Dr Umar Toseeb Hello, welcome to the Podcast series for the Association for Child and Adolescent Mental Health, or ACAMH for short. I’m Umar Toseeb, Professor of Psychology. My research focuses on special educational needs and mental health in childhood and adolescence. All listeners to this and indeed, any of ACAMH’s podcasts, are eligible for a free CPD certificate. Do please visit acamhlearn.org for details of this, together with information on how you can access hundreds of hours of free talks, lectures, interviews, all of which you can also get free CPD certificates for. The web address is acamhlearn.org, that’s a-c-a-m-h-l-e-a-r-n.org. Today, I’ll be speaking to Professor Corey Keyes, Professor Emeritus of Sociology at Emory University in Atlanta, Georgia. Professor Keyes is the author of the book, “Languishing How to Feel Alive Again in a World that Wears Us Down,” published by Transworld Publishers, part of the Penguin Random House UK. He’s also the co-author of two seminal papers, “Mental Illness and Mental Health The Two-Continua Model Across the Lifespan,” published in the Journal of Adult Development, and “The Structure of Psychological Wellbeing Revisited,” published in the Journal of Personality and Social Psychology. Professor Keyes’ work will be the focus of today’s podcast. Corey, thank you so much for joining me. Professor Corey Keyes It’s wonderful to be with you. Dr Umar Toseeb Can you begin by telling us a bit about who you are and what you do? Professor Corey Keyes I am a Professor of Sociology, but I retired early. I just want to put that in, I’m – I – at the age of 60, I decided to leave academia and begin more of a writing career in terms of books and in advocacy, to try to get more atten – draw more attention to the work that I’ve done, where I’d like to move public health into more of a prevention model. That’s – it’s nothing new there, but my approach is if you promote good mental health, you can actually get what you want, which is a mentally healthier population, and at the same time, prevent some mental disorders. So, that’s what I’ve been doing since my retirement. Dr Umar Toseeb Excellent, and when you started your research career, how did you get into this line of research? Professor Corey Keyes Well, it started, actually, with, I’ll have to admit, some naivety, which is always good, because you end up looking and thinking about ideas without any limits. And so, I went into the field thinking, you know, when I used the word ‘health’, I had a naïve view that people were already measuring it the way I was thinking about it, which was not merely the absence of illness, but the presence of good things. Let’s just say that I was wrong, which led to a career, because I was surprised, to tell you the truth, that people hadn’t been measuring health as more than the absence, especially with regard to mental health. And so, that’s where it all started for me and of course, there’s a bit of a personal experience that I outline in my book, as well. It begins with the introduction around – entitled, “Running on Empty,” which was a song that I identified with as a teenager when I was feeling what I would later call ‘languishing’. When I was a teenager, I felt it, but I had no words for it, and when I heard the song by Jackson Browne, “Running on Empty,” I felt understood and for the first time. Those were the two things that really, sort of, led me down this path. My own personal experience with emptiness and then, also, the naïve idea that somehow, people were already out there measuring health as the presence of good things and then the absence of good mental health being a condition that I thought people were also paying attention to, which was languishing. Dr Umar Toseeb Let’s think about the positive psychology movement in general, and you’ve touched on this already. Why is it important to focus on the positive aspects of mental health and then, more broadly, why should we care about the positive psychology movement? Professor Corey Keyes I think they should care, in part, because there is now a lot of scientific support for what I’m – I’ve called “The Two-Continua Model,” and that is that when you have measures that are commonly used to assess depression and anxiety, for example, or any mental illness for that matter, you measure it in a population. And then, if you also include my measurement of the “Mental Health Continuum Short Form,” which you ten – typically find is – there’s a very modest correlation between measures of mental illness, like depression, and the presence/absence of good mental health, as measured by my Mental Health Continuum. What that means is there’s very strong support for The Two-Continua Model, which argues that the absence of things like mental illness does not translate into the presence of good mental health, or what I came to call ‘flourishing’. There is this in between category, you can be free of mental illness, but you may not also be flourishing. You might be stuck in the middle, and what I call ‘languishing’. And all of the evidence that I’ve compiled, and other people have compiled, is that languishing is a serious condition if you stay there too long. Not only will it lead to bouts of clinical depression and anxiety, but it leads to a variety of other forms of malfunctioning or dysfunction in young people and in adults. So, I think it’s really important to recognise that The Two-Continua Model exists and we’ve even found evidence at the genetic level, using twin studies. And when you understand The Two-Continua Model, what you realise is that we haven’t been paying attention to the second continuum that I’d mapped out with my model, the presence and absence of good mental health, or