Positive mental health levels
flourishing, languishing, moderate mental health
Psychological distress

How to Cite



OBJECTIVE: The current research aimed to investigate prevalence of mental health states (positive mental wellbeing levels) across professional groups, working in diverse work settings in indigenous context.

METHODS: This Cross-sectional study was conducted at public tertiary care hospitals (Jinnah hospital Lahore, combined military hospital, telecommunication companies (Warid, Telecom, Telenor, Multinational firms, consultancy firms, Askari, bank, Muslim Commercial Bank located at Islamabad and Lahore (Pakistan)from February  2016 to December 2016. Data was collected through purposive sampling technique. The present research employed mental health continuum Short form (MHC-SF) and Brief symptom inventory (BSI) for measuring positive mental wellbeing levels and psychological distress (complete mental health).Data from (N=509) professionals working in Health care, telecom, Consultancy companies had been collected.

RESULTS: Descriptive statistics revealed satisfactory psychometrics of MHC-SF (α=.86) and BSI (α=.97) and its subscales. Analysis of Variance was computed for analyzing mean differences on positive mental health and psychopathology among health care professionals and other professional categories. Findings revealed significant mean differences for social wellbeing somatization, interpersonal sensitivity and paranoid ideation subscales of BSI. Moreover, mental health levels i.e. flourishing, moderate and languishing mental health among professional categories were also computed. Health care professionals had shown lower percentage of flourishing mental health levels as compared to other professional categories.

CONCLUSION: Mental health promotion strategies need to be employed for developing flourishing, productive workforce, for enhancing positive mental health rather than focusing solely on mental illness and psychological distress.



Magyary D. Positive mental health: A turn of the century perspective. Int J Ment Health Nurs. 2002 Jan 1; 23(4):331-49. DOI: 10.1080/01612840290052550.

Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J Consult Clin Psychol. 2005 Jun; 73(3):539-48. DOI: 10.1037/0022-006X.73.3.539.

Huppert FA, Whittington JE. Evidence for the independence of positive and negative wellbeing: Implications for quality of life assessment. British Journal of Health Psychology. 2003 Feb; 8(1):107-122.

Keyes CL, Dhingra SS, Simoes EJ. Change in level of positive mental health as a predictor of future risk of mental illness. Am J Public Health. 2010 Dec; 100(12):2366-71.DOI:10.2105/AJPH.2010.192245.

World Health Organization. Mental Health Action Plan for Europe: Facing the Challenges, Building Solutions. Geneva, Switzerland: World Health Organization. 2005

Keyes CL, Shmotkin D, Ryff CD. Optimizing well-being: The empirical encounter of two traditions. J Pers Soc Psychol, 2002 Jun; 82(6):1007-.1022.

Deci EL, Ryan RM. Facilitating optimal motivation and psychological well-being across life's domains. Can Psychol. 2008 Feb; 49(1):14-23. DOI.org/10.1037/0708-5591.49.1.14.

Keyes, C. L. M. The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 2002, 43, 207-222.

Keyes, C. L. M. Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 2005a, 73, 539– 548.

Wang X, Zhang D, Wang J. Dual-factor model of mental health: Surpass the traditional mental health model. Psychology. 2011 Nov 4; 2(08):767. DOI:10.4236/psych.2011.28117.

Keyes CL. Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. Am Psychol. 2007 Feb; 62(2):95- 108. DOI: 10.1037/0003-066X.62.2.95.

Westerhof GJ, Keyes CL. Mental illness and mental health: The two continua model across the lifespan. J Adult Dev. 2010 Jun 1; 17(2):110-119. DOI: 10.1007/s10804-009-9082-y.

Keyes CL. The mental health continuum: From languishing to flourishing in life. J Health Soc Behav. 2002, Jun 43 (1):207-222.

Seow LS, Vaingankar JA, Abdin E, Sambasivam R, Jeyagurunathan A, Pang S, Chong SA, Subramaniam M. Positive mental health in outpatients with affective disorders: Associations with life satisfaction and general functioning. J Affect Disord. 2016 Jan 15; 190:499-507. DOI: 10.1016/j.jad.2015.10.021.

Schönfeld P, Brailovskaia J, Bieda A, Zhang XC, Margraf J. The effects of daily stress on positive and negative mental health: Mediation through self-efficacy. Int J Clin Health Psychol. 2016 Jan; 16(1):1-10. doi.org/10.1016/j.ijchp.2015.08.005

Thompson WT, Cupples ME, Sibbett CH, Skan DI, Bradley T. Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study. BMJ: Br Med J. 2001 Sep 29; 323(7315):728-731. DOI:10.1136./bmg.323. 7315.728.

Dowell AC, Hamilton S, McLeod, D.K. Job satisfaction, psychological morbidity and job stress among New Zealand general practitioners. N Z Med J, 2000 Jul 14; 113(1113):269-72.

