GWI Mentalwellnessresearch2020

Defining the Mental
Wellness Economy
November 2020
Copyright © 2020 by the
Global Wellness Institute
Quotation of, citation from, and reference to any of

the data, findings, and research methodology from
this report must be credited to “Global Wellness
Institute, Defining the Mental Wellness Economy,
November 2020.” For more information, please
contact research@globalwellnessinstitute.org or
visit www.globalwellnessinstitute.org.
Contents
Executive Summary..................................................................................... i
Full Report.............................................................................................................. 1
I. Mental Wellness Takes Center Stage.......................................................... 3
II. Defining Mental Wellness............................................................................. 9
III. Personal Agency Versus Collective Responsibility................................. 25
IV. The Mental Wellness Economy................................................................... 31
V. Mental Wellness Industry Subsectors....................................................... 47

Self-Improvement..................................................................................................................... 47
Meditation & Mindfulness........................................................................................................53
Brain-Boosting Nutraceuticals & Botanicals................................................................... 59
Senses, Spaces, & Sleep......................................................................................................... 65
Appendices
Appendix A: Understanding Key Terminologies – Mental Illness, Mental Health,
Mental Well-being, and Happiness..............................................................................................77
Appendix B: Measuring Individuals’ Mental Wellness.......................................................... 81
Appendix C: History of Modern Mental Wellness Practices............................................. 83
Appendix D: Selected Bibliography........................................................................................... 93
Appendix E: Acknowledgements..............................................................................................107
Industry Research Sponsors....................................................................................................... 109
List of Figures
Figure 1: What Is Mental Wellness?............................................................................................. 10
Figure 2: Dual Continuum Model of Mental Wellness and Mental Illness.......................11
Figure 3: Mental Illness/Health versus Mental Wellness/Well-being..............................15
Figure 4: Pathways to Mental Wellness..................................................................................... 16
Figure 5: Supporting Mental Wellness for All: Three Levels of Action......................... 28
Figure 6: From Pathways to the Emerging Industry of Mental Wellness.....................35
Figure 7: Global Mental Wellness Industry (2019)................................................................ 39
Figure 8: Global Wellness Economy.......................................................................................... 42
Figure 9: Keyes’ 13 Factors for Measuring Mental Wellness.............................................. 81
About the Authors
About the Global Wellness Institute

The Global Wellness Institute (GWI), a 501(c)(3) non-profit organization, is considered the leading global
research and educational resource for the global wellness industry and is known for introducing major
industry initiatives and regional events that bring together leaders and visionaries to chart the future. GWI
positively impacts global health and wellness by advocating for both public institutions and businesses
that are working to help prevent disease, reduce stress, and enhance overall quality of life. Its mission is
to empower wellness worldwide.
www.globalwellnessinstitute.org
About the Authors

Defining the Mental Wellness Economy was co-authored by Ophelia Yeung and Katherine Johnston, Senior
Research Fellows at the Global Wellness Institute. Together, they have four decades of experience leading
research and strategy development for businesses, governments, and nonprofits worldwide. Since 2008,
Ms. Yeung and Ms. Johnston have pioneered groundbreaking research and co-authored numerous studies
that define and measure the global wellness economy and its subsectors, under the auspices of the Global
Wellness Institute. Tonia Callender, GWI Research Fellow, contributed significant research in industry and
regional developments and data for this study.
Defining the Mental Wellness Economy
Executive Summary
NOVEMBER 2020
Global Wellness Institute | i

Executive Summary
Mental wellness can offer a path forward in a world suffering
from a mental health and well-being crisis.
Our mental unwellness has been a growing public health crisis for some time. Over 15% of the global
population suffers from mental and substance use disorders.1 Dementia is on the rise; happiness is on the
decline in many countries; and stress, worry, sadness, burnout, and loneliness are increasing all around the
world.2 In 2020, COVID-19 has accelerated the deterioration of our collective mental health and well-being.
The pandemic has exposed the wide gap between mental health needs and mental health resources, as
well as our vulnerability to mental distress even when we do not have a diagnosed mental illness.3
In this dire landscape, mental wellness offers a path forward to help meet widespread needs and increase
well-being for all. In fact, a big shift toward mental wellness is just beginning: as a personal pathway
toward higher levels of well-being, as a public health and community strategy, and as a business and
investment opportunity. Practitioners and consumers have been leading the way, with a vibrant private
sector creating new solutions, services, and products to help people build resilience and improve their
mental wellness. Yet, the understanding of mental wellness is often fuzzy, and to date there has been no
definition or quantification of this burgeoning mental wellness marketplace.
This study will offer a definition for mental wellness; clarify

concepts and outline pathways; define mental wellness as
an industry for the first time and delineate its segments; and
estimate the size of the global mental wellness economy.
Global Wellness Institute | iii

What is mental wellness?
Figure A
Mental wellness is a dynamic, renewable, and positive resource; an active process that requires initiative
and conscious action; and an internal experience that encompasses multiple dimensions: mental (how we
process, understand, and use information); emotional (how we manage and express our feelings); social
(how we connect with others); and psychological (how we function or “put the pieces together” to make
decisions or do things). This definition distills the concepts included in many existing definitions (from
the World Health Organization and others). It builds upon well-established theories from psychology
and academic literature, and it frames them in a language that is more understandable to consumers,
businesspeople, and policymakers.
Defining the Mental Wellness Economy – November 2020 | iv

Five things everyone should know about mental wellness.
1. Mental wellness is more than just the absence of mental illness. The complex relationship between
mental illness and mental wellness is best understood by envisioning them sitting on two separate
continuums (see Figure B). The horizontal axis measures mental illness from high to low, while the vertical
axis measures mental wellness from languishing to flourishing.4 About 85% of the world’s population does
not have a diagnosed mental illness, but these people are not all “mentally well” or thriving, because of
pervasive stress, worry, loneliness, and other challenges. On the other hand, those who have a diagnosed
mental disorder can still have moderate or positive mental wellness (e.g., having good relationships, feeling
happy, or functioning well at a job). Practices that increase our mental wellness are increasingly recognized
as protective factors for our mental health, as well as helping reduce the severity and symptoms of mental
illness (alongside conventional treatment regimens).5
Figure B
2. Mental wellness is an active process of moving from languishing, to resilience, to flourishing. On one
level, mental wellness is about prevention; coping with life’s adversity; and being resilient when we face
stress, worry, loneliness, anger, and sadness. On another level, mental wellness moves us toward a deeper,
richer, and more meaningful human experience, which is often described as flourishing. What it means
to flourish is subjective and personal, and it is shaped by individual values, culture, religion, and beliefs.
For one person it can mean functioning at the top of their game and achieving their life goals, while for
another it might mean self-transcendence.
Global Wellness Institute | v

3. Mental wellness helps to shift the perspective away from stigma to shared humanity. Even though
the mental health field has done a lot of work to mitigate the stigma surrounding mental illness, a sense
of shame, denial, and secrecy continues to afflict people in communities and cultures around the world.6
Mental wellness can help shift our focus toward a more positive and empowering approach (how we can
feel, think, connect, and function better), rather than just avoiding or coping with illness. It emphasizes our
capacity to build resilience; to reduce suffering; to find inner peace and joy; and to seek meaning, purpose,
and connection – a universal longing shared by all people.
4. Mental wellness grows out of a grassroots, consumer-driven movement. People desperately need
non-clinical, non-pathologizing strategies to cope with everyday mental and emotional challenges like
stress, burnout, loneliness, and sadness. Evidence shows that improving our mental wellness can even
reduce our risk of developing mental illness,7 but not enough attention is paid globally to mental illness
prevention and mental wellness promotion.8 Consumers, practitioners, and businesses have led the charge
in seeking self-directed, alternative solutions outside of the established fields of medicine, psychiatry,
and psychology. They are bringing centuries-old natural and holistic mental wellness modalities into the
mainstream, pushing science into areas where it has not gone before to consider the efficacy of ancient
practices and emerging solutions.
Figure C
5. Mental wellness is multi-dimensional, holistic, and personal. Mental wellness recognizes the integrated
and holistic nature of our health and well-being. The state of our mind affects our body, and vice versa.
Sometimes, when our circumstances change, we need to adopt new practices or strategies to handle
stress, improve resilience, and deal with adversity. In this study, we segment the key strategies for mental
wellness into four main pathways: activity and creativity; growth and nourishment; rest and rejuvenation;
and connection and meaning. Each of these has mind-body and internal-external dimensions (see Figure
D, and see the full report for a detailed description of each pathway). Together, they represent a menu
of options for pursuing mental wellness; there is no set path, and people can choose the strategies and
activities that are the most important or effective for them.
Defining the Mental Wellness Economy – November 2020 | vi

Personal agency or collective responsibility?
The notion that mental wellness is about individuality, self-care, and personal responsibility does not imply
that it is solely an individual pursuit or that it is fully within our control. In fact, there is great inequity in our
access to mental wellness pathways and modalities. Many people do not have easy access to healthy food,
exercise facilities, or nature; many do not have the money to pursue certain mental wellness activities. In
addition, external and macro-level circumstances are a major determinant of our mental wellness. People
who suffer from systematic violence, discrimination, abuse, injustice, war, poverty, famine, and natural
disasters suffer major blows to their mental wellness and have basic needs that must be addressed (safety,
security, food, shelter, medical care, employment). But even in the most adverse circumstances, a growing
body of evidence shows that individual mental wellness practices can reduce our stress and help us build
greater resilience, clarity, and hopefulness.9
Mental wellness can help address the rising cost burden of

mental illness and unwellness.
Mental illness and mental unwellness impose a massive economic and societal burden around the world.
Beyond the economic costs – estimated to reach $16.1 trillion globally by 203010 – mental illness takes a
staggering toll on individuals, families, and society in the form of homelessness, poor educational and health
outcomes, unemployment, and higher rates of poverty.11 Poor mental wellness can also be debilitating; it is
more common than depression and is associated with emotional and psychosocial impairment comparable
to that of a depressive episode.12 Those who suffer from mental unwellness (even when free of a diagnosed
mental illness) tend to do worse in terms of “physical health outcomes, healthcare utilization, missed days
of work, and psychosocial functioning.”13
Governments and businesses have an incentive to promote mental wellness because it can help address
these rising costs. Practices that improve our mental wellness can not only lessen the symptoms of
mental illness, but also reduce our risk of developing a mental illness.14 Good mental wellness is linked with
many other positive outcomes, including better physical health, longevity, social relationships, and work
performance.15
• Government policies (economic, healthcare, education, urban planning, parks and recreation, etc.)
play a critical role in our mental wellness, because they shape our macro environments and our
access to wellness-enhancing physical and built environments.
• Private businesses across many industries (hospitality, spas, technology, consumer goods,
housewares, books and media, etc.) play a major role in developing new products and solutions;
offering more choices to meet diverse needs at a variety of price points; leveraging technology;
and attracting research and investments.
Global Wellness Institute | vii

Defining the mental wellness economy.
The scope of mental wellness pathways and practices is wide-ranging. Mental wellness permeates the
entire economy because every aspect of our daily lives can have a profound impact on our mental wellness.
In this study, we focus more narrowly on the businesses that provide products, solutions, and experiences
to consumers specifically for their mental wellness.
To delineate the mental wellness industry, we focus on two pathways: growth and nourishment and rest
and rejuvenation. We do not include activity and creativity in the industry because the category is too
broad (fitness, sports, learning, hobbies), and it already sits solidly in other industries; we also exclude
connection and meaning because these activities are primarily non-commercial (religion, gratitude,
altruism, friends, nature, civic engagement). Specifically, four sectors are coalescing into an emerging
mental wellness industry: 1) self-improvement; 2) meditation and mindfulness; 3) brain-boosting
nutraceuticals and botanicals; and 4) senses, spaces, and sleep (see Figure D).
Figure D
Defining the Mental Wellness Economy – November 2020 | viii