flourishing versus languishing. And so, I think public health and Clinicians, as well, need to pay more attention to whether their clients and whether their population are flourishing, or if the majority of them are languishing. Dr Umar Toseeb The Two-Continua Model divides mental illness and mental health into quadrants and now might be a good time to just try and unpack that a bit more. So, the way I understand it is the model has two perpendicular continuums, one of them is mental illness and one of them is mental wellbeing, and then they divide into quadrants. Do you just want to tell me if my understanding is correct, and do you just want to elaborate on what those quadrants are? Professor Corey Keyes It’s close in the fact that they are, sort of – those two dimensions, in the figures that I’ve published, suggest that they’re independent, but they are definitely correlated. And what happens is that imagine the Mental Health Continuum is – goes from left to right and it’s the vertical dimension and then, mental illness, the presence and absence of symptoms of mental illness, is the horizontal dimension. What you do get is that the ideal condition or the place you would like most of your population, is to be free of common mental illnesses, like depression and anxiety, and flourishing in the – so, you would want them up in the upper right-hand quadrant. That’s the ideal. You want most of your population there, because all the evidence suggests that those people who are free of mental illness and are flourishing are doing really well in life, at work and in school and so forth. Now, you could also have, and it’s true, there’s a lot of people who are free of mental illness, but they don’t end up in the upper right quadrant. They’re free of mental illness, they have some degree of languishing. It could be mild, it could be moderate, and it could be very severe languishing, and that level of languishing it really matters, because it predicts your level of dysfunction of malfunctioning at work and at school, and so forth. But then again, what’s interesting is that there’s a whole group of people who fall on the left si – hand side, who like – who would meet the clinical criteria for things like depression. And it’s possible that some people with mental illnesses might be flourishing in young student populations in – I’m thinking of college age students. You might find 4-6% of young people who would meet the criteria for depression, but they might be flourishing, and that might sound odd at first to people. How can you be mentally healthy and mentally ill at the same time? Well, I have two mental illnesses and they’re not acute. They’re not obvious all the time. If people like myself can manage our mental illnesses, it’s possible that we can actually flourish. And evidence suggests when you are flourishing with a mental illness, you are protected from a variety of other problems emerging, even though you have a mental illness. So, people with mental illnesses aren’t always in their acute phase or state when they have a mental illness, but it’s – let’s make it clear, it’s rare that people are flourishing and have a mental illness. Most people fall somewhere in the mild to moderate category of languishing with a mental illness and a pretty sizeable portion also fit the criteria for severe languishing with a mental illness. So, what’s interesting there is a lot of research misattributes all of the dysfunction to depression or other mental illnesses, when in fact, a lot of people who have a mental illness are languishing to some degree and their level of languishing is also contributing to their dysfunction or malfunctioning. It’s not just their mental illness that’s causing problems. It’s the fact they’re also languishing with a mental illness. So, your languishing is there with your mental illness and it’s causing problems, along with things like if you’re – you have depression. So, that’s a long description of The Two-Continua Model and it has lots of implications. Dr Umar Toseeb Okay, excellent, lots of follow-up questions there. Let’s just put a pin in those questions for a second and go back and try and think about some of the things that you’ve talked about with wellbeing and try and unpack those definitions a bit more. So, you’ve talked about wellbeing and in your book, you talk about “emotional wellbeing, social wellbeing and psychological wellbeing,” and there’s a really nice schematic that you use to describe. Can you just talk us through what those things mean? Professor Corey Keyes Wellbeing is a category that can get very confusing very fast, because a lot of people use the word, but you’re – but what they mean is they’re looking at specific aspects of wellbeing. A lot of Researchers, when they talk about wellbeing, and the – a very famous one was named Ed Diener, who championed a subjective wellbeing, he was referring to what I came to call ‘emotional wellbeing’. He was very interested in things like satisfaction and happiness. Here, the equivalent is, right, people experience more positive emotions, and you can ask them how happy and satisfied they are with life. Now, I ask those two questions, along with a third question, “How interested in life are you?” And I, kind of, put that in the emotional category be – simply because it’s, sort of, a – it doesn’t fit well in what I’m going to talk about next, which is the functioning well, and it doesn’t fit quite purely as an emotion, but it’s close. So, emotional wellbeing refers to those feeling states, particularly satisfaction with life, happiness and interest in life. That goes back, actually, to a very important philosophical tradition, an Ancient Greek philosophy, that argued that the secret to a