The 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.
The mental health continuum model, developed in collaboration with the United States Marine Corps (USMC) in 2008, promotes awareness of mental health indicators in self and others, early recognition of distress, management strategies and prevention. 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.
The mental health continuum model is designed to help identify specific changes in health and performance in six different domains: mood, attitude and performance, sleep, physical health, social well-being, and substance use/gambling/gaming issues.

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Healthy | Reacting | Injured | Ill | |
---|---|---|---|---|
Mood | Normal mood fluctuations Calm & takes things in stride |
Irritable/ Impatient Nervous Sadness/ Overwhelmed |
Anger Anxiety Pervasively sad/ Hopeless |
Angry outbursts/ aggression Excessive anxiety/ Panic Depressed/ Suicidal thoughts |
Attitude & Performance | 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 concentration |
Sleep | Normal sleep patterns Few sleep difficulties |
Trouble sleeping Intrusive thoughts Nightmares |
Restless disturbed sleep Recurrent images Recurrent nightmares |
Can't fall asleep or stay asleep Sleeping too much or too little |
Physical Health | Physically well Good energy level |
Muscle tension Headaches Low energy |
Increased aches and pains Increased fatigue |
Physical illnesses Constant fatique |
Social Well-being | Physically and socially active | Decreased social activity Reduced socializing |
Avoidance Withdrawal |
Not going out or answering phone |
Substance Use & Gaming | No or low risk use of alcohol/ cannabis/ gambling/ gaming | Alcohol/ cannabis/ gambling/ gaming increasingly used to relieve tension/ cope with stress | Difficulties limiting use of alcohol/ cannabis/ gambling/ gaming | Unable to control use of alcohol/ cannabis/ gambling/ gaming |
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