The four mental wellness industry subsectors are defined below. These subsectors – including their
detailed definitions, historical evolution, and current developments – are described in Chapters IV and V
of the full report.
1. Self-improvement includes a wide range of activities typically associated with self-help and personal
development, which can be done individually, in groups, and with professional guidance and support.
The sector includes: self-help books; self-help gurus, organizations, and institutes that deliver a variety of
classes, workshops, seminars, and retreats; self-help organizations and mutual support groups; personal
and life coaches; cognitive enhancement and brain training products and services; a wide array of self-help
apps and online platforms; and anti-loneliness efforts. This sector is especially hard to quantify because
the activities overlap with so many other sectors. Self-help gurus, groups, and organizations now deliver
content through a variety of media channels (e.g., Instagram, Facebook, Reddit, YouTube, websites,
magazines, TED talks, podcasts, etc.), which cannot be easily separated as a consumer spending category.
2. Meditation & mindfulness includes all forms of meditation practice, related/spin-off mindfulness
practices (e.g., breathwork and breathing methods, guided imagery, body scan, relaxation exercises), and
products and services that support these practices. Key spending categories include classes, teachers,
retreats, online platforms, apps, books, and videos. There is a growing market for meditation accessories
(e.g., cushions, beads, chimes) and mindfulness products (e.g., journals, coloring books), as well as a fast-
growing range of connected gadgets, trackers, monitors, and aids to support meditation (e.g., headbands,
headsets, glasses, wearable sensors, lamps) – many of which build upon biofeedback, neurofeedback, and
virtual reality technologies.
3. Brain-boosting nutraceuticals & botanicals includes products that we ingest or put into our bodies with
the specific aim of improving our mental health and well-being. Many over-the-counter natural supplements,
herbals and botanicals, and traditional remedies specifically claim to support better sleep, brain health,
memory, energy, and overall mental wellness. A wide range of functional foods and beverages claim to
have brain health benefits, across nearly every packaged food and beverage category. There is growing
interest in the potential of cannabis and its derivatives, psilocybin, and other plant-based and synthetic
psychedelic drugs for both mental wellness and treatment purposes. A growing number of supplements
and functional foods and beverages incorporate cannabis, hemp, CBD, THC, and medicinal mushrooms.
(Note that our figures include only the legal, over-the-counter cannabis and cannabis derivatives market.)
4. Senses, spaces, & sleep includes products, services, and design that target our senses and the mind-
body connection, based upon the growing understanding that environmental stimuli have a major impact
on our mood, stress levels, sleep, and mental health and well-being. This broad sector encompasses sound
(sound healing, white noise, noise cancellation, wellness music); scent (aromatherapy, home fragrances);
light (circadian lighting, light therapy consumer products); and touch (stress toys and gadgets, weighted
blankets). Sleep is a major focus of this sector, with an exploding array of sensory products and services
that promote relaxation and improve our sleep environments (e.g., sleep accessories, smart bedding, nap
cafés, sleep retreats, etc.). Many new tech gadgets, wearables, and apps target sleep hygiene, ambience,
and tracking. Multi-sensory experiences are appearing in wellness travel, spas, fitness, and entertainment
venues (e.g., forest bathing, hugging therapy, scream therapy, laughter yoga, cuddle parties, flotation
tanks), while sensory-based design and architecture are a rapidly growing part of wellness real estate
(biophilic design, human-centric lighting).
Global Wellness Institute | ix

Mental wellness is a $121 billion global market.
We estimate that the global mental wellness industry was worth $120.8 billion in 2019 (see Figure E).
This estimate represents consumer expenditures on the four subsectors that we identified and described
above, and it focuses on proactive, wellness-focused, consumer- and private sector-driven activities (that
is, things outside of the psychiatry, psychology, and clinical/medical spheres). These figures are broad,
global estimates that we aggregated based on a wide range of secondary data sources.16
Senses, spaces, & sleep is the largest subsector (at $49.5 billion), followed by brain-boosting nutraceuticals
& botanicals ($34.8 billion) and self-improvement ($33.6 billion), which are similar in size (see Figure E).
Meditation & mindfulness is the smallest subsector, at $2.9 billion; it is important to keep in mind that
millions of people around the world practice meditation, but only a small fraction of them spend any
money on the practice. The historical context, evolution, and current developments in these subsectors are
discussed in Chapter V of the full report.
Figure E
How to interpret these numbers.

What does a 2019 market size estimate mean, given the global upheaval unleashed by COVID-19 in
2020? The mental wellness industry figures presented above can serve as a 2019 baseline on which to
anticipate the future. Clearly, the human suffering and economic dislocations caused by the pandemic
have negatively impacted our mental health and well-being, and therefore have increased demand for
mental wellness pathways and solutions on a global scale. Companies in some segments – such as those
delivering virtual solutions, home entertainment, and vitamins and supplements – have reported an
upswing in demand during the pandemic. However, since disposable income and consumer confidence
have taken a severe hit worldwide, consumer spending is shrinking across many industries.17 The pandemic
has also accelerated the global trend of polarization and concentration of income and wealth. Therefore,
future opportunities will depend upon how a business provides value to its targeted consumer segment,
such as luxury versus mass market. Some businesses may also face increasing competition from mental
wellness activities that people have learned to do on their own, or free/affordable amenities and services
provided by governments, communities, and nonprofits.
Defining the Mental Wellness Economy – November 2020 | x

This is the first time a global mental wellness industry has been defined. However, the boundaries across
the four mental wellness subsectors above are not clearly delineated. For example, a mindfulness workshop
or retreat would fit into the meditation & mindfulness subsector, while a life coach could also provide
guidance on mindfulness practices (which fits in the self-improvement subsector). Sound healing and
aromatherapy products (e.g., gongs, chimes, incense, candles) fit in the senses, spaces, & sleep subsector,
but are also often used as accessories for meditation & mindfulness.
By singling out four subsectors, we are not implying that these are the most important or most effective
practices for pursuing mental wellness. They are simply the practices that are most closely and proactively
identified by businesses and consumers as being related to mental wellness. There are many things we
can and should do to support our mental wellness that are not a business opportunity and do not require
spending money (like spending time in nature, joining a spiritual community, or listening to music).
As an emerging sector, many mental wellness practices and products have not yet accumulated extensive
clinical evidence when compared to the conventional medical and mental health industries (e.g., drugs
that treat mental disorders). The regulation of most mental wellness businesses is fragmented, and it
is generally left to consumers to determine whether they believe in and find benefit from them or not.
However, a body of evidence is quickly growing – especially for some modalities, like meditation, light
therapy, and circadian science – bolstered by an acceleration of public and private research investments.
Meanwhile, consumers also need to be educated on the importance of basic healthy habits (exercise,
healthy eating, human connections) for their mental health and well-being.
Technology is not a standalone segment within the mental wellness industry, but is pervasive across all
subsectors (as described in detail in Chapter V of the full report). Mental health and mental wellness tech
startups have become a major target for investors, receiving massive amounts of funding. Investment
levels reached $750 million in 2019, a five-fold increase over 2014, while funding has topped $1 billion in
the first half of 2020.18 These figures indicate that the perceived growth potential of this segment is huge.
An important development is the merging of traditional mental health solutions with mental wellness
technology platforms to provide preventive and supplemental care, and some businesses may be seeking
to access the resources of a much larger healthcare market, beyond consumer discretionary spending on
mental wellness.19 Finally, these investment figures reflect flows of startup capital and are not included in
our market size figures for 2019 (which measure consumer expenditures).
Global Wellness Institute | xi

Mental wellness is a new “industry bubble” within the
Global Wellness Economy framework.
The Global Wellness Economy Monitor, first published by the Global Wellness Institute (GWI) in 2014,
defines and measures the size of the wellness economy worldwide. The wellness economy encompasses
industries that enable consumers to incorporate wellness activities and lifestyles into their daily
lives. To date, the wellness economy has included ten industries, which we estimated at $4.5 trillion in
2017/2018.20 With a growing share of consumers embracing wellness as a dominant lifestyle value, the
wellness economy has become ever more dynamic and pervasive in all aspects of our lives. Emerging
consumer needs drive business and technology innovations and create new sectors, and mental wellness
is just a such a sector. In defining and measuring mental wellness as an industry for the first time, we are
adding an 11th industry sector within the wellness economy (see Figure F). This is a significant addition to
our framework, capturing an important set of economic activities that were not previously included in our
wellness economy measurements.
Figure F
As mentioned earlier, the COVID-19 pandemic has brought unprecedented challenges to the whole world,
affecting every aspect of human welfare, our society, and the global economy. It is crucial to examine how
the wellness economy has evolved since we last published figures for 2017/2018. An update of the global
wellness economy will be the subject for GWI’s upcoming research study in 2021.
Defining the Mental Wellness Economy – November 2020 | xii

Endnotes
1
Authors’ analysis of data from the Global Burden of Disease Study 2019, downloaded from: Institute
for Health Metrics and Evaluation, Global Health Data Exchange, http://ghdx.healthdata.org/, accessed
October 16, 2020. In this dataset, “mental disorders” include schizophrenia, depressive disorders, bipolar,
anxiety disorders, eating disorders, autism spectrum disorders, attention-deficit/hyperactivity disorder,
conduct disorder, idiopathic developmental intellectual disability, and other mental disorders; “substance
use disorders” include alcohol use and drug use disorders.
2
See: 1) Alzheimer’s Disease International (2018). World Alzheimer Report 2018. https://www.alz.co.uk/
research/WorldAlzheimerReport2018.pdf. 2) Helliwell, J.F., et al (2019). Changing World Happiness.
In J.F. Helliwell, R. Layard, and J.D. Sachs (Eds.), World Happiness Report 2019 (pp. 11-46). New York:
Sustainable Development Solutions Network. https://s3.amazonaws.com/happiness-report/2019/
WHR19_Ch2.pdf. 3) Gallup (2019). Gallup Global Emotions 2019. Washington, DC: Gallup. https://www.
gallup.com/analytics/248906/gallup-global-emotions-report-2019.aspx. 4) DiJulio, B., Hamel, L., et al
(2018, Aug. 30). Loneliness and Social Isolation in the United States, the United Kingdom, and Japan:
An International Survey. https://www.kff.org/other/report/loneliness-and-social-isolation-in-the-united-
states-the-united-kingdom-and-japan-an-international-survey/.
3
See: 1) World Health Organization (2020, May 14). Substantial investment needed to avert mental health
crisis. https://www.who.int/news-room/detail/14-05-2020-substantial-investment-needed-to-avert-
mental-health-crisis. 2) United Nations (2020, May 13). Policy Brief: COVID-19 and the Need for Action on
Mental Health. https://unsdg.un.org/sites/default/files/2020-05/UN-Policy-Brief-COVID-19-and-mental-
health.pdf. 3) World Health Organization (2020, Oct. 5). COVID-19 disrupting mental health services in
most countries, WHO survey. WHO News Release. https://www.who.int/news/item/05-10-2020-covid-19-
disrupting-mental-health-services-in-most-countries-who-survey.
4
The dual continuum model used in this report was adapted by the authors from work first developed
by the Canadian Minister of Health and Welfare (1988), social worker/psychotherapist Keith Tudor
(1996), and sociologist/psychologist Corey Keyes (2002). See: Keyes, C.L.M. (2002). The Mental Health
Continuum: From Languishing to Flourishing in Life. Journal of Health and Social Research, 43, 207-222.
https://pubmed.ncbi.nlm.nih.gov/12096700/.
5
See: 1) Keyes, C.L.M. (2005). Mental Illness and/or Mental Health? Investigating Axioms of the Complete
State Model of Health. Journal of Consulting and Clinical Psychology, 73(3), 539-548. https://doi.
org/10.1037/0022-006X.73.3.539. 2) Keyes, C.L.M. (2014). Mental Health as a Complete State: How
the Salutogenic Perspective Completes the Pictures. In G.F. Bauer and O. Hämmig (Eds.), Bridging
Occupational, Organizational and Public Health: A Transdisciplinary Approach (pp. 179-192). Dordrecht:
Springer. https://doi.org/10.1007/978-94-007-5640-3_11.
6
See, for example: 1) Harrison, N. (2018). Enough talk: Fighting stigma in mental health. The Lancet
Psychiatry, 5(6), E15. https://doi.org/10.1016/S2215-0366(18)30194-9. 2) Wainberg, M.L., et al (2017).
Challenges and Opportunities in Global Mental Health: A Research-to-Practice Perspective. Current
Psychiatry Reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z. 3) Saxena, S., et al (2007).
Resources for mental health: Scarcity, inequity, and inefficiency. The Lancet, 370, 878-889. https://doi.
org/10.1016/S0140-6736(07)61239-2. 4) Funk, M., et al (2010). Mental health and development: Targeting
people with mental health conditions as a vulnerable group. Geneva: World Health Organization.
https://www.mhinnovation.net/sites/default/files/downloads/resource/Mental%20Health%20and%20
Development.pdf.
7
Keyes, C.L.M. (2014).
Global Wellness Institute | xiii