good life is experiencing more pleasure and not experiencing too much unnecessary pain. We all experience pain, but what this Philosopher named Epicurus was getting at is we can cause a lot of unnecessary pain just by the way we act and the way we think. And he’s arguing, when you experience more pleasure, which is, you know, just the standard for positive emotions, than pain, you’re doing well in life. He was not the only one to be talking about the good life and there’s this fellow named Aristotle that you may have heard of, a very important Philosopher, who argued that the good life is about excellence, or what he called ‘virtue’, aretē. And when human beings work to become good or excellent at being what we’re designed to be, really good people and citizens, he said – he argued that as we become more excellent at the job of being a person and a member of society, we begin to experience pleasure as a result. But he argued we need to champion functioning well. And social and psychological wellbeing are those questions in my Mental Health Continuum questionnaire that get at aspects that both Psychologists and Sociologists have argued are indicators of functioning well. Such as, you have a sense of belonging to – you have a community where you feel you belong. You are able to contribute things and to other people, of worth and value. You’re accepting of other people. You also like most parts of your personality, you have self-acceptance. I’m just going to give you a few ‘cause there’s 11 of them. Your life has direction and meaning. You have warm, trusting relationships with other people. You have good interpersonal relationships. That’s just a flavour of some of the psychological and some of the social aspects of wellbeing that represent what I came to believe was a sign that people are functioning well as individuals and as members of communities. Dr Umar Toseeb Thank you, and then, you also talk about the “six domains of human excellence” in your book. What’s that about? Professor Corey Keyes If you were to think about those aspects of functioning well and try to boil down the social and the psychological wellbeing, they share in common some of those domains of excellence. Like acceptance is one domain of human excellence, right? You have to work at becoming more accepting of yourself, which not everyone’s very good at. We are very hard on ourselves and if you were to monitor internal talk and dialogue that people have, we’re not – we’re pretty hard on ourselves. So, people need to work on being more accepting and kind and compassionate to themselves. But that acceptance also goes beyond just a self-acceptance, right? We live in a diverse world, with people who look different, think different, worship different, eat different things, you name it. And we function well when we can be more accepting of other people without trying to change them or exclude them or discriminate against them or even be violent towards them, right? It’s important to be self-accepting, but it’s important to accept other people for who they are. And so, those domains of excellence, you could think of ‘em as boiling down the social and the psychological wellbeing into common categories. Like another domain is competence or mas – and mastery. On the personal side, mastery and competence is about personal growth. Are you challenging – being challenged to become a better person? But there’s a social counterpart to mastering growth, one of which is are you developing yourself in such a way that you have skills and talents that the world needs so that you can contribute to the world or your community, your family and so forth? We Sociologists call that ‘mattering’. Do you matter? And to matter in the world, other people need things from you, so you need to work on becoming and growing socially so that you have skills and talents that you can give to others in your community and your family and in society. So, those are just two of the six domains of excellence. That’s where I’m trying to give the reader a sense there’s a social side to one of those domains of excellence and then there’s a psychological or individual side, as well. Dr Umar Toseeb Thank you. So, if we take what you’ve told us so far about wellbeing, the domains of excellence and The Two-Continua Model of Mental Health and Mental Illness, I’m going to ask you a few questions, which I get asked by students all the time. So, I’m just going to put them straight to you usually how the students ask me. So, what’s the difference between languishing and depression? Professor Corey Keyes Well, if you were to line up the clinical symptoms, the nine symptoms that Psychiatrists and Clinicians use to actually assess depression, you would see they’re all negative. So, there’s two signs or symptoms of what they call anhedonia, which is the loss of pleasure or interest in life and the presence of, for instance, sadness, when it comes to depression. So, to be depressed, you have to have at least one of those signs of anhedonia every day, or almost every day, for the last two weeks or more. But then, you also have to meet the criteria of – you have to have at least four out of the seven signs of what they call malfunctioning, and again, those are all negative. They’re things like, have you suddenly found yourself not eating like you normally eat, that is undereating, or have you suddenly found yourself eating more than you normally eating, that is overeating? Same with sleeping, has your sleep patterns changed so that you’re not sleeping, you’re experiencing insomnia, or are you sleeping for much longer each day? Not your typical seven to eight hours, but maybe 12 hours out of the day you just stay in bed and you sleep. It’s signs of