1. GOVERNMENT POLICIES AND
POPULATION MENTAL WELL-BEING
Dora Gudmundsdottir, Directorate of Health in IcelandHealth in all
policies,

2. What you measure affects what you
do...
…if you don´t measure the right thing,
you don´t do the right thing.“ Joseph
Stiglitz, 2009
 Governments measure progress by
economic indicators such as Gross Domestic
Products

3. GDP increases with
 Each sale of antidrepressant medication
 Each divorce pronounced
 Each prison built
 Air pollution
 Cigarette advertising
 But NOT
„the health of our children, the quality of their
education, or the joy of their play. It does not get
the beauty of our poetry or the strength of our
marriages......it measures everything, in short
except that which makes life worthwile“ Robert
Kennedy, 1968

4. GDP and Happiness in USA 1945-1991
GDP per capita
Happiness

5. The focus in public policy
 Economy growth
 Health
 How do we get health on the agenda: Health in all
policies?
 Mental health
 How do we get mental health on the agenda?
 Happiness
 Economists are more interested than mental health
specialist
 Well-being or Mental well-being
 Is it easier to get well-being on the agenda?

7. Shifting the Wellbeing Bell Curve
of a Population

8. Too much focus on economic
growth
 Led to the collapse of the
whole economic system
in Iceland in October
2008
 which led to the biggest
financial crisis in the
country since 1929

9. What happens in a society where:
 Unemployment increases
 Exchange rate of the currency falls
 Income decreases
 Purchasing power decreases
 debt increases
 All in a month?

10. At that time
 There was an opportunity to shift the focus
 Welfare, Mental Wellbeing, Equity and Social
Indicators

11. The Welfare Watch
 Watch out for the basic services provided
by the state and local authorities
 Put special emphasis on assistance to
vulnerable groups
 Developed social indicators
 Demographics
 Inequality
 Sustainability
 Health
 Cohesion

12. 14. júní 2013
“Young people in action”
 To avoid that young people become permanently stuck
outside the labour market
 All young people (16 – 25 years) who have been
unemployed for 3 months or longer get special
assistant.
 Now 90% of them is active (work, programs and
schools)
 Each summer around 800 new jobs have been offered
to students and persons receiving unemployment
benefits.
 Young students and some of the unemployed are now
actively working in a variety of jobs for the local
authorities and the state.

13. Iceland 2020 – a governmental policy
statement focusing on:
 Knowledge, sustainability, welfare
 Mental wellbeing where the aim is:
 To improve wellbeing and sound mental
health so that the average measurements on
the mental wellbeing index rise from 26,6 in
2009 to 28

14. Ensuring an impact on policy-
makers and policy
 The decision to measure mental wellbeing at the
national level affected both health and whole-of-
society policies.
 The mental wellbeing measures are used
as an indicator in
 Health 2020 for Iceland
 “Iceland 2020”, led by the Prime Minister

15. Impact of the crises on mental well-
being
 Good social relationships – the quality
of relationships with family and
friends, along with the amount of time
spent with family – predict happiness.
 Despite the crises there was an increase in happiness
among adolescents
 Difficulty making ends meet is the strongest predictor of
unhappiness.
 The population subgroups that find it difficult to make ends
meet are not the same as the unemployed or those in the
lowest income group.
Gudmundsdottir, D. (2013). The Impact of Economic Crisis on Happiness. Social Indicators
Research, 110(3), 1083-1101.