8
As noted by the World Health Organization, “Early in the 20th century the mental hygiene movement
was successful in putting mental health promotion on the international agenda. During the 1920s and
30s there was substantial activity to stimulate ‘the integration of mental health principles into the
practices of social work, nursing, public health administration, education, industry and government,’
views that are still very prevalent today. Despite the efforts of the pioneers, the movement initially failed
to attract sufficient interest from these wider groups. It was not until the 1970s that the first studies into
the value of integrating mental health principles into practice in other fields were initiated. During the
past 30 years, however, some 2000 outcome studies have been published on promotion, prevention and
related fields.” See: WHO, Department of Mental Health and Substance Abuse (2005). Promoting Mental
Health: Concepts, Emerging Evidence, Practice. Geneva: WHO Press. https://www.who.int/mental_health/
evidence/en/promoting_mhh.pdf.
9
See, for example: 1) Herron, R.E. (2018, Jan.-Feb.). The Transcendental Meditation Program’s Impact
on the Symptoms of Post-traumatic Stress Disorder of Veterans: An Uncontrolled Pilot Study. Military
Medicine, 183(1-2), e144-e150. https://doi.org/10.1093/milmed/usx059. 2) Azad Marzabadi, E., and
Hashemi Zadeh, S.M. (2014, Oct). The Effectiveness of Mindfulness Training in Improving the Quality of
Life of the War Victims with Post Traumatic Stress Disorder (PTSD). Iranian Journal of Psychiatry, 9(4),
228-236. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361826/. 3) Santa Maria, D., et al (2020, Jan.).
Feasibility of a Mindfulness-Based Intervention with Sheltered Youth Experiencing Homelessness. Journal
of Child and Family Studies, 29, 261-272. https://doi.org/10.1007/s10826-019-01583-6. 4) Maddock,
A., et al (2017). Mindfulness Training as a Clinical Intervention with Homeless Adults: A Pilot Study.
International Journal of Mental Health and Addiction, 15, 529-544. https://doi.org/10.1007/s11469-016-
9718-7. 5) Muirhead, J., and Fortune, C.-A. (2016, May-June). Yoga in prisons: A review of the literature.
Aggression and Violent Behavior, 28, 57-63. https://doi.org/10.1016/j.avb.2016.03.013. 6) Nauert, R.
(2014, Feb. 11). Meditation Helps Refugees Recover from PTSD. Psych Central. https://psychcentral.com/
news/2014/02/11/meditation-helps-refugees-recover-from-ptsd/65732.html.
10
Bloom, D.E., et al (2011). The Global Economic Burden of Non-communicable Diseases.
Geneva: World Economic Forum. http://www3.weforum.org/docs/WEF_Harvard_HE_
GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf.
11
Funk, M., et al (2010). Mental health and development: Targeting people with mental health conditions
as a vulnerable group: Summary. Geneva: World Health Organization. https://www.who.int/mental_
health/policy/development/mh_devel_targeting_summary_2010_en.pdf.
12
See: 1) Keyes, C.L.M. (2003). Complete mental health: An agenda for the 21st century. In C. L. M. Keyes
and J. Haidt (Eds.), Flourishing: Positive psychology and the life well-lived (pp. 293-312). Washington,
DC: American Psychological Association. https://doi.org/10.1037/10594-013. 2) Keyes, C.L.M. (2002). The
Mental Health Continuum: From Languishing to Flourishing in Life. Journal of Health and Social Research,
43, 207-222. https://pubmed.ncbi.nlm.nih.gov/12096700/.
13
Keyes, C.L.M. (2014).
14
Keyes, C.L.M. (2014).
15
For example, see: 1) Kansky, J., and Diener, E. (2017). Benefits of Well-Being: Health, Social
Relationships, Work, and Resilience. Journal of Positive Psychology and Wellbeing, 1(2), 129-169. https://
www.journalppw.com/index.php/JPPW/article/view/20. 2) Great Britain Department of Health (2014,
Feb. 6). A compendium of factsheets: Wellbeing across the lifecourse: What works to improve wellbeing?
https://www.bl.uk/collection-items/compendium-of-factsheets-wellbeing-across-the-lifecourse-what-
works-to-improve-wellbeing.
Defining the Mental Wellness Economy – November 2020 | xiv

16
The mental wellness industry figures presented in this report are estimates made by the authors. We
draw upon a wide variety of secondary data sources as a baseline, and we develop original estimates
based upon our own economic models and our extensive knowledge of adjacent wellness sectors.
Key sources consulted include: Euromonitor International, World Bank, United Nations, World Health
Organization, U.S. National Center for Complementary and Integrative Health, International Coaching
Federation, Statista, Frost & Sullivan, Arcview Group/BDS Analytics, Prohibition Partners, and a wide
variety of industry-specific organizations, databases, publications, and media sources.
17
See, for example: 1) Jones, K. (2020, May 2). These charts show how COVID-19 has changed consumer
spending around the world. World Economic Forum. https://www.weforum.org/agenda/2020/05/
coronavirus-covid19-consumers-shopping-goods-economics-industry. 2) JP Morgan (2020, Sept. 24).
How COVID–19 Has Transformed Consumer Spending Habits. https://www.jpmorgan.com/solutions/cib/
research/covid-spending-habits.
18
See: 1) Somauroo, J. (2020, Feb. 24). New Research Shows Global Mental Health Investment Topped
$750 Million in 2019. Forbes. https://www.forbes.com/sites/jamessomauroo/2020/02/24/new-research-
shows-global-mental-health-investing-topped-750-million-in-2019/#5593a3941962. 2) CBInsights
(2020). State Of Wellness H1’20 Report: Investment & Sector Trends To Watch. https://www.cbinsights.
com/research/report/wellness-trends-h1-2020/. 3) Gaussen, E. (2018, July 13). Mapping out the Mental
Health startup ecosystem. Medium. https://medium.com/venture-beyond/mapping-out-the-mental-
health-startup-ecosystem-5cb4db031b54.
19
See: Raphael, R. (2020). Mental Wellness and Technology: Rethinking the Relationship. 2020 Global
Wellness Trends. Miami, FL: Global Wellness Summit. https://www.globalwellnesssummit.com/2020-
global-wellness-trends/mental-wellness-and-technology/.
20
See: 1) Yeung, O., and Johnston, K. (2019). Move to be Well: The Global Economy of Physical Activity.
Miami, FL: Global Wellness Institute. https://globalwellnessinstitute.org/industry-research/global-
economy-physical-activity/. 2) Yeung, O., and Johnston, K. (2018). Global Wellness Economy Monitor
2018. Miami, FL: Global Wellness Institute. https://globalwellnessinstitute.org/industry-research/2018-
global-wellness-economy-monitor/.
Global Wellness Institute | xv

Defining the Mental Wellness Economy
Full Report
NOVEMBER 2020
Global Wellness Institute | 1

I. Mental Wellness Takes Center Stage
Our mental unwellness is a public health crisis.
If health is the new wealth, then mental wellness sits at the core of our personal health portfolio. And yet,
collectively, our mental health and well-being are in crisis. Over 15% of the world’s population (approximately
1.1 billion people) suffered from mental and substance use disorders in 2019.1 The prevalence of mental
illness is even higher (22%) in countries with conflict and violence,2 and the poor are disproportionately
affected by these disorders.3 Depression is a leading cause of illness and disability, affecting nearly 280
million people worldwide. More than 108 million abuse alcohol, and over 750,000 people die from suicide
each year.4 Since mental disorders are widely underreported and underdiagnosed, their true prevalence
may be even higher. Stigma and misunderstanding are pervasive, and mental health treatment resources
are inadequate across every region of the world.5
Our mental unwellness extends far beyond mental illnesses. As the world’s population ages, the number
of people with dementia is expected to increase from 50 million in 2018 to 82 million by 2030.6 Stress,
anxiety, and burnout are rising across all age groups and in all corners of the world. According to Gallup’s
Global Emotions Report, one in three people globally said they have experienced a lot of worry or stress
in 2018.7 Work-related distress has become so alarming that in May 2019, the World Health Organization
(WHO) began to recognize “burnout” as an “occupational phenomenon” linked to chronic workplace
stress.8 Loneliness is surging in countries around the globe9 and is associated with a greater risk of heart
disease, depression, anxiety, dementia, and premature death.10 And according to the World Happiness
Report, happiness is on the decline in many countries, while sadness, worry, and anger have been rising
worldwide over the past decade.11
Many factors conspire against our mental wellness. At the individual level, numerous lifestyle factors play a
role, including poor nutrition, lack of sleep, inadequate physical activity, declining participation in religious
and community organizations, and increased time spent indoors and in front of screens instead of in
nature. Our living and working environments create significant stress and reduce our mental wellness,
including ever-present technology and social media, the 24/7 intrusion of work into our lives, and modern
built environments and cityscapes that discourage community connections and social trust. Our mental
wellness is also influenced by broad social and macroeconomic shifts, such as changing family structures;
the rise of personal values that emphasize individualism, consumerism, and status; and the hyper-
competitive nature of the globalized economy.
According to The Lancet, the true burden of mental illness is underestimated, and it is “a major driver of
the growth of overall morbidity and disability globally.” Mental illness ranks first among all causes of the
global burden of non-fatal disease and disability (accounting for 32.4% of years lived with disability). It
is on par with cardiovascular and circulatory diseases for the total years of life lost to disability, ill-health,
and premature death.12 Beyond the economic costs – estimated to reach $16.1 trillion globally by 203013 –
mental illness takes a staggering toll on people and society in the form of homelessness, poor educational
and health outcomes, unemployment, and higher rates of poverty.14

COVID-19 has accelerated the deterioration of mental
health and well-being worldwide.
Both the United Nations (UN) and World Health Organization (WHO) have warned of a looming mental
health crisis as “millions of people worldwide are surrounded by death and disease and forced into
isolation, poverty and anxiety by the pandemic of COVID-19”15 – a crisis that some have labelled the
“second pandemic.”16 The stress, trauma, and fear of physical illness and death are massive, but the mental,
psychological, and emotional burden extends far beyond the disease itself. According to the Director-
General of the WHO, “Social isolation, fear of contagion, and loss of family members is compounded by
the distress caused by loss of income and often employment.”17 Highly vulnerable populations include
frontline and healthcare workers, children and youth, the elderly, women and parents, and those who are
unemployed or living in financial duress – in addition to those who have contracted the virus themselves,
cared for a sick family member, or lost loved ones.18
Data from the first three months of the pandemic show that 60% of the population in Iran, 45% in the
United States, and 35% in China suffered mental distress due to COVID-19.19 One recent study found that
the prevalence of depressive symptoms in U.S. adults more than tripled during the early months of the
pandemic.20 Increasing symptoms of depression and anxiety have been reported across many countries.
Those who previously suffered from some form of mental distress (e.g., anxiety, loneliness, grief) may
be pushed toward a full-blown mental illness, while those with diagnosed conditions can experience a
worsening of symptoms. Pandemic-related social isolation, reduced physical activity, and stress may affect
brain health and development in children and adolescents, while increasing the risk of cognitive decline
and dementia in the elderly.21 Governments around the world are bracing for a historic wave of depression,
substance abuse, self-harm, post-traumatic stress disorder, and suicide.22 To make matters worse, COVID-19
has further diminished access to mental health treatment resources that were already grossly inadequate
worldwide prior to the pandemic. A WHO survey conducted in summer 2020, across 130 countries, found
that COVID-19 has disrupted or halted critical mental health services in 93% of countries, even as demand
for these services is increasing.23
Mental wellness offers a path forward to meet widespread

needs and increase well-being for all.
Unprecedented times call for unprecedented strategies. COVID-19 has not only exposed the wide gap
between mental health needs and mental health resources, but also how vulnerable we all are, even when
our level of mental distress does not meet the criteria for a diagnosed mental disorder. Mental wellness –
both as a concept and as a set of strategies – can help to address this mounting crisis.
A rapidly growing number of consumers are embracing wellness as a dominant lifestyle value, and there is
growing recognition that our physical and mental health are closely connected. Our increased willingness
to acknowledge the stress, anxiety, and unhappiness of modern life – alongside our growing interest
in meditation and mindfulness, self-help, sleep, and brain health – signal a collective awakening to the
importance of mental wellness and the need for integrative strategies and solutions. We are reaching back
to ancient practices and spiritual traditions for mental wellness (e.g., meditation, chanting, shamanism),
while simultaneously leveraging cutting-edge science and technologies that offer new services and
solutions, new avenues to learn and access different mental wellness modalities, and new research and
scientific understanding of how our brains work.
Defining the Mental Wellness Economy – November 2020 | 4

A big shift toward mental wellness is just beginning: as a personal pathway toward higher levels of
well-being, as a public health and community strategy, and as a business and investment opportunity.
Practitioners and consumers have been leading the way, with a vibrant private sector creating new
solutions, services, and products to help people build resilience and improve their mental wellness. Yet, the
understanding of mental wellness is often fuzzy, and to date there has been no definition or quantification
of this burgeoning mental wellness marketplace.
This study will offer a definition for mental wellness; clarify

concepts and outline pathways; define mental wellness as
an industry for the first time and delineate its segments; and
estimate the size of the global mental wellness economy.

Endnotes
1
October 16, 2020. In this dataset, “mental disorders” include schizophrenia, depressive disorders, bipolar,
anxiety disorders, eating disorders, autism spectrum disorders, attention-deficit/hyperactivity disorder,
conduct disorder, idiopathic developmental intellectual disability, and other mental disorders; “substance
use disorders” include alcohol use and drug use disorders.
2
Charlson, F., et al (2019, June 11). New WHO prevalence estimates of mental disorders in conflict
settings: a systematic review and meta-analysis. The Lancet, 394(10194), 240-248. https://doi.
org/10.1016/S0140-6736(19)30934-1.
3
See: 1) Funk, M., et al (2012). Mental health, poverty, and development. Journal of Public Mental Health,
11(4), 166-185. https://doi.org/10.1108/17465721211289356. 2) Lund, C., et al (2010). Poverty and common
mental disorders in low and middle income countries: A systematic review. Social Science & Medicine,
71(3), 517-528. https://doi.org/10.1016/j.socscimed.2010.04.027. 3) WHO (n.d.). Breaking the Vicious
Cycle Between Mental Ill-Health and Poverty. https://www.who.int/mental_health/policy/development/1_
Breakingviciouscycle_Infosheet.pdf?ua=1.
4
October 16, 2020.
5
Henderson, C., et al (2013). Mental Illness Stigma, Help Seeking, and Public Health Programs. American
Journal of Public Health, 103(5), 777-780. https://doi.org/10.2105/AJPH.2012.301056.
6
Alzheimer’s Disease International (2018). World Alzheimer Report 2018. https://www.alz.co.uk/
research/WorldAlzheimerReport2018.pdf.
7
Gallup (2019). Gallup Global Emotions 2019. Washington, DC: Gallup. https://www.gallup.com/
analytics/248906/gallup-global-emotions-report-2019.aspx.
8
World Health Organization (2019, May 28). Mental health: Burn-out an “occupational phenomenon”:
International Classification of Diseases. https://www.who.int/mental_health/evidence/burn-out/en/.
9
DiJulio, B., Hamel, L., et al (2018, August 30). Loneliness and Social Isolation in the United States, the
United Kingdom, and Japan: An International Survey. https://www.kff.org/other/report/loneliness-and-
social-isolation-in-the-united-states-the-united-kingdom-and-japan-an-international-survey/.
10
See: 1) McGregor, J. (2017, Oct. 4). This former surgeon general says there’s a ‘loneliness epidemic’
and work is partly to blame. Washington Post. https://www.washingtonpost.com/news/on-leadership/
wp/2017/10/04/this-former-surgeon-general-says-theres-a-loneliness-epidemic-and-work-is-partly-
to-blame/?utm_term=.47eb7d4d8bc5. 2) U.S. Centers for Disease Control and Prevention (2020, May
26). Loneliness and Social Isolation Linked to Serious Health Conditions. https://www.cdc.gov/aging/
publications/features/lonely-older-adults.html.
11
Helliwell, J.F., et al (2019). Changing World Happiness. In J.F. Helliwell, R. Layard, and J.D. Sachs (Eds.),
World Happiness Report 2019 (pp. 11-46). New York: Sustainable Development Solutions Network.
https://s3.amazonaws.com/happiness-report/2019/WHR19_Ch2.pdf. See also: Helliwell, J., Layard, R., et
al (Eds.) (2020). World Happiness Report 2020. New York: Sustainable Development Solutions Network.
https://worldhappiness.report/ed/2020/.