malfunctioning like that that are all negative and you have to have four out of the seven, combined with at least one other than two anhedonia. So, languishing is the absence of positive symptoms, not the presence of negative symptoms. So, when I measure flourishing, I have 14 questions, all of which are positive. I gave – just gave you and your listeners a description of some of ‘em. “Have you felt happy, satisfied or interested in life?” Then I ask, “Have you felt that your life had direction and meaning? Were you challenged to grow and become a better person? Did you feel that you liked most parts of yourself? Were you accepting of other people?” Those are all positive questions getting at the presence or the absence of wellbeing. Languishing is the absence of those good things. It’s not the presence of the negative things that have to do with depression. Even though we’ve seen with a lot of people who stay there in that category of languishing too long, their risk of sliding over or developing things like depression, increases as the severity of their languishing increases and if they stay languishing for too long. So, the way you want to think about languishing is it’s the absence of good stuff. Depression is the presence of negative stuff, and flourishing is the presence of all – a lot of those good things that I just described that go into wellbeing. Dr Umar Toseeb That’s very helpful. So, in a similar way, what’s the difference between flourishing and happiness? And in your book, you talk about maybe flourishing being “an indirect route to happiness.” Professor Corey Keyes In the way I just described clinical depression, right, you have anhedonia and malfunctioning, it’s very interesting that when you look at the signs and symptoms of wellbeing in my Mental Health Continuum, there’s hedonia, or hedonic wellbeing and that’s the emotional wellbeing, happy, satisfied or interested in life. And to meet the criteria for flourishing, there is a formal diagnosis. You have to have at least one out of the three emotional wellbeing every day, or almost every day, for two weeks or longer. Often, I measure it in the past month, but some – you can measure it in the past two weeks. But flourishing isn’t just about feeling good. That is you – it’s not – it goes way beyond just feeling happy, satisfied or interested in life. You also have to have six out of the 11 signs of functioning well. It could be some of the psychological wellbeing, it could be some of the emot – the social wellbeing. It could be any combination of those two kinds, but you have to have at least six out of the 11, every day or almost every day, combined with at least one out of the three emotional wellbeing, every day or almost every day. So, it’s almost as if I flipped depression and its diagnosis literally on its head, right? You have to have one of the signs of hedonic wellbeing, that is the emotional wellbeing, combined with at least six out of the 11 functioning well. Depression is the opposite, you have to have one out of the two signs of anhedonia every day or almost every day for two weeks or more, combined with at least four out of the seven malfunctioning. So – and my diagnosis there – of good mental health as flourishing literally turns depression on its head, but by measuring those signs and symptoms of emotional wellbeing, psychological and social wellbeing. Dr Umar Toseeb And then, if we apply this to children and adolescents, what might a languishing child look like? Professor Corey Keyes I interviewed one young teenager, and he’s featured in my book, because the family was very worried. There was this shift in the young man and he started literally spending more time alone, often in his bedroom, and when he came out, he barely talked with his parents. He had his hoodie on, as if he was trying to disappear. You see shifts in behaviour that you may think they’re depression, but they may not be. Because when I ask the parents, “Well, ask him some of these questions that go into my assessment of languishing and flourishing,” it turns out he wasn’t depressed. He met the criteria for languishing, and he was languishing moderately, which is not good. So, you see a lot of teenagers who will engage in, sort of – they begin to – you see a shift from being engaged to disengaged from their family and their peers. You might see a slide in their functioning at school in terms of whether they were in sports, they’re – and not doing well there and not doing well in the classroom and grades. They might start – and evidence shows that teenagers who are languishing often begin to think about things like suicide, they contemplate it and make plans, engage in suicidality. They start engaging in delinquent behaviour, evidence shows. They start acting out. They might start drinking, smoking marijuana or getting in trouble with the law by doing what we call pranks, and I – and other mischievous or – things. And when I was writing the book, a study came across my desk that showed in Hungarian teenagers who were languishing, they had a very high risk of engaging in non-suicidal self-harming behaviours, like cutting, pinching themselves, pulling their hair. In other words, they’re hurting themselves, and this makes sense when you think about descriptions of languishing. Languishing feels – you don’t – you feel numb and empty. You don’t feel anything bad, you don’t feel any good. You just feel, sort of, nothing, and that’s a very haunting place to be. And so, what happens is people will engage in self-harming behaviours to feel something, which is some kind of pain, rather than nothing. So, a lot of teenagers will start to engage in things like what I just described, but if you’re at all suspicious