Ali BS, Rahbar MH, Naeem S, Tareen AL, Gul A, Samad L. Prevalence of and factors associated with anxiety and depression among women in a lower middle class semi-urban community of Karachi, Pakistan. Prevalence. J Pak Med Assoc, 2002 Nov; 52(11):513-7.

Khuwaja AK, Qureshi R, Andrades M, Fatmi Z, Khuwaja NK. Comparison of job satisfaction and stress among male and female doctors in teaching hospitals of Karachi. JAMC. 2004; 16(1):23-7.

. Atif K, Khan HU, Malik AF. Do doctors have hidden distress; a study conducted at tertiary care hospital at Lahore. JPMA. 2016; 66(63). PMid: 26712184.

Khaula A, Gholamheidar T B Javed, A, Javed, S. Does lack of job satisfaction intensify psychological distress among clinicians, and vice versa? Electron J Gen Med, 2018; 15(5):em82.

Khuwaja AK, Qureshi R, Azam SI. Prevalence and factors associated with anxiety and depression among family practitioners in Karachi, Pakistan. JPMA. 2004 Feb; 54(2):45-9.

Gabriele Gi 1, Giulio A Milda P, Chiara L Ariza-Montes, A, Fiz-Perez, J, Di Fabio A and Nicola Mucci 2* Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences. Front Psychol 8: 2166. DOI: 10.3389/fpsyg.2017.02166

Khuwaja AK, Qureshi R, Andrades M, Fatmi Z, Khuwaja NK. Comparison of job satisfaction and stress among male and female doctors in teaching hospitals of Karachi. JAMC. 2004; 16(1):23-7.

Chatta HA, Zafar A, Amin F. Measurement of Stress among Doctors in Surgical Intensive Care Unit (ICU) of Lahore General Hospital, Lahore. Pakistan Journal of Medical & Health Sciences. 2017; 11 (3):874-7.

Picco L, Yuan Q, Vaingankar JA, Chang S, Abdin E, Chua HC, et al. (2017) Positive mental health among health professionals working at a psychiatric hospital. PLoS ONE 12(6):e0178359.https://doi.org/10.1371/journal.pone.0178359

Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psychol Med, 1983 Aug; 13(3):595-605

Keyes CL, Wissing M, Potgieter JP, Temane M, Kruger A, Van Rooy S. Evaluation of the mental health continuum–short form (MHC–SF) in Setswana speaking South Africans. Clin Psychol Psychother. 2008 May; 15(3):181-92.

Keyes CL, Grzywacz JG. Health as a complete state: The added value in work performance and healthcare costs. J Occup Environ Med, 2005b, May 1; 47(5):523-32.

Keyes CL. The nature and importance of positive mental health in America’s adolescents. Handbook of positive psychology in schools. 2009 Feb 20; 1:9-23.

Lim YJ, Ko YG, Shin HC, Cho Y. Prevalence and correlates of complete mental health in the South Korean adult population. In Mental Well-Being 2013 (pp. 91-109). Springer, Dordrecht.

Keyes CL, Eisenberg D, Perry GS, Dube SR, Kroenke K, Dhingra SS. The relationship of level of positive mental health with current mental disorders in predicting suicidal behavior and academic impairment in college students. J Am Coll Health 2012, Feb 1; 60(2):126-33.

Llena-Nozal A, OECD F. Are all jobs good for your health? The impact of work status and working conditions on mental health. 2008.

Cappelli P, Bassi L, Katz H, Knoke D, Osterman P, Useem M. Change at work. New York: Oxford University Press; 1997.

Robone S, Jones AM, Rice N. Contractual conditions, working conditions, health and well-being in the British household panel survey. Health, Econometrics and Data Group Working Paper. 2008 Jul; 8:19.

Firth J. Understanding doctors’ performance. In: Cox J, King J, Hutchinson A & McAvoy P, editors. A perspective on stress and depression. Oxford: Radcliffe Publishing; 2006.p.22-25.

Baldwin PJ, Dodd M, Wrate RM. Young doctors' health—II. Health and health behaviour. Soc Sci Med. 1997 Jul 1; 45(1):41-4.

Marušič A. Mental health in the enlarged European Union: need for relevant public mental health action. Br J Psychiatry. 2004 May; 184(5):450-1. DOI:10.1192/bjp.184.5.450.

Gopalkrishnan N, Babacan H. Cultural diversity and mental health. Australas Psychiatry. 2015 Dec; 23(6-suppl):6-8.

Rehman, G, Malik, N, Taj, R. (2006) Jan-Jun 3 (1). Psychological wellbeing and work motivation amongst medical professionals. Jr Pak Psych Soc, 2006, Jan-Jun 3 (1). 43-47.