Good mental health requires more than the mere absence of a mental illness, argued sociologist Corey Keyes, PhD, during a presidential invited address at APA's 2005 Annual Convention. People aren't necessarily functioning well just because they don't have major depression or another mental illness, he said.

"There really is a thing called emptiness, being devoid of any feeling toward your life...but not being mentally ill," said Keyes, an associate professor of sociology at Emory University in Atlanta who measures mental health by evaluating people's positive feelings toward their life and their social and emotional functioning.

Keyes emphasized the need for health-care providers and public health officials to move beyond just preventing and treating mental illnesses to promoting mental health--or flourishing. Flourishing happens when people feel high levels of emotional, psychological and social well-being, which can result from experiencing vigor and vitality, self-determination, continuous self-growth, close relationships and a purposeful and meaningful life, Keyes said. Flourishing adults tend to miss fewer days of work, experience fewer physical health problems, such as cardiovascular disease, and are more productive at work than people who are not flourishing, according to Keyes's research.

However, only about 18 percent of adults fit Keyes's criteria for flourishing. Most adults fall in the category of "moderately mentally healthy"--they aren't flourishing but they don't have a mental illness either. And one step below that, 10 percent of adults are languishing. These adults feel empty or devoid of emotional, psychological and social well-being, but they don't have a mental illness. Some of these findings appear in the June issue of APA's Journal of Consulting and Clinical Psychology (Vol. 73, No. 3, pages 539-548).

Anything less than flourishing is associated with higher levels of developing mental illnesses such as anxiety and depression, Keyes has found. For example, in a sample of children, he found that 10 percent of those considered "languishing" reported depressive symptoms. Meanwhile, 3.9 percent of "moderately mentally healthy" children reported depressive symptoms, and just 1.4 percent of "flourishing" children supported them.

"This raises serious questions about what we should be doing [as health-care providers]," said Keyes, author of "Flourishing: Positive Psychology and the Life Well-Lived" (APA, 2003). "We need to promote health at the same time that we are preventing and treating illness."