9. 1 311 9. 2 The results in the four areas 313 9. 3 Likely causes of the growing demand for services 314 9. 4 The dominant perception of mental health problems 315 95 A shifting balance 317 9. 6 Mental health problems as a policy issue 319 311) 9. 7 Culture-dependence as an approach 9. 8 Culture-dependence and the four tbemes 322 9. 9 The value of a socia-cultural approach 323 9. 10 Two core notions: normality and identity 325 9. 11 Conclusions and policy options 328 Bibliography 333 Appendix Basic ~ssumptions in the exploratory and target-seuing sccnanos 368 v Preface This study of mental health issues breaks new ground. The task set by the Steering Committee on Future Health Scenarios was twofold, encompassing issues relating both to mental health and to mental health care. Discussions of mental health normally narrow down immediately to a focus on its care; this study, in contrast, seeks to deal with mental health as a theme in its own right alongside that of mental health care. This task led to the establishment of a broadly based committee whose members possessed a wide range of knowledge and experience in the field. The study was carried out by an equally expert team from the Netherlands Institute of Mental Health. In the course of the study over a hundred people with wide ranging expertise took part in consultative panels.