that your teenager is going down the wrong path, there is the questionnaire, and I highly recommend asking them those questions that are on my Mental Health Continuum Short Form. Dr Umar Toseeb And then, on the other hand, what does a child and adolescent who’s flourishing, what does that look like? Professor Corey Keyes To all the negative things that I just talked about and turn it into all of these ways in which teenagers are – they’re very engaged at school, they’re doing well, they can enga – they’re independent, they have goals and they’re self-directed. They’re engaged with their peers. They describe their relationships in constructive ways and they have often – and in fact, one study, over 80% of teenagers were flourishing when they desc – they had five indicators of very good relationships with adults in their lives, especially their parents. But it can go – if you don’t have those – you’re not getting along at home, you can actually have really good, high-quality relationships with adults, say at school or in your community, like a Coach or a Teacher, or your Minister or Rabbi, right, or your – so, they’re engaged with adults and peers in their lives. They’re doing well at school. They’re often in extracurricular activities. They’re, sort of, your model teenager. Dr Umar Toseeb And in terms of the correlates and the influences on mental health and mental illness, are they the same, are they different? Professor Corey Keyes There are several papers and one – it was published in the U – from scholars in the UK at UCL, and I remember reading that paper, and what it did show was that there is partial overlap of the thing – correlates, or predictors of mental illnesses, like depression and predictions of languishing. So, one example is there’s a modest overlap – you would imagine, yes, stress. Stress is typical – a typical correlate of things like mental illness, like anxiety and depression, high levels of it, and it’s – there’s maybe a little overlap with wellbeing. But what’s intriguing to me is the absence of stress does not mean you’re doing well in terms of wellbeing, because it takes a little bit of challenge in our lives. Some might even say we have to experience some adversities sometimes to actually achieve some levels of wellbeing, because it takes challenge and adversity for us to grow. That’s just the nature of being human. And so, stress is an interesting one because there’s some – a little bit of overlap, but it’s much more predictive of mental illness than it is of mental health, and it may not be a good thing that you have no adversity and no challenge for your wellbeing. And I find that interesting because I think we walk around and convey to young people that the best form of life, which is very unrealistic, is to have very little adversity. “I wish you a life free of adversity.” Well, good luck with that. Most spiritual traditions advise us to beware of that message because everyone will experience some form of pain, some form of suffering, and some form of adversity. So, it’s better to be prepared and how you resolve adversity and challenge is the key to wellbeing. And that’s also why social support is often a very important ingredient of wellbeing. If you have challenge, you might be able to do it on your own, but it’s much better to experience adversity and challenge, but to have loving, warm, trusting relationships that you can draw on for support. Dr Umar Toseeb So, one of my favourite parts of reading popular science books is where you learn about the theory and then there’s some practical tips and suggestions, and in your book, you’ve done that, as well. So, you’ve talked about the things that we can do to promote flourishing and learn, connect, transcend, help and play. How can we apply that to childhood and adolescence and what do those look like in childhood and adolescence? Professor Corey Keyes I think those vitamins, as I came to think of them, right, they’re activities, they’re actions, things you do. And the studies show that people who chose one of those five and did more of it that day, had a much better day. They would describe their day as being filled with inspiration, awe, gratitude, hope, all kinds of good things, right, that make up a really good day. And so, you don’t have to do all five every day. The evidence showed that if you pick one, do it and do enough of it that you will experience, sort of, what – some benefit, like if you’re going to play, don’t do it just during recess, like for the half hour or even 20 minutes. Go out and play for an hour or two, maybe, and really engage with an act – that activity. For teenagers, it’s – this would be an interesting thing that if you made this part of their daily life, you tried to prioritise play. Of course, we do – one other vitamin was learning something new. Now, our young people in school, at least nine months out of the 12 months, the typical year, learning things. The key here is there’s got to be some independence and autonomy and freedom to choose the things you want to learn each days. A lot of the things kids are learning, they have to learn. It’s required curriculum. So, you may, as a parent, think they’re learning something new every day. Why aren’t they benefitting? Well, because they have to, because it’s work, in other words. So, what you want your children to do is prioritise something that day where they learn it, something only they are interested in. They want to see themselves grow in that direction. It may not actually align with what they’re learning in school, that’s fine, but it’s something they are really interested in. So, encourage them to learn something new that they want to learn and it isn’t connected to the work of school. And