16. Planning for the future
It is of importance to have good measures for
mental wellbeing on a population level
 indicators of mental wellbeing are now used to
monitor policies in Iceland, where several actions
aim to increase mental well-being.
 Even in times of austerity, there is an opportunity
to strengthening mental wellbeing by public
policies

17. THANKS
p.s.
….if we measure the right thing,
we might end up doing the right thing

18. Thank you

19. 5 ways to wellbeing (5 a day)
- a public health message – popular publication
 In 2008, nef was commissioned by the UK
Government’s Foresight Project on Mental
Capital and Well-being to review the inter-
disciplinary work of over 400 scientists from
across the world. The aim was to identify a set
of evidence-based actions to improve well-
being, which individuals would be encouraged
to build into their daily lives.
 Evidence suggests that a small improvement
in wellbeing can help to decrease some
mental health problems and also help people
to flourish

22. Thank you

23.  What you focus on – gets more attention
 What you measure – gets more attention
 We´ve been measureing economic factors for
a long time
 Gross domestic product (Gross national
income)
 Gross happiness

24. Wealth and well-being
UK - GDP and Life Satisfaction 1973 - 2002
0%
20%
40%
60%
80%
100%
120%
140%
160%
180%
200%
1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001
GDP
Life Satisfaction
Source: Eurobarometer

25. 14. júní 2013
Focus on Vulnerable Groups
 Sensitive families with young children: single
parents, the handicapped, the chronically ill, the
disabled, old people living in poverty, immigrants, the
unemployed and those who depend on social
assistance from the local authorities for their survival.
 The populatin of Iceland is quite young: children are ap.
25% of the nation. 7.800 children live in families that are
below the poverty at risk rate, that is 10% of the
icelandic children.

26. Main focus on economic growth
 Led to the collhas been one of the richest and
happiest countries in the world for decades

27. 6 steps linking assessments and
interventions to improve well-being
3. Ensuring the assessment responds to
the current context
 When its banking system collapsed in
October 2008, Iceland’s public health
authorities decided to conduct a new
study to assess the impact of the economic crisis
on Icelanders’ well-being.
 The protocol included the single measure of
happiness, WEMWBS and PSS.

28. 6 steps linking assessments and
interventions to improve well-being
2. Selecting methods and processes, including stakeholders, and gathering
information
 When the Public Health Institute of Iceland (which was incorporated into the Directorate of Health in 2011)
decided to implement a national survey on health and well-being in 2007, a module on well-being therefore
126 needed to be constructed. A group of experts was convened to decide what to include from measures
already published:
 a single measure of happiness;
 the WHO-Five Well-being Index (WHO-5);
 Satisfaction With Life Scale (SWLS) created by Diener et al.
 a short version of the Perceived Stress Scale (PSS) created by Cohen et al.
 the short version of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) created by Stewart-
Brown et al., which was translated specially for this purpose and has since been used as the main
measure on well-being within public policy.
 All these measures were included in the health and well-being study in 2007
 which was repeated in 2009 and 2012.
 The second and third rounds added further scales, including the Meaning in Life Scale by Steger & Samman
and new well-being questions based on Huppert & So’s conceptual framework for defining well-being.

29. How did the crises impact well-
being
4. Presenting and communicating the results
 An analysis of the impact of the economic crisis in Iceland, using
data from studies on both health and wellbeing and economics
and well-being, documented the findings (Gudmundsdottir).
 An open seminar presented the results, including a panel
discussion with the Minister of Welfare and the studies’ project
leader. The panel discussed the kind of society that would
increase well-being in the population, and highlighted the
following points:
 Good social relationships – the quality of relationships with
family and friends, along with the amount of time spent with
family – predict happiness.
 Difficulty making ends meet is the strongest predictor of
unhappiness.
 The population subgroups that find it difficult to make ends
meet are not the same as the unemployed or those in the
lowest income group.
 The results and the reaction from the Minister received
extensive attention from the mass media (newspapers, radio

30. Aims for health and well-being by 2020
 To improve wellbeing and sound mental
health so that the average measurements on
the mental wellbeing index rise from 26,6 in
2009 to 28
 To reduce the percentage of people (aged 18-66) with
disability from 7.3 % of the population to 5.7%
 To reduce the unemployment rate from 7% in 2010 to
3%
 To achieve greater equality in Iceland, by lowering the
Gini coefficient for disposable income to around 23
 To narrow the gender gap in order to bring the Global
Gender Gap Index close to 0.9

31. Social indicators were
developed
 Demographics
 Inequality
 Sustainability
 Health
 Cohesion