Mental Health Continuum Model (MHCM)

Mental health, like physical health, exists on a continuum. It is a dynamic changing state that can deteriorate or improve given the right set of circumstances. Therefore, mental health concerns, if identified and treated early, have the potential to be temporary and reversible. This model goes from healthy adaptive coping (green), through mild and reversible distress or functional impairment (yellow), to more severe, persistent injury or impairment (orange), to clinical illnesses and disorders requiring more concentrated medical care (red).

The arrows under the four color blocks denote movement in both directions is possible, thus indicating that there is always the possibility for a return to full health and functioning.

It is important for you as leaders to be able to recognize the behavioural signs indicative of each of the phases of the MHCM which become more severe as the sailor/soldier/air man/air woman moves to the right on the mental health continuum.

• Health: Normal functioning
• Reacting: Common and reversible distress
• Injured: Severe and persistent functional impairment
• Ill: Clinical disorder; Severe functional impairment

Signs and Symptoms

Healthy	Reacting	Injured	Ill
Normal mood fluctuations Calm & takes things in stride	Irritable/ Impatient Nervous Sadness/ Overwhelmed	Anger Anxiety Pervasively sad/ Hopeless	Angry outbursts/ aggression Excessive anxiety/ panic attacks Depressed/ Suicidal thoughts
Good sense of humour Performing well In control mentally	Displaced sarcasm Procrastination Forgetfulness	Negative attitude Poor performance/ Workaholic Poor concentration Poor decision-making	Overt insubordination Can't perform duties, control behaviour or concentrate
Normal sleep patterns Few sleep difficulties	Trouble sleeping Intrusive thoughts Nightmares	Restless disturbed sleep Recurrent images/ nightmares	Can't fall asleep or stay asleep Sleeping too much or too little
Physically well Good energy level	Muscle tension Headaches Low energy	Increased aches and pains Increased fatigue	Physical illnesses Constant fatique
Physically and socially active	Decreased activity/ socializing	Avoidance Withdrawal	Not going out or answering phone
No/ limited alcohol use/ gambling	Regular but controlled alcohol use/ gambling	Increased alcohol use/ gambling - hard to control	Frequent alcohol or gambling use - inability to control with severe consequences