so, those five activ – like the transcendence one is another interesting one. Can you imagine – what that’s really about is engaging in some form of religious or spiritual practices. So, for example, a lot of us, including me, I’ve – I have practised yoga very seriously for a long time, and we think of yoga as a just physical exercise, like doing poses, but if you start studying yoga, it’s got a deeply philosophical and ethical orientation. You engage in things like meditation and yoga to calm the mind so that you have a clear, calm mind that allows you then to engage and learn how to live more ethically, how to behave more ethically, how to be a better or a good person for others and with others. How to get along, so to speak. So, all of those things that go into those vitamins are things that I would, if I were a parent or a Teacher, encourage young people to practice regularly. Dr Umar Toseeb Thank you, and I suppose what your work and the broader field suggests is that the positive aspects of development is something that we should be looking at more and things like the presence of ‘good’ things and rather than just the presence of ‘bad’ things, as you’ve described it. And I think there’s been some work in this journal, in JCPP or JCPP Advances, I’m not quite sure which one it was, but around the need for future research to focus on the positive aspects of mental health and wellbeing. Where would you like to see the field of child and adolescent mental health and wellbeing in, say, 20 years’ time? Professor Corey Keyes I suspect that what happens is that scholars specialise in some form of problem, right, that’s – that characterises you – adolescents, right? And I understand that there’s a lot – there are problems in – that – in kids’ lives that need to be understood, like maltreatment at home or pov – exposure to addictions or alcoholism at home, to exposures to poverty or violence in your neighbourhood. There will always be problems and the things that we need to improve upon for – in communities and in families and in schools, for our kids. But what I’d like to see the field do more research where they include in every study, not just the problem focused, but the asset or the strength focus. It’s simply not enough to get rid of the bad things. That go – that’s important, don’t get me wrong, but getting rid of the negative things and the problems is part of the solution, but it’s not the entire solution. Imagine a world where we could get rid of all the problems for our children and yet, you could imagine a world where they may not – we may not know what strengths and challenges they need to be introduced, to develop physically and mentally and emotionally. It’s just the nature of human being that what we want to do is get focused on the negative and get rid of those things. I think more research needs to have a complementary focus, both the problems and the strengths and assets that kids need in their lives, ‘cause they’re both necessary. And that’s really another way of bringing The Two-Continua Model back into the conversation, because that would represent research that’s – that addresses the reality of The Two-Continua Model in all of our lives, and even – and it’s true for kids, as well. Dr Umar Toseeb And you’ve mentioned during this podcast that you’ve developed your own measure of wellbeing. Could you maybe give us a reference for that measure and where people could find it if they want to use it? Professor Corey Keyes They – it’s freely available online and it’s called “The Mental Health Continuum Short Form” and yes, they’re very simple, straightforward questions that I think we need to be asking more of our young people. Do they have some of these good things going on in their lives, a sense of belonging? Are they con – do they feel like they’re getting ready to – in developing skills that allow them to contribute things to their family, their community, their school? And do they like most parts of their personality? Are they able to manage their own lives? Imagine that. Are they confident that they can express their own ideas and opinions? If I were a Teacher or a parent, I would want my kid developing along those lines myself. So, I’d encourage the adults and Researchers who care about kids to ask those questions of them. Dr Umar Toseeb Finally, what’s your take home message for our listeners? Professor Corey Keyes If you were to take my work and boil it down into one saying, it – the – it would be this, the absence of mental illness does not mean the presence of mental health. And so, we need to focus on both mental illness and the presence and absence of good mental health, so that we can get a much more complete picture of where kids and – fall in The Two-Continua Model. And ideally, we should be helping them to move into that upper right quadrant, where they can stay flourishing and pre – and their risk of developing mental illnesses is very low, and they do well in life. So, that’s the dream, where we take good mental health much more seriously than we have been, and dream of a world where we actually engage in activities where we help more young people, adolescents and teenagers, flourish. Dr Umar Toseeb Thank you, Corey, for that really clear take home message and fantastic and wide-ranging and insightful conversation. Thank you so much. Professor Corey Keyes I’m very pleased to have had the opportunity to talk to you. Dr Umar Toseeb Thank you. For more details, please visit the ACAMH website, www.acamh.org, and Twitter @ACAMH. ACAMH is spelt A-C-A-M-H, and don’t forget to follow us on your preferred streaming platform, let us know if you enjoy the podcast, with a rating or review, and do share with your friends and colleagues.