12
Vigo, D., et al (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3, 171-
178. https://doi.org/10.1016/S2215-0366(15)00505-2.

13

14
Funk, M., et al (2010). Mental health and development: Targeting people with mental health conditions
as a vulnerable group: Summary. Geneva: World Health Organization. https://www.who.int/mental_
health/policy/development/mh_devel_targeting_summary_2010_en.pdf.
15
Kellend, K. (2020, May 14). U.N. warns of global mental health crisis due to COVID-19 pandemic. World
Economic Forum. https://www.weforum.org/agenda/2020/05/united-nations-global-mental-health-
crisis-covid19-pandemic/.
16
See, for example: 1) Choi, K.R., et al (2020, July 1). A Second Pandemic: Mental Health Spillover From
the Novel Coronavirus (COVID-19). Journal of the American Psychiatric Nurses Association, 26(4), 340-
343. https://doi.org/10.1177/1078390320919803. 2) Lake, J. (2020, June 15). A Mental Health Pandemic:
The Second Wave of COVID-19. Psychiatric Times. https://www.psychiatrictimes.com/view/a-mental-
health-pandemic-the-second-wave-of-covid-19. 3) Thomas, N., and Romano, S. (2020, Oct. 12). A ‘second
wave’ of mental health devastation due to Covid-19 is imminent, experts say. CNN. https://www.cnn.
com/2020/10/12/health/mental-health-second-wave-coronavirus-wellness/index.html.
17
World Health Organization (2020, May 14). Substantial investment needed to avert mental health crisis.
https://www.who.int/news-room/detail/14-05-2020-substantial-investment-needed-to-avert-mental-
health-crisis.
18
United Nations (2020, May 13). Policy Brief: COVID-19 and the Need for Action on Mental Health.
https://unsdg.un.org/sites/default/files/2020-05/UN-Policy-Brief-COVID-19-and-mental-health.pdf.
19
United Nations (2020, May 13).
20
Ettman, C.K., et al (2020). Prevalence of Depression Symptoms in U.S. Adults Before and
During the COVID-19 Pandemic. JAMA Network Open, 3(9), e2019686. https://doi.org/10.1001/
jamanetworkopen.2020.19686.
21
United Nations (2020, May 13).
22
See, for example: 1) Simon, N.M., et al (2020, Oct. 12). Mental Health Disorders Related to COVID-19-
Related Deaths. JAMA, 324(15), 1493-1494. https://doi.org/10.1001/jama.2020.19632. 2) Wan, W. (2020,
May 4). The coronavirus pandemic is pushing America into a mental health crisis. The Washington
Post. https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/. 3) Ribeiro, E.
(2020, Aug. 12). Fighting suicide during COVID-19: Lessons from past pandemics and recessions. Vox
EU. https://voxeu.org/article/fighting-suicide-during-covid-19. 4) United Nations, Regional Information
Centre for Western Europe (2020, May 5). Concerns are raised over the threat of COVID-19 to mental
health in Europe. https://unric.org/en/concerns-are-raised-over-the-threat-of-covid-19-to-mental-health-
in-europe/. 5) Sher, L. (2020, June 30). The impact of the COVID-19 pandemic on suicide rates. QJM: An
International Journal of Medicine, hcaa202. https://doi.org/10.1093/qjmed/hcaa202.
23
World Health Organization (2020, Oct. 5). COVID-19 disrupting mental health services in most
countries, WHO survey. WHO News Release. https://www.who.int/news/item/05-10-2020-covid-19-
disrupting-mental-health-services-in-most-countries-who-survey.

II. Defining Mental Wellness
Mental wellness is a term that is increasingly used in the popular lexicon, but it is vague and not well-
understood. People associate mental wellness with many different types of activities: meditating, listening
to music, talking to a friend, taking a walk in nature, taking a vacation, getting a massage, taking a bubble
bath, squeezing a stress ball, or just carving out some time for peace and quiet in daily life. When we
talk about mental wellness, we are not just focusing on our mental or cognitive functioning, but also our
emotions; our social relationships; our ability to function in daily life; and even our spiritual, religious,
or existential state. Most people would agree that mental wellness is different than happiness, but very
few could elaborate precisely how the two are different. Sometimes the term mental wellness is used
synonymously with mental health or mental well-being, two terms that are also not well-defined. Below
we offer a simple and concise definition for mental wellness. A summary of related terminologies and
definitions (for mental illness, mental health, mental well-being, and happiness) is provided in Appendix A.
What is mental wellness?
Mental wellness is an internal resource that helps us think, feel,

connect, and function; it is an active process that helps us to build
resilience, grow, and flourish.
This definition characterizes mental wellness as a dynamic, renewable, and positive resource, and as an
active process that requires initiative and conscious action. It recognizes mental wellness as an internal
experience that encompasses multiple dimensions:
• Mental: How we think; how we process, understand, and use information.
• Emotional: How we feel; how we manage and express our emotions.
• Social: How we connect; our relationships with others.
• Psychological: How we act or function, or how we “put the pieces together;” taking external
inputs along with our internal capacity and then making decisions or doing things.
Our new definition of mental wellness distills the concepts included in many existing definitions, notably
from the World Health Organization (WHO) and the U.S. Surgeon General (see Appendix A),1 to align with
current practices and understanding. Key concepts included in those definitions are: feeling good, being
resilient and functional, enjoying positive relationships, contributing to society or community, realizing
potential, and having a sense of fulfilment or coherence. Mental wellness is sometimes associated with
the concept of psychological well-being, which includes self-acceptance, growth, purpose, autonomy,
environmental mastery, and positive relationships.2 Mental wellness has been described as a process, a
resource, a state of being, or a balance point between resources and challenges.3 Our definition builds upon
well-established (but not widely known) theories from psychology and academic literature, and it frames
them in a language that is more understandable to consumers, businesspeople, and policymakers.

Figure 1

Five key things everyone should know about mental
wellness.
1. Mental wellness is more than just the absence of mental illness.

There is a tendency to think of mental wellness and mental illness as a simple continuum, with severe and
chronic mental disorders on one end, happiness and flourishing on the other end, and varying degrees of
resilience or coping with mental and emotional disturbances in the middle. This view does not accurately
reflect the nuanced and dynamic relationship between mental illness and mental wellness. The complex
relationship between mental illness and mental wellness is best understood by envisioning them sitting
on two separate continuums (see Figure 2).
Figure 2
This “dual continuum” model has been adapted by the authors from work first developed by the Canadian
Minister of National Health and Welfare (19884), social worker/psychotherapist Keith Tudor (19965), and
sociologist/psychologist Corey Keyes (20026). The dual continuum model aligns with the core tenets of
wellness. It embraces a holistic or “complete state” approach to mental and physical health, in which good
health is not just the absence of illness (a pathogenic approach), but also the presence of wellness or
something positive (a salutogenic approach).7

• The horizontal axis measures mental illness from high to low. This axis measures the presence
or absence of diagnosable mental disorders (e.g., depression, anxiety, personality disorders,
etc.), based upon the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
Treatment of mental illness typically takes a clinical or pathogenic approach, which focuses on
diagnosing a problem, treating the symptoms, and bringing a person back to “normal.” Care is
typically delivered by trained mental health professionals (e.g., psychiatrists, psychologists, social
workers, etc.).
• The vertical axis measures mental wellness from languishing to flourishing. This axis captures
the many factors that shape our overall mental health and well-being, but are not clinical
conditions – e.g., stress, worry, loneliness, or sadness at the negative end, and happiness, life
satisfaction, strong relationships, or personal growth at the positive end. Mental wellness offers a
salutogenic approach that focuses on positive human functioning: preventing illness, maintaining
good mental health, and pursuing optimal mental well-being. Mental wellness is self-directed,
personal, and subjective; it typically relies on self-care and personal agency to cope with everyday
challenges and proactively pursue a higher level of happiness and well-being. Mental wellness can
be empowering because it acknowledges the universal desire for peace, joy, happiness, meaning,
and purpose.
Subsequent research over the last two decades has supported the dual continuum model, which captures
several important concepts about mental wellness and mental illness:8
• A lack of mental illness does not equate to mental wellness. About 15% of the world’s population
suffers from a diagnosed mental or substance use disorder,9 but that does not mean that the
other 85% of the population is “mentally well” or leading healthy, happy, productive, and satisfied
lives. Many people who do not have a mental illness still “do not feel healthy or function well,”10
because of pervasive stress, worry, loneliness, and other challenges. Those who are “languishing”
rather than “flourishing” (even when free of a diagnosed mental illness) tend to do worse in
terms of “physical health outcomes, healthcare utilization, missed days of work, and psychosocial
functioning.”11 Low mental wellness (“languishing”) can be debilitating; it is more common than
depression and is associated with emotional and psychosocial impairment comparable to that of
a depressive episode.12
• Mental wellness can co-exist with mental illness. Research on the dual continuum model shows
that the presence of mental illness does not necessarily imply an absence of mental wellness, and
vice versa. For example, a person with obsessive compulsive disorder, attention deficit disorder,
or mild depression can still demonstrate moderate or positive mental wellness (e.g., having good
relationships, feeling happy, or functioning well at a job). Corey Keyes’ study of Americans ages
25-74 found that 70% of those with a diagnosed mental illness had a “moderate” or “flourishing”
level of mental wellness. Meanwhile, among those free of mental illness in the previous year, only
20% were “flourishing” in their mental wellness.13
• Mental wellness can mitigate and prevent mental illness. Increasing our level of mental wellness
can protect us against developing mental illness and can also mitigate the symptoms of these
illnesses. Keyes’ studies showed that those who are “flourishing” function better than those with
moderate or “languishing” mental wellness, regardless of whether a person has a diagnosed

mental illness or not. People whose level of mental wellness declined from flourishing to moderate
were over 3.5 times more likely to develop mental illness than those who stayed flourishing, while
people whose mental wellness declined from moderate to languishing were 86% more likely to
develop mental illness. Meanwhile, Keyes’ research also showed that improving one’s mental
wellness from languishing to moderate reduced the risk of future mental illness by nearly half.14
We are not suggesting here that mental wellness can solve or cure mental illness, but that the
practices that support and improve our mental wellness (e.g., good sleep, good nutrition, exercise,
meaningful relationships, reducing stress, meditation) are increasingly recognized as protective
factors for our mental health, as well as helping reduce the severity and symptoms of mental
illness (alongside conventional treatment regimens).15
2. Mental wellness is an active process of moving from languishing,

to resilience, to flourishing.
Our mental wellness is not a static state of being. Mental wellness is a lifelong process and a proactive
strategy to strengthen our mental, emotional, social, and psychological resources. On one level, mental
wellness is about prevention; coping with life’s adversity; and being resilient when we face stress, worry,
loneliness, anger, and sadness. On another level, mental wellness moves us toward a deeper, richer, and
more meaningful human experience, which is often described as flourishing. The notion of flourishing as
the peak mental state has been shaped by developments in the psychology field during the 20th century,
including Abraham Maslow’s hierarchy of needs, Carl Rogers and humanistic psychology (a holistic
approach of self-exploration and working toward full human potential), and Martin Seligman’s positive
psychology (emphasizing eudaimonia and human flourishing). Concepts of self-actualization, the pursuit
of fulfillment, and the untapped potential that lies in all people were disseminated and popularized by the
Human Potential Movement in the 1960s-1970s.16
The psychology field has explored various methods of measuring individuals’ mental wellness (see Appendix
B for more information on the approach proposed by Corey Keyes, in relation to the dual continuum
model), but these tools depend upon self-reporting and are inherently subjective.17 Flourishing is a personal
experience. For some people, it may mean functioning at the top of their game on a daily basis – staying
engaged, sharp, and focused; and achieving their life goals and vision. For others, flourishing could mean
moving toward self-transcendence – going beyond the “self” to associate with a higher purpose; living
in truth, unity, and harmony with the universal order; and developing a sense of peace and joy that is
independent of external circumstances or events. This concept of mental wellness is often associated with
the realms of human consciousness, spiritual practices, and religious devotion.18 Our definition of what it
means to flourish is also shaped by culture.19 For example, in some cultures people put the highest value on
individual balance and inner harmony for living a thriving and happy life. Other cultures may take a more
collectivist view, placing high value on peace, family relationships, and social harmony. The important
point is that flourishing (as a peak level of mental wellness) is different for different people, depending on
their values, beliefs, culture, and personal journey.

3. Mental wellness helps to shift the perspective away from stigma
to shared humanity and shared responsibility.
Even though the mental health field has done a lot of work to mitigate the stigma surrounding mental
illness, a sense of shame, denial, and secrecy continues to afflict people in communities and cultures
around the world.20 Mental wellness can help shift our focus toward a more positive and empowering
approach (how we can feel, think, connect, and function better), rather than just avoiding or coping with
illness. Importantly, mental wellness emphasizes our capacity to build resilience; to reduce suffering; to
find inner peace, joy, and fulfilment; to seek purpose, meaning, and happiness; and to connect to others.
By acknowledging this as a universal condition and longing shared by all people, there is no need to feel
shame or to feel that we are alone in this endeavor.
During the last century, modern psychology and its approaches to treating mental illness have tended
to focus on individual behavior and individual-level interventions, such as talk therapy and drugs. Mental
wellness favors a more holistic approach that encompasses personal agency alongside social and
environmental dimensions (e.g., family, friends, community connections, living environments). In doing so,
mental wellness helps shift our perspective toward a sense of shared humanity and shared responsibility,
while also bringing attention to the many external forces that deeply influence our overall mental health
and well-being – including socioeconomic status, culture and values, built environment, technology, and
much more.
This approach does not ignore or refute the immense need for more resources and better methods
to address and treat mental illness. Rather, it emphasizes that the promotion of mental wellness is an
equally important (yet often overlooked) approach that can address a multitude of individual and societal
problems (such as loneliness and stress), while also complementing approaches to mental illness and even
helping to prevent mental illness and reduce its associated costs.
4. Mental wellness grows out of a grassroots, consumer-driven

movement.
There is a huge global need to address mental illness and to help people in mental distress who are
vulnerable to developing a full-blown mental disorder. The needs are vast, and resources are scarce, and
the “talk and pills” approach does not work for everyone. Meanwhile, people with poor mental wellness
(“languishing”) desperately need non-clinical, non-pathologizing strategies and tools to cope. As discussed
above, evidence shows that improving our mental wellness can even reduce our risk of developing mental
illness. And yet, not enough attention is paid globally to mental illness prevention and mental wellness
promotion, and mental health has never been well-integrated into public health structures.21
Our healthcare systems (including mental health) are not set up to help the spiraling number of people
who are facing everyday mental and emotional challenges like stress, burnout, loneliness, or sadness. In
response to these immense gaps, mental wellness has grown out of a grassroots, consumer-led movement
that seeks self-directed, alternative solutions outside of the established fields of medicine, psychiatry,
and psychology. Mental wellness encompasses many natural and complementary modalities that have
been around for millennia, and that have operated on the fringes of modern psychology and medicine
for decades. It embraces a holistic approach that recognizes the mind-body connection, and therefore
extends to lifestyle strategies such as nutrition and exercise. Mental wellness modalities mostly exist
outside of healthcare systems and reimbursement schemes. Presently, many of these modalities lack the
validation of clinical evidence and double-blind studies that are required for approval of medical treatment
protocols and pharmaceuticals.

Figure 3
Since the beginning of mankind, humans have been on a quest for mental wellness – to understand
ourselves, to improve our minds, and to find happiness and fulfillment. All of the modalities that we typically
associate with mental wellness today (from meditation and sound healing, to crystals, stress gadgets, and
psychedelic drugs) are rooted in ancient practices, spanning every corner of the globe. The hippies and
counterculture movement brought these practices to a modern, mainstream Western audience in the
1960s-1970s (see Appendix C).22 In recent decades, it was the practitioners of meditation – including the
Dalai Lama – who boldly advocated that neuroscientists study the human brain in relation to meditation,
much to the chagrin of many scientists.23 Since then, the concept of neuroplasticity has gained significant
understanding and recognition, and hundreds of scientific studies have examined meditation’s potential
to address numerous mental disorders, improve mental wellness, and prevent cognitive decline.24 In the
realm of mental wellness, practitioners, consumers, and businesses will continue to lead the way, pushing
science into areas where it has not gone before to consider the efficacy of ancient practices and emerging
solutions.

5. Mental wellness is multi-dimensional, holistic, and personal.
Mental wellness recognizes the integrated and holistic nature of our health and well-being. The state of
our mind affects our body, and vice versa. Our mental wellness is also connected to our beliefs and values,
to other people, to nature, and even to the realms of consciousness and spirituality. The approaches for
improving our mental wellness are diverse and inclusive, and they are enriched by cultural, social, and
religious traditions and contexts. The numerous pathways toward mental wellness have been extensively
catalogued in GWI’s 2018 Mental Wellness Initiative white paper25 and in a recently published chapter in
the Oxford Research Encyclopedia of Global Public Health.26
Figure 4
In this study, we segment mental wellness pathways into four broad domains: activity and creativity;
growth and nourishment; rest and rejuvenation; and connection and meaning (see Figure 4). Each of
these domains has mind-body and internal-external dimensions, although their boundaries may be blurred
due to the inherently holistic and interconnected nature of wellness and wellness modalities. For example,
some people do yoga as exercise (putting it in the “activity and creativity” domain), while for others yoga
is more of a meditative practice (putting it in the “rest and rejuvenation” domain). Likewise, mindfulness
spun out of and is most closely associated with meditation (“rest and rejuvenation”), but it has been
integrated into therapy (“growth and nourishment”) and many other aspects of life, from mindful eating
to mindful coloring. The point of this framework is not to put each activity or modality cleanly into a box,
but rather to emphasize several important points (which are discussed further in Chapter III):

• Mental wellness pathways are multi-dimensional and holistic. Just like wellness in general,
mental wellness is linked to many dimensions of our health and well-being (physical, social,
emotional, spiritual, etc.). The things we can do to support and improve our mental wellness are
vast and limitless, from taking a walk, to meditating, to getting better sleep, to volunteering in our
community.
• The mind-body connection is critical to mental wellness. The things we do for our physical health
(like eating well or exercising) are just as (or more) important for our mental wellness as the things
we do specifically for our minds (like meditating or reading a self-help book).
• Mental wellness pathways are personal and subjective. Each of us has different needs and
interests when it comes to supporting our mental wellness – some of us may relax and de-stress
by going to the gym, others find solace in prayer, while others may feel best when playing with
their pet.
• Mental wellness pathways can be accessed through many places and spaces in our daily lives.
When we look at the diversity of mental wellness pathways, it is clear that countless places, spaces,
organizations, and businesses can play a role in helping or hindering our mental wellness – from
our homes, neighborhoods, and cities; to our workplaces and schools; to our churches, mosques,
and temples; to fitness centers and grocery stores.
Activity and Creativity:

Physical activity – from walking and running, to cardiovascular exercise, to sports, dance, yoga, and martial
arts – can require concerted mental engagement, can help us relax and de-stress, and can have a profound
impact on our mental wellness. While there is insufficient scientific consensus as to how exactly exercise
elevates mood (whether by increasing serotonin, improving sleep regulation, promoting social connection,
or providing a meaningful activity or a sense of accomplishment, etc.), its beneficial impacts on our mental
wellness are well-established and well-documented.27
Similar to our bodies, our minds need exercise in the form of play, creativity, discovery, and learning. We
all have different things that interest and engage us, both in our jobs and in our leisure time. There are
countless ways to stimulate our minds, to express ourselves, to be curious, to feel alive, to master new
things, and to experience fun and laughter. For some people it could be reading, cooking food, making
furniture, playing a board game, or listening to hip hop music; for others it could be painting, singing in a
choir, fixing an appliance, writing a computer program, or doing a spreadsheet.
Growth and nourishment:

Our minds need to be nourished in order to grow. Some of the activities mentioned above (e.g., music,
arts, hobbies, reading, and other intellectual or creative pursuits) can also nourish our minds and promote
growth. In this category, however, we include strategies such as self-help, therapy, coaching and mentoring,
and cognitive enhancement and brain training, which are all conscious and proactive efforts to support
our personal development or brain health. Obviously, not everyone will feel the need to seek out self-help
books, therapy, or cognitive training, but these modalities are available to those who have an interest in or
a need for these kinds of proactive efforts.
On the physical side, a growing body of research has demonstrated the importance of a healthy diet and
nutrition for brain health.28 Emerging understanding of the gut-brain axis, the microbiome, and the impacts
of nutrition on neurological function/decline is creating new opportunities to nourish the brain through

dietary supplements such as vitamins, minerals, pre- and probiotics, and polyphenols. Since ancient times,
plant-based drugs (e.g., mushrooms, cannabis) have been used by humans for their mind-altering and
mind-enhancing properties. New scientific research over the last couple of decades has brought renewed
interest in the potential of these drugs for boosting energy, creativity, and brain performance, as well as
for treating some mental disorders.
Rest and rejuvenation:

To counterbalance mental activity, creativity, and growth, our brains also need rest, recovery, and
rejuvenation. Sleep is a physical process that is vitally important to our mental wellness; a lack of sleep
increases our risk of developing some mental illnesses (e.g., anxiety, depression), affects our cognitive
functioning, and can lead to chronic physical health conditions.29 In addition to their physical health benefits,
mind-body practices such as yoga, tai chi, qigong, and breathwork are believed to promote mental rest
and recovery, and clinical research is increasingly demonstrating their efficacy in mitigating specific mental
and physical health conditions. An ever-growing array of sensory products and experiences are available
in the wellness arena and in the consumer retail space, including touch (e.g., massage, reiki, weighted
blankets, fidget spinners), aroma (e.g., aromatherapy, home fragrances), sound (e.g., gong baths, white
noise machines), and light (e.g., circadian lightbulbs). These products and services are rising in popularity
because of a growing recognition that our senses can affect our stress levels, our ability to relax and sleep,
our ability to focus, and our overall mental wellness – even though most of these have not yet been vetted
by rigorous clinical studies.
Meditation and mindfulness have received the most attention in recent years as important mental wellness
practices; however, the two are sometimes misunderstood and conflated. Today, there are many different
types of meditation (from 2 to 23, depending on the source). The Global Wellness Summit’s Meditation Goes
Plural30 lays out three main types of meditation: 1) focused attention (mostly associated with Vipassana
meditation in the Buddhist tradition); 2) open monitoring (focused on opening awareness, and spanning
many forms of mindfulness meditation and related mindfulness practices outside of meditation); and 3)
self-transcending (typically using a mantra). Numerous research studies have documented the impacts
of meditation on brain activity, such as accelerating or slowing certain brain waves (Alpha, Beta, Gamma,
Theta, and Delta) during practice. Among the documented mental wellness impacts of meditation are:
reduction of the “fight or flight” response; improved cognitive function, better focus, and higher creativity;
and improved neuroplasticity in long-term practitioners. The concept of mindfulness initially spun out
of Jon Kabat-Zinn’s efforts to bring Buddhist meditation to medicine and a Western, secular audience in
the 1970s-1980s. Today, mindfulness is viewed more as a quality, an awareness, or a way of living rather
than a “practice” like meditation. Mindfulness can be cultivated through formal practices like meditation
(including “mindfulness meditation”) or therapy (such as mindfulness-based cognitive therapy), as well as
informally in our daily lives (mindful eating, mindful walking, mindful conversation, mindful parenting).31

Connection and meaning:
Internally, connection means being grounded in a deeper and more profound sense of purpose beyond
our physical existence and our individual, biological instincts for survival. Many people find connection
and meaning through religious and spiritual practices; studies have repeatedly shown that people who
actively practice a religion have a higher sense of well-being and happiness.32 Faith practices help take our
focus off ourselves, while putting our lives and experiences into a larger context. The practices of gratitude,
altruism, and compassion, while rooted in many world religions, can also be pathways to happiness and
well-being in an agnostic sense. Studies have shown that altruism – elevating the well-being of others,
or serving and helping others – contributes to individual resilience and happiness, even during times of
hardship.33
Externally, the sense of being connected to other people, and to the broader world, is intrinsic to our
mental wellness. Unfortunately, loneliness and social isolation have been recognized by global public health
organizations as having reached epidemic proportions, a development further aggravated by COVID-19.34
In addition to connections with friends, family, and other people, studies have shown that being close to
nature, pets, and living things can have a therapeutic effect on us, helping to reduce negative emotions,
promoting calmness of the mind, and even aiding in physical healing.35 Civic engagement and volunteering
give us an avenue to contribute to our community and society, and empower us to effect change in the
world around us, and have also been shown to have positive effects on our health and well-being.36

Endnotes
1
As discussed in Appendix A, the WHO and U.S. Surgeon General discuss and define the concept
of “mental health,” which the Global Wellness Institute interprets in this report as being the
same as “mental wellness.” See: 1) World Health Organization (2018, March 30). Mental health:
Strengthening our response. WHO Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/
mental-health-strengthening-our-response. 2) Satcher, D.S. (1999). Mental Health: A Report of the
Surgeon General – Executive Summary. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1308561/pdf/
pubhealthrep00023-0091.pdf.
2
See: 1) Ryff, C. (1989). Happiness is everything, or is it? Explorations on the meaning of
psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069-1081. https://doi.
org/10.1037/0022-3514.57.6.1069. 2) Ryff, C.D., and Keyes, C.L.M. (1995). The Structure of Psychological
Well-Being Revisited. Journal of Personality and Social Psychology, 69(4), 719-727. https://doi.
org/10.1037/0022-3514.69.4.719. 3) Ryff, C.D. (2014). Psychological Well-Being Revisited: Advances in
the Science and Practice of Eudaimonia. Psychotherapy and Psychosomatics, 83(1), 10-28. https://doi.
org/10.1159/000353263.
3
See, for example: 1) Dodge, R., et al (2012). The challenge of defining wellbeing. International Journal of
Wellbeing, 2(3), 222-235. https://doi.org/10.5502/ijw.v2i3.4. 2) Patel, V., et al (2018, Oct. 27). The Lancet
Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553-1598.
https://doi.org/10.1016/S0140-6736(18)31612-X. 3) Lehtonen, J. (1978). Mental health as a resource-like
phenomenon and some considerations of suicide problems. Psychiatria Fennica, 9, 139-142. https://
psycnet.apa.org/record/1981-11008-001.
4
Epp, J. (1988). Mental Health for Canadians: Striking a Balance. Ottawa: Minister of National Health and
Welfare.
5
Tudor, K. (1996). Mental Health Promotion: Paradigms and Practice. London: Routledge.
6
Keyes, C.L.M. (2002). The Mental Health Continuum: From Languishing to Flourishing in Life. Journal of
Health and Social Research, 43, 207-222. https://pubmed.ncbi.nlm.nih.gov/12096700/.
7
Keyes, C.L.M. and Martin, C.C. (2017). The complete state model of mental health. In M. Slade, L. Oades,
and A. Jarden (Eds.), Wellbeing, Recovery and Mental Health (pp. 86-98). Cambridge, UK: Cambridge
University Press. https://doi.org/10.1017/9781316339275.009. For more information on pathogenesis
vs salutogenesis, see: 1) Bhattacharya, S., et al (2020, Jan.). Salutogenesis: A bona fide guide towards
health preservation. Journal of Family Medicine and Primary Care, 9(1), 16-19. https://doi.org/10.4103/
jfmpc.jfmpc_260_19. 2) Mittelmark, M.B., et al (Eds.) (2017). The Handbook of Salutogenesis. Cham,
Switzerland: Springer. https://doi.org/10.1007/978-3-319-04600-6. 3) Fries, C.J. (2020). Healing Health
Care: From Sick Care Towards Salutogenic Healing Systems. Social Theory & Health, 18(1), 16-32. https://
doi.org/10.1057/s41285-019-00103-2. 4) Jonas, W.B., et al (2014). Salutogenesis: The Defining Concept
for a New Healthcare System. Global Advances in Health & Medicine, 3(3), 82-91. https://doi.org/10.7453/
gahmj.2014.005.
8
See: 1) Keyes, C.L.M. (2014). Mental Health as a Complete State: How the Salutogenic Perspective
Completes the Pictures. In G.F. Bauer and O. Hämmig (Eds.), Bridging Occupational, Organizational
and Public Health: A Transdisciplinary Approach (pp. 179-192). Dordrecht: Springer. https://doi.
org/10.1007/978-94-007-5640-3_11. 2) Westerhof, G.J. and Keyes, C.L.M. (2010). Mental Illness and
Mental Health: The Two Continua Model Across the Lifespan. Journal of Adult Development, 17(2), 110-
119. https://doi.org/10.1007/s10804-009-9082-y.

9
October 16, 2020.
10
Keyes, C.L.M. (2005). Mental Illness and/or Mental Health? Investigating Axioms of the Complete
org/10.1037/0022-006X.73.3.539.
11
Keyes, C.L.M. (2014).
See: 1) Keyes, C.L.M. (2003). Complete mental health: An agenda for the 21st century. In C. L. M. Keyes
12
and J. Haidt (Eds.), Flourishing: Positive psychology and the life well-lived (pp. 293-312). Washington, DC:
American Psychological Association. https://doi.org/10.1037/10594-013. 2) Keyes, C.L.M. (2002).
13
Keyes, C.L.M. (2014).
14
Keyes, C.L.M. (2014).
15
For further discussion of protective factors and prevention in the mental health field, see: 1) Arango,
C., et al (2018, July 1). Preventive strategies for mental health. The Lancet Psychiatry, 5(7), 591-604.
https://doi.org/10.1016/S2215-0366(18)30057-9. 2) Miller, J.E. (2014, April). Reducing the Burden of
Mental Health: The Role of Preventive Activities and Public Health Strategies. Alexandria, VA: National
Association of State Mental Health Program Directors. https://www.nasmhpd.org/sites/default/files/
Prevention%20Issue%20Brief%20-%209-23-14%20FINAL.pdf. 3) Jeste, D. (2012, Sept. 7). Preventing
Mental Illness Is No Fantasy. Psychiatric News. https://doi.org/10.1176/pn.47.17.psychnews_47_17_3-a. 4)
Saxena, S., et al (2006, Feb.). Prevention of mental and behavioural disorders: Implications for policy
and practice. World Psychiatry, 5(1), 5-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472261/.
5) World Health Organization and Gulbenkian Mental Health Platform (2014). Social Determinants of
Mental Health. Geneva: World Health Organization. https://www.who.int/mental_health/publications/
gulbenkian_paper_social_determinants_of_mental_health/en/. 6) Weir, K. (2012, June). The roots of
mental illness. APA Monitor on Psychology, 43(6), 30. https://www.apa.org/monitor/2012/06/roots. 7)
Phillips, L. (2019, Aug. 29). Challenging the inevitability of inherited mental illness. Counseling Today.
https://ct.counseling.org/2019/08/challenging-the-inevitability-of-inherited-mental-illness/. 8) Vic
Health and Sax Institute (2019). Evidence Check: Mental wellbeing risk & protective factors. https://
www.vichealth.vic.gov.au/-/media/ResourceCentre/PublicationsandResources/General/VicHealth-
Attachment-1---Evidence-review-of-risk--protective-factors.pdf. 9) Chételat, G., et al (2018). Why could
meditation practice help promote mental health and well-being in aging? Alzheimer’s Research & Theory,
10, 57. https://doi.org/10.1186/s13195-018-0388-5.
Puttick, E. (2004). The Human Potential Movement. In C. Partridge (Ed.), Encyclopedia of New
16
Religions (p. 399). Oxford, UK: Lion Publishing.
17
For a review of various instruments used to measure mental wellness or well-being, see: 1) Cooke, P.J.,
et al (2016). Measuring Well-Being: A Review of Instruments. The Counseling Psychologist, 44(5), 730-
757. https://doi.org/10.1177%2F0011000016633507. 2) Linton, M.-J., et al (2016). Review of 99 self-report
measures for assessing well-being in adults: Exploring dimensions of well-being and developments over
time. BMJ Open, 6, e010641. https://doi.org/10.1136/bmjopen-2015-010641. 3) Diener, E. (n.d.). Scales.
https://eddiener.com/scales. See also: Lee Kum Sheung Center for Health and Happiness, Harvard
T.H. Chan School of Public Health. Well-Being Measurement. https://www.hsph.harvard.edu/health-
happiness/research-new/positive-health/measurement-of-well-being/.
For a deeper discussion of mental wellness and religious/spiritual practices, see: Bodeker, G., and
18
Hernandez, A. (2018), Spirituality and Faith; Bodeker, G. (2018), What is Consciousness and What is Its

Place in Mental Wellness; and Hernandez, A., and Bodeker, G. (2018), Higher Human Potential – Beyond
Ordinary Limits. In G. Bodeker (Ed.), Mental Wellness: Pathways, Evidence and Horizons (pp. 80-81, 82,
and 86-91). Miami, FL: Mental Wellness Initiative, Global Wellness Institute. https://globalwellnessinstitute.
org/wp-content/uploads/2018/10/GWI-MWI-WhitePaper2018.pdf.
19
In 2020, Gallup announced that it is adding a new set of culturally inclusive measures to the Gallup
World Poll to complement its standard questions and metrics for well-being. See: 1) Daly, J. (2020,
July 7). Making the Study of the World’s Wellbeing More Inclusive. Gallup Blog. https://news.gallup.
com/opinion/gallup/313472/making-study-world-wellbeing-inclusive.aspx. 2) Lambert, L., et al (2020).
Towards a greater global understanding of wellbeing: A proposal for a more inclusive measure.
International Journal of Wellbeing, 10(2), 1-18. https://www.internationaljournalofwellbeing.org/
index.php/ijow/article/view/1037. For more discussion of culture, happiness, and well-being, see: 1)
Newman, K.M. (2019, May 22). How Cultural Differences Shape Your Happiness. Greater Good Magazine.
https://greatergood.berkeley.edu/article/item/how_cultural_differences_shape_your_happiness. 2)
Pogosyan, M. (2016, May 24). How Does Culture Affect Our Happiness? Psychology Today. https://www.
psychologytoday.com/us/blog/between-cultures/201605/how-does-culture-affect-our-happiness.
3) Joshanloo, M., and Weijers, D. (2014). Aversion to Happiness Across Cultures: A Review of Where
and Why People are Averse to Happiness. Journal of Happiness Studies, 15(3), 713-735. https://doi.
org/10.1007/s10902-013-9489-9.
20
See, for example: 1) Harrison, N. (2018). Enough talk: Fighting stigma in mental health. The Lancet
Psychiatry, 5(6), E15. https://doi.org/10.1016/S2215-0366(18)30194-9. 2) Wainberg, M.L., et al (2017).
Challenges and Opportunities in Global Mental Health: A Research-to-Practice Perspective. Current
Psychiatry Reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z. 3) Saxena, S., et al (2007).
Resources for mental health: Scarcity, inequity, and inefficiency. The Lancet, 370, 878-889. https://doi.
org/10.1016/S0140-6736(07)61239-2. 4) Funk, M., et al (2010). Mental health and development: Targeting
people with mental health conditions as a vulnerable group. Geneva: World Health Organization.
https://www.mhinnovation.net/sites/default/files/downloads/resource/Mental%20Health%20and%20
Development.pdf.
21
As noted by the World Health Organization, “Early in the 20th century the mental hygiene movement
was successful in putting mental health promotion on the international agenda. During the 1920s and
30s there was substantial activity to stimulate ‘the integration of mental health principles into the
practices of social work, nursing, public health administration, education, industry and government,’
views that are still very prevalent today. Despite the efforts of the pioneers, the movement initially failed
to attract sufficient interest from these wider groups. It was not until the 1970s that the first studies into
the value of integrating mental health principles into practice in other fields were initiated. During the
past 30 years, however, some 2000 outcome studies have been published on promotion, prevention and
related fields.” See: WHO, Department of Mental Health and Substance Abuse (2005). Promoting Mental
Health: Concepts, Emerging Evidence, Practice. Geneva: WHO Press. https://www.who.int/mental_health/
evidence/en/promoting_mhh.pdf.
22
See: Ingram, M. (2020). Retreat: How the Counterculture Invented Wellness. London: Repeater Books.
23
Some of the first significant Western scientific studies on meditation were conducted on Swami Rama
during the 1960s-1970s. For the last two decades, the Dalai Lama has advocated for the compatibility
between science and spirituality, and he has advocated for his followers to participate in scientific
studies on meditation. For more information, see: 1) Hamilton, J. (2005, Nov. 11). The Links Between
the Dalai Lama and Neuroscience. National Public Radio. https://www.npr.org/templates/story/story.
php?storyId=5008565. 2) Carey, B. (2005, Oct. 19) Scientists Bridle at Lecture Plan for Dalai Lama. New
York Times. https://www.nytimes.com/2005/10/19/us/scientists-bridle-at-lecture-plan-for-dalai-lama.

html. 3) Sedenberg, E. (2011, Aug. 2). An Uncommon Ally for Science. Center for American Progress.
https://www.americanprogress.org/issues/religion/news/2011/08/02/10130/an-uncommon-ally-for-
science/. 4) Luce, G., and Peper, E. (1971, Sept. 12). Mind Over Body, Mind Over Mind. New York Times.
https://www.nytimes.com/1971/09/12/archives/mind-over-body-mind-over-mind-such-is-the-twin-
promise-of.html. 5) Mead, E. (2020, Jan. 9). The History and Origin of Meditation. PositivePsychology.
com. https://positivepsychology.com/history-of-meditation/.
34
See: 1) National Center for Complementary and Integrative Health (n.d.). Meditation: In Depth. https://
www.nccih.nih.gov/health/meditation-in-depth. 2) Powell, A. (2018, April 9). When science meets
mindfulness. The Harvard Gazette. https://news.harvard.edu/gazette/story/2018/04/harvard-researchers-
study-how-mindfulness-may-change-the-brain-in-depressed-patients/. 3) Ahmad, S. (2019, July 17).
Meditation and Mental Health: Does the science support the hype? Psychology Today. https://www.
psychologytoday.com/us/blog/balanced/201907/meditation-and-mental-health.
35
Bodeker, G. (Ed.) (2018). Mental Wellness: Pathways, Evidence and Horizons. Miami, FL: Mental
Wellness Initiative, Global Wellness Institute. https://globalwellnessinstitute.org/wp-content/
uploads/2018/10/GWI-MWI-WhitePaper2018.pdf.
36
Bodeker, G., et al. (2020). Well-being and mental wellness. Oxford Research Encyclopedia of Global
Public Health. https://oxfordre.com/publichealth/view/10.1093/acrefore/9780190632366.001.0001/
acrefore-9780190632366-e-162.
37
For a summary discussion of physical movement in relation to mental wellness, see: Bodeker, G. (2018).
Movement. In G. Bodeker (Ed.), Mental Wellness: Pathways, Evidence and Horizons (pp. 60-68). Miami,
FL: Mental Wellness Initiative, Global Wellness Institute. https://globalwellnessinstitute.org/wp-content/
uploads/2018/10/GWI-MWI-WhitePaper2018.pdf.
38
For a summary discussion of diet and nutrition in relation to mental wellness, see: Bodeker, G., and
Hoare, B. (2018), The Gut-Brain Axis; and Bodeker, G. (2018), Nutrition and the Brain. In G. Bodeker (Ed.),
Mental Wellness: Pathways, Evidence and Horizons (pp. 30-32 and 33-37). Miami, FL: Mental Wellness
Initiative, Global Wellness Institute. https://globalwellnessinstitute.org/wp-content/uploads/2018/10/
GWI-MWI-WhitePaper2018.pdf.
39
See, for example: 1) Harvard Health Publishing, Harvard Medical School (2019, March 18). Sleep and
mental health. https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health. 2) Kilgore,
W.D.S. (2010). Effects of sleep deprivation on cognition. Progress in Brain Research, 185, 105-129. https://
doi.org/10.1016/B978-0-444-53702-7.00007-5.
40
McGroarty, B. (2019). Meditation Goes Plural. 2019 Global Wellness Trends. Miami, FL: Global Wellness
Summit. https://www.globalwellnesssummit.com/2019-global-wellness-trends/meditation-goes-plural/.
41
See: 1) Eisler, M. (2019, Aug. 27). What’s the Difference Between Meditation and Mindfulness? Chopra.
https://chopra.com/articles/whats-the-difference-between-meditation-and-mindfulness. 2) Schultz,
J. (2019, Jan. 9). 5 Differences Between Mindfulness and Meditation. PositivePsychology.com. https://
positivepsychology.com/differences-between-mindfulness-meditation/.
42
See, for example: 1) Villani, D., et al (2019, July 9). The Role of Spirituality and Religiosity in Subjective
Well-Being of Individuals With Different Religious Status. Frontiers in Psychology, 10, 1525. https://doi.
org/10.3389/fpsyg.2019.01525. 2) Jackson, B.R., and Bergeman, C.S. (2011, May 1). How Does Religiosity
Enhance Well-Being? The Role of Perceived Control. Psychology of Religion and Spirituality, 3(2), 149-
161. https://doi.org/10.1037/a0021597. 3) Pew Research Center (2019, Jan. 31). Religion’s Relationship to
Happiness, Civic Engagement and Health Around the World. https://www.pewforum.org/wp-content/
uploads/sites/7/2019/01/Wellbeing-report-1-25-19-FULL-REPORT-FOR-WEB.pdf.

43
See, for example: 1) Post, S.G. (2005). Altruism, Happiness, and Health: It’s Good to Be Good.
International Journal of Behavioral Medicine, 12(2), 66-77. https://doi.org/10.1207/s15327558ijbm1202_4.
2) Post, S.G. (2014, June). It’s Good to Be Good: 2014 Biennial Scientific Report on Health, Happiness,
Longevity, and Helping Others. https://unlimitedloveinstitute.org/downloads/ITS-GOOD-TO-BE-GOOD-
2014-Biennial-Scientific-Report-On-Health-Happiness-Longevity-And-Helping-Others.pdf. 3) Xi, J., et al
(2016, Feb. 17). Altruism and Existential Well-Being. Applied Research in Quality of Life, 12, 67-88. https://
doi.org/10.1007/s11482-016-9453-z.
44
McGroarty, B. (2020, May). Resetting the World with Wellness: Human Connection in a Time of Physical
Distancing. Miami, FL: Global Wellness Institute. https://globalwellnessinstitute.org/industry-research/
resetting-the-world-with-wellness/.
45
See, for example: 1) White, M.P. (2019, June 30). Spending at least 120 minutes a week in nature is
associated with good health and wellbeing. Scientific Reports, 9, 7730. https://doi.org/10.1038/s41598-
019-44097-3. 2) Chowdhury, M.R. (2020, Aug. 9). The Positive Effects of Nature On Your Mental Well-
Being. PositivePsychology.com. https://positivepsychology.com/positive-effects-of-nature/. 3) Van den
Bosch, M. (2017, March 29). Natural Environments, Health, and Well-Being. Oxford Research Encyclopedia
of Environmental Science. https://doi.org/10.1093/acrefore/9780199389414.013.333.
46
See, for example: 1) Piliavin, J.A., and Siegl, E. (2015, May). Health and Well-being Consequences
of Formal Volunteering. In D.A. Schroeder and W.G. Graziano (Eds.). Oxford Handbook of
Prosocial Behavior (pp. 494-523). New York: Oxford University Press. https://doi.org/10.1093/
oxfordhb/9780195399813.013.024. 2) Nelson, C., et al (2019). Examining Civic Engagement Links to
Health. Santa Monica, CA: RAND Corporation. https://doi.org/10.7249/RR3163.

III. Personal Agency Versus Collective
Responsibility
Our individual pathways for mental wellness are unique
and subjective.
Similar to wellness in general, our pursuit of mental wellness is personal and subjective. In the previous
chapter, Figure 4 presents the wide range of pathways and modalities that can help us improve our
mental wellness (or to “move up” the mental wellness continuum, from languishing, to moderate, to
flourishing). The connections between these pathways and our mental wellness have all, to some extent,
been demonstrated by scientific research. But, this certainly does not mean that we have to do all of
these things for our mental wellness. And, science does not indicate that certain pathways and modalities
are more essential or more effective than others, because each individual has unique needs and will be
motivated by different things.
We can think of Figure 4 as a menu of options for pursuing mental wellness; people can choose from many
different strategies and activities and find the ones most important for them. Essentially, these options are
the “building blocks” that form the foundation and structure of our mental wellness resource. Each one of
us can put different blocks together in different ways. For some of us, being physically active is critical to
our mental wellness; exercise not only affects our mood, but also our sleep patterns and eating habits, and
can help us find a sense of community. For others, art and creativity are essential to relaxing, expressing
ourselves, and connecting with the world. Some of us may need to be in nature – listening to bird songs
and the rustling of leaves, breathing in the scent of soil, and walking in solitude – in order to feel a sense of
calm and peace. Millions of people make religious practice the center of their mental wellness, with their
faith giving them not only meaning, purpose, and transcendence, but also a framework for lifestyle habits
like diet, exercise, and social connections (e.g., Seventh Day Adventists). There are many options but no
set path that everyone must follow. Sometimes, our circumstances change, and we need to adopt new
practices or strategies to handle stress, improve resilience, and deal with adversity.
There is great inequity in our access to mental wellness

pathways and modalities.
The notion that mental wellness is about individuality, self-care, and personal responsibility does not imply
that it is solely an individual pursuit or that it is fully within our own locus of control. Many of the pathways
for mental wellness may sound like simple healthy lifestyle habits (e.g., eating well, exercising), but a
multitude of factors outside of our own control determine whether we can practice these habits at all.
Some obstacles might be financial: while many mental wellness modalities can be done for free (e.g.,
taking a walk, meditating, participating in a religious community), many others are only affordable for
the wealthy (e.g., joining a fitness center, hiring a life coach, going on a meditation retreat). Other major
obstacles include the physical, social, cultural, and economic environments in which we live: a lack of time
for exercise and recreation; a lack of knowledge about good diet or lack of access to healthy foods; a
lack of access to parks and natural areas; disturbances by noise and light pollution; a lack of opportunity
to practice or enjoy music and the arts; cultural norms that prevent women and girls from participating
in certain activities; a lack of freedom to practice our faith; or a political system that prevents us from
participating in civic life. The built environment, macroeconomic conditions, social and cultural norms,
government policies, employers, schools, community organizations, and businesses all play a major role in
enabling access to healthy lifestyles and removing obstacles for people to build up their mental wellness
resources.

The external and macro environment is a major determinant
of our mental wellness.
The external and macro environment is not only an enabler or obstacle to pursuing mental wellness; it is
often the very cause of our mental distress (see Figure 5). People who are subject to systematic violence,
cruelty, discrimination, abuse, injustice, war, poverty, famine, displacement, natural and manmade disasters,
and other dire situations suffer major blows to mental wellness that are outside of their control. In these
situations, meeting basic needs (e.g., safety, security, food, shelter, medical care, employment) may be
more essential to mental wellness than the individual pathways elaborated above (in Figure 4). These
types of trauma can trigger chronic mental distress that may take years, a lifetime, or even generations to
overcome, and that may also lead to clinical mental illness.
The wellness, happiness, and positive psychology movements are sometimes criticized for implying that
happiness and wellness are within everyone’s reach, or that if we just make changes from within, we will have
the power to improve ourselves and feel better. Critics have pointed out that this viewpoint can be a form
of “victim blaming” – i.e., if we are unhappy, it is our own fault for not practicing mental wellness strategies.
This view also deflects responsibility from the greater ills in our economic, social, and political systems that
create mental distress and unhappiness in the first place.1 The interactions between our mental wellness
and the external environment can be complex. The World Happiness Report, for example, has found that
even in adverse situations such as ill-health, unemployment, discrimination, family breakdown, and fears
about the safety of the streets, people who have higher levels of social trust and institutional trust report
higher levels of well-being as compared to people living in a low social/institutional trust environment.2
Individual practices can fortify our mental wellness, even

under adverse circumstances.
It would be naïve and unfair to suggest that all of our troubles – personal, emotional, financial, societal,
political, etc. – can be “meditated away.” And yet, even in negative situations, the individual mental
wellness pathways described in Chapter II (e.g., yoga, meditation, mindfulness, faith, gratitude, altruism,
connection with friends, time in nature, etc.) can reduce stress and help us build greater resilience, clarity,
and hopefulness, thereby fortifying our mental wellness resources to help us deal with adversity (see Figure
5). For example, research studies (albeit with relatively small sample sizes) are accumulating evidence that
yoga and meditation have helped populations in adverse circumstances such as those living in homeless
shelters, prisons, or refugee camps; war victims and veterans with post-traumatic stress disorder; or those
dealing with addiction.3
Businesses and governments can give people a boost on

their mental wellness pathways.
Many mental wellness strategies can be incorporated into our daily lives and can help us, no matter
what our life circumstances might be. Many of these practices are free and are accessible to all people,
especially if we live in an enabling and supportive environment (see Figure 5). In fact, as a society, we need
to make sure that our living environments are not harmful to our mental wellness. We should support the
mental wellness of everyone, especially those who are vulnerable due to their personal and socioeconomic
situation, because mental wellness is for all.

Mental illness and mental unwellness impose a massive economic and societal burden around the world.
Governments and businesses have an incentive to promote mental wellness because it can mitigate
these rising costs. As discussed in Chapter II, practices that improve our mental wellness can not only
lessen the symptoms of mental illness, but also reduce our risk of developing a mental illness. Mental
wellness is also linked with many other positive outcomes, including better physical health, longevity,
social relationships, and work performance.4 And yet, most of the focus in government and healthcare
circles is on improving treatment, care, and resources for mental illness, while not enough resources go
to the promotion of better mental wellness (e.g., community-based and lifespan-based interventions,
increasing access to mental wellness pathways and modalities for individuals, etc.).
Governments play a major role in our access to mental wellness. At the highest level, external and macro-
level circumstances (e.g., poverty, unemployment, war, hunger) are major impediments to mental wellness,
and these are shaped by government policies both nationally and locally (see Figure 5). Governments
can help build up our mental wellness resources and enhance neuroplasticity early in our lifespans by
supporting good pre- and post-natal care,5 or by teaching key skills like meditation and mindfulness in
schools. At the city and community level, government policies can support mental wellness-enhancing
physical and built environments (e.g., access to parks and green space).
Industry and businesses play a vitally important role in the mental wellness landscape. As discussed
in Chapter II, mental wellness has grown out of a consumer-led, grassroots movement that demands
self-directed, holistic, natural, and alternative solutions outside of the established fields of medicine,
psychiatry, and psychology. Private businesses across many industries (hospitality, spas, technology,
consumer goods, housewares, books and media, etc.) have become a major vehicle for developing new
solutions by adopting and adapting mental wellness modalities and delivering them to consumers through
multiple channels. For example, businesses have been especially active in launching technology-based
innovations that expand access to mental wellness practices at a variety of price points; offer more choices
and adaptations to individual preferences; provide new products, solutions, and experiences; collect new
data and evidence; and attract research resources and investments. Chapter IV will describe the mental
wellness modalities, services, products, experiences, and businesses that are emerging as part of this new
mental wellness economy.

Figure 5
Supporting Mental Wellness for All: Three Levels of Action

We should not view mental wellness as a “hierarchy of needs,” where the bottom of the pyramid
represents basic macroeconomic and physical needs and stressors (e.g., safety, employment, food)
that must be addressed before we can pursue “loftier” mental wellness practices like meditation
and mindfulness. Mental wellness is not a luxury only for people who already have plenty of food,
a good income, and a secure job. To the contrary, mental wellness is a basic and critical resource
that we all need, no matter our life circumstances. We can envision mental wellness as a set of
three concentric circles, which work together from the inside out and from the outside in:6
MACRO
Society- & Economy-Wide Environment, economy,
poverty/inequality,
employment, education,
peace/safety, health
MESO
Community-Level Neighborhoods,
workplaces, schools,
families & households
MICRO Individual pathways:

knowledge & skills,
Individual behaviors & practices,
lifestyles & outlook
Source: Global Wellness Institute
• The micro level represents individual practices and behaviors. These are the ways we can
build up our internal resources by engaging in the mental wellness pathways and modalities
described in Figure 4. However, the importance of individual practices does not absolve
society, governments, and businesses of responsibility for dealing with problems at the meso
and macro levels.
• The meso level represents our immediate living environments, including our neighborhoods,
workplaces, schools, and families. Research increasingly shows that environmental factors are
a major determinant of our mental and physical health and well-being. For example, living in a
neighborhood with a park, trees, and green space can enhance our mental wellness by giving
us contact with nature and a place for respite and exercise. A toxic workplace culture can
cause severe and ongoing stress, which we cannot mitigate through mindfulness or exercise.
We depend upon our local governments, employers, community organizations, and families to
help build environments that are supportive of positive mental wellness.
• The macro level represents our society and economy. This level refers to all of the broad,
macro-level factors that often cause mental distress: pandemics, poverty, unemployment,
inequality, hunger, war and conflict, education, etc. Individual mental wellness pathways cannot
solve these problems. However, even those living in the worst macro-level circumstances (e.g.,
war zones, refugee camps) can benefit from individual mental wellness pathways to help them
cope, build resilience, and deal with adversity.

Endnotes
1
For examples of some of these critiques, see: 1) Shade, C. (2020, Oct. 19). Self-Help Hacks at the End
of the World. The New Republic. https://newrepublic.com/article/159819/self-help-hacks-end-world.
2) Winant, G. (2018, May 23). Mind Control: Barbara Ehrenreich’s radical critique of wellness and self-
improvement. The New Republic. https://newrepublic.com/article/148296/barbara-ehrenreich-radical-
crtique-wellness-culture. 3) Schwartz, A. (2018, Jan. 8). Improving Ourselves to Death. The New Yorker.
https://www.newyorker.com/magazine/2018/01/15/improving-ourselves-to-death. 4) Purser, R. (2019,
June 14). The mindfulness conspiracy. The Guardian. https://www.theguardian.com/lifeandstyle/2019/
jun/14/the-mindfulness-conspiracy-capitalist-spirituality. 5) Spicer, A. (2019, Aug. 21). ‘Self-care’:
How a radical feminist idea was stripped of politics for the mass market. The Guardian. https://www.
theguardian.com/commentisfree/2019/aug/21/self-care-radical-feminist-idea-mass-market. 6) Love,
S. (2018, Dec. 11). The Dark Truths Behind Our Obsession With Self-Care. Vice. https://www.vice.com/
en_us/article/zmdwm4/the-young-and-the-uncared-for-v25n4. 6) Smith, J. (2019, Nov. 20). Is positive
psychology all it’s cracked up to be? Vox. https://www.vox.com/the-highlight/2019/11/13/20955328/
positive-psychology-martin-seligman-happiness-religion-secularism.
2
Helliwell, J., Layard, R., et al (Eds.) (2020). World Happiness Report 2020. New York: Sustainable
Development Solutions Network. https://worldhappiness.report/ed/2020/.
3
See, for example: 1) Herron, R.E. (2018, Jan.-Feb.). The Transcendental Meditation Program’s Impact
on the Symptoms of Post-traumatic Stress Disorder of Veterans: An Uncontrolled Pilot Study. Military
Medicine, 183(1-2), e144-e150. https://doi.org/10.1093/milmed/usx059. 2) Azad Marzabadi, E., and
Hashemi Zadeh, S.M. (2014, Oct). The Effectiveness of Mindfulness Training in Improving the Quality of
Life of the War Victims with Post Traumatic Stress Disorder (PTSD). Iranian Journal of Psychiatry, 9(4),
228-236. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361826/. 3) Santa Maria, D., et al (2020, Jan.).
Feasibility of a Mindfulness-Based Intervention with Sheltered Youth Experiencing Homelessness. Journal
of Child and Family Studies, 29, 261-272. https://doi.org/10.1007/s10826-019-01583-6. 4) Maddock,
A., et al (2017). Mindfulness Training as a Clinical Intervention with Homeless Adults: A Pilot Study.
International Journal of Mental Health and Addiction, 15, 529-544. https://doi.org/10.1007/s11469-016-
9718-7. 5) Muirhead, J., and Fortune, C.-A. (2016, May-June). Yoga in prisons: A review of the literature.
Aggression and Violent Behavior, 28, 57-63. https://doi.org/10.1016/j.avb.2016.03.013. 6) Nauert, R.
(2014, Feb. 11). Meditation Helps Refugees Recover from PTSD. Psych Central. https://psychcentral.com/
news/2014/02/11/meditation-helps-refugees-recover-from-ptsd/65732.html.
4
For example, see: 1) Kansky, J., and Diener, E. (2017). Benefits of Well-Being: Health, Social
Relationships, Work, and Resilience. Journal of Positive Psychology and Wellbeing, 1(2), 129-169. https://
www.journalppw.com/index.php/JPPW/article/view/20. 2) Great Britain Department of Health (2014,
Feb. 6). A compendium of factsheets: Wellbeing across the lifecourse: What works to improve wellbeing?
https://www.bl.uk/collection-items/compendium-of-factsheets-wellbeing-across-the-lifecourse-what-
works-to-improve-wellbeing.
5
See: Pecorelli, S. (2018). Early Life Prevention: The First 1000 Days. In: Bodeker (Ed.), Mental Wellness:
Pathways, Evidence and Horizons (pp. 13-17). Miami, FL: Mental Wellness Initiative, Global Wellness Institute.
https://globalwellnessinstitute.org/wp-content/uploads/2018/10/GWI-MWI-WhitePaper2018.pdf.
6
For more information on the micro/meso/macro framework, see: Lahtinen, E., et al (2005). Strategies
for Promoting the Mental Health of Populations. In H. Hermann, S. Saxena, and R. Moodie (Eds.),
Promoting Mental Health: Concepts, Emerging Evidence, Practices (pp. 226-242). Geneva: World Health
Organization. https://www.who.int/mental_health/evidence/en/promoting_mhh.pdf.

IV. The Mental Wellness Economy
From ancient traditions into a modern industry.
Since the beginning of civilization, humans have sought out ways to understand and improve ourselves,
to find wholeness and happiness, to comprehend and cope with life’s mysteries, to work toward a moral
good, and to please the gods. Over the last 50-60 years, many of these efforts have come to be associated
with the pursuit of mental wellness – from meditation to self-help, from stress gadgets to sound baths,
and from sleep aids to brain supplements. All of these practices have deep roots in ancient culture,
healing traditions, spirituality, philosophy, and literature, spanning every corner of the globe. However, the
commercialization of these products and services and the coalescing of a “mental wellness industry” is a
modern development. (See Appendix C for a more detailed history of various mental wellness practices).
The hippies brought mental wellness practices to a mainstream Western

audience.
Almost every mental wellness practice that we know today was brought to a modern, mainstream, Western
audience by the hippies and counterculture movement in the 1960s-1970s.1 In fact, the various labels
applied to this era – the “Me Decade,” the “New Age movement,” the “psychedelic era” – illustrate the
prominent role that mental wellness practices played during this time. The “New Age movement” captures
the exploration of Eastern and occult spirituality, mysticism, alternative lifestyles, and holistic and natural
medicine. Meditation and yoga first took off in the West during this era, alongside a resurgence of ancient
traditions such as sound healing (e.g., chanting, singing bowls), energy healing, crystals, aromatherapy,
worry stones, and more. During the “psychedelic era” there was widespread experimentation with
psychedelic drugs, acid trips, and altered states of consciousness. The “Me Decade” (a label coined by
author Tom Wolfe2) popularized the concepts of self-actualization, personal well-being, recovery, and
spiritual growth, marking the take-off of the modern self-help industry. During this period, many holistic
wellness centers, retreat centers, ashrams, communes, and intentional communities sprung up across the
United States and Europe, becoming centers for teaching and spreading practices related to mind-body
connection, humanistic psychology, self-actualization, and many other fringe mental wellness ideas that
have now become mainstream.
Gurus, sages, and celebrities are foundational to the development and

spread of mental wellness, bringing both credibility and quackery to these
practices.
Guruism is central to the development of many mental wellness practices. Today’s self-help books have
their roots in ancient works of literature and philosophy, in which philosophers and sages provided maxims
and guidance on how to live (e.g., Socrates, Marcus Aurelius, Boethius, Machiavelli, Lao Tzu, Confucius,
Rumi). Modern interest in self-help exploded in the 1980s-1990s, as people turned to media celebrities
and writers for bite-sized wisdom to address daily problems. Oprah has had tremendous influence in
bringing pop psychology and self-improvement concepts to a mainstream, worldwide audience, turning
a number of personalities into overnight best-selling self-help gurus. Gurus and celebrities also played a
key role in the rise of meditation and yoga, which were introduced to the West in the mid-20th century by
Eastern spiritual masters who gave lectures and established communities of followers. In the 1980s and
1990s, yoga and meditation attracted a high-profile following among celebrities and athletes, making
these practices hip and bringing them from the fringe into mainstream culture.

Today, gurus and self-help pundits have moved beyond the bookshelf and ashram, creating a multi-
media self-help empire: TED talks, television channels, websites, social media, streaming platforms, apps,
workshops, retreats, and more. Ever since the first modern self-help book was published in 1859 (Samuel
Smiles’ Self-Help), self-help authors have been criticized for quackery and hypocrisy, for being frauds, and
for capitalizing on people’s insecurities. Those criticisms have reached an apex today, now that anyone
can become a guru if they can collect enough Instagram followers or celebrity endorsements. Some self-
help gurus are real psychologists with academic pedigrees, and some meditation gurus have studied with
renowned spiritual masters, while others may simply be peddling pseudoscience and hollow promises. It
is ever more challenging for people to decipher the difference.
Modern science, medicine, and psychology are starting to catch up and

legitimize traditional mental wellness practices.
For most of history, mental wellness practices remained in the realms of spirituality, philosophy, literature,
intellectualism, and alternative/traditional medicine. In the last 150 years, advances in the physical
sciences, biological sciences, neuroscience, and medicine have brought new discoveries and technologies
that are allowing researchers to understand and document whether, and how, many popular mental
wellness practices actually “work.” In particular, medical imaging technologies and neuroscience (e.g.,
EEG, ultrasound, CT scanning, MRI) have paved the way for new research and scientific understanding of
sleep, meditation, circadian rhythms, sound and vibration, aromatherapy, psychoactive drugs, and plant-
based healing, as well as the critical connections between the mind and the body. In the future, building
up a stronger body of scientific and clinical evidence for various mental wellness modalities will continue
to be essential in legitimizing their efficacy, bringing them into the mainstream medical and psychological
communities as effective treatment options, and encouraging public policy changes and investments in
preventive mental wellness strategies. Scientific evidence is also essential to help consumers cut through
the “guru culture” and “cult of celebrity,” and to understand which mental wellness businesses, products,
services, and solutions are real, and which are just woo-woo pseudoscience.
Technology and media are democratizing access to mental wellness

practices, while simultaneously exposing us to mental wellness risks.
Technology and media platforms have helped to popularize and democratize many mental wellness
practices, in particular, yoga, meditation, and self-help. In the 1960s and 1970s, Richard Hittleman’s TV
programs, such as “Yoga for Health,” introduced yoga to millions of Americans. Through the 1980s-1990s,
self-help gurus like Tony Robbins built up millions of new followers via TV broadcasts and infomercials.
Bill Moyers’ pioneering 1993 TV documentary, “Healing and the Mind,” has introduced 40 million viewers
to mind-body healing practices. Oprah’s media empire brought meditation to millions of mainstream
consumers when she promoted Deepak Chopra’s 1993 book Ageless Body, Timeless Mind on her show.
Today, mobile technologies, apps, streaming services, and social media are proliferating access to mental
wellness concepts, guidance, and programming to new audiences around the world. The most notable trend
is the booming business of meditation and mindfulness apps, with an estimated 2,000 new meditation
apps launched just between 2015-2018 (and the number is certainly much higher today).3
And yet, technology has a fraught relationship with mental wellness. Our use of technology is increasingly
recognized as having a negative impact on our mental and physical health. Our culture of constant
connectivity creates stress, reduces sleep quality, and affects our attention and productivity. Screen time
and social media usage can reduce the quality of our social relationships, affect childhood cognitive
development, and have been linked with depression and anxiety.4 There is a deep irony in apps’ use of
activity tracking, gamification, push notifications, and social media sharing to promote a sense of calm

and mindfulness. Sometimes, the most mindful thing we can do is to turn off our mobile phones and all of
our digital screens entirely.
Mental wellness has a long but complex relationship with spirituality.

Most of today’s mental wellness practices are rooted in ancient spiritual traditions, but have been adapted
by the modern wellness movement into secularized forms. In spite of these spiritual underpinnings, mental
wellness has a complex and often uncomfortable relationship with religion. In particular, the spread of
secular forms of meditation and yoga have created many controversies in Christian and Muslim religious
communities around the world. Simultaneously, the secularