks. The meditation intervention focused on cultivating mindfulness, kindness, compassion and self-compassion. The positive psychology intervention focused on enhancing skills such as goal setting and aligning strengths and values. We used a multi-source, multi-method approach with repeated measures to provide a comprehensive evaluation of both interventions. Results: Improvements in the nurses’ wellbeing and self-compassion were found for both interventions, compared to a waitlist control, with the meditation intervention also reducing avoidance of uncomfortable experiences. All improvements were maintained at 6 months. Nurses’ practice of techniques was associated with better outcomes. Patients of nurses in the meditation intervention reported greater compassionate care, whereas patients of nurses in the positive psychology intervention reported greater confidence in care. From interviews we found a focus on physical wellbeing and greater awareness of the body in the meditation intervention and a focus on knowledge and skills in the positive psychology intervention. Conclusion: There is evidence to support both wellbeing and compassion interventions, and integrating the two may be an effective way forward. Preregistration: The study was pre-registered with Australian and New Zealand Clinical Trials Registry (ACTRN12617000677303).

When people hear the word ‘health’, they almost invariably think of medical conditions and the treatment and prevention of disorders. In this chapter, however, we focus on what leads to good health and wellbeing, examining the individual and social determinants of good physical and mental health. Individual factors associated with good health and longer life expectancy include positive emotions and positive attitudes; having a sense of autonomy, competence, and meaning; and above all, having close social connections. We show that the mind and body always interact – physical health has an effect on mental states, and our mental states effect our physical health and physiology. We show how both physical states and mental states such as stress can be improved through the foundational skills of mindfulness and compassion towards ourselves and others. Research on the social determinants of health shows populations are healthier when there are low rates of insecurity, inequity, and deprivation, and people can play a full and useful role in their society's economic, social, and cultural life. Taking a whole of society approach to health, and engaging the public in the co-creation of health, are approaches that can optimise health for all.

Taking a whole-population perspective, the chapter argues that improved well-being is the most important outcome of policy. Despite growing awareness of its importance, accepting the primacy of well-being has been a challenge within public mental health because there has been no uniform definition or measure, nor consensus on how to apply such a subjective concept across diverse populations. Confusion created by using terms such as happiness, or the continuing tendency to equate mental well-being with lack of mental illness, have created barriers to gaining widespread agreement on the importance of well-being in policy. In this chapter, historical approaches to defining well-being, issues of measurement, and evidence underpinning well-being interventions are explored. The chapter closes with a proposal on how best to consider well-being as an outcome, making use of the evidence in driving public mental health policy.

Empirical urban design research emphasizes the support in vitality of public space use. We examine the extent to which a public space intervention promoted liveliness and three key behaviors that enhance well-being (“connect,” “be active,” and “take notice”). The exploratory study combined directly observed behaviors with self-reported, before and after community-led physical improvements to a public space in central Manchester (the United Kingdom). Observation data (n = 22,956) and surveys (subsample = 212) were collected over two 3-week periods. The intervention brought significant and substantial increases in liveliness of the space and well-being activities. None of these activities showed increases in a control space during the same periods. The findings demonstrate the feasibility of the research methods, and the impact of improved quality of outdoor neighborhood space on liveliness and well-being activities. The local community also played a key role in conceiving of and delivering an effective and affordable intervention. The findings have implications for researchers, policy makers, and communities alike.

Background: Mindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have evaluated their effectiveness among young people.Aims: To assess the acceptability and efficacy of a schools-based universal mindfulness intervention to enhance mental health and well-being.Method: A total of 522 young people aged 12–16 in 12 secondary schools either participated in the Mindfulness in Schools Programme (intervention) or took part in the usual school curriculum (control).Results: Rates of acceptability were high. Relative to the controls, and after adjusting for baseline imbalances, children who participated in the intervention reported fewer depressive symptoms post-treatment (P = 0.004) and at follow-up (P = 0.005) and lower stress (P = 0.05) and greater well-being (P = 0.05) at follow-up. The degree to which students in the intervention group practised the mindfulness skills was associated with better well-being (PP = 0.03) at 3-month follow-up.Conclusions: The findings provide promising evidence of the programme's acceptability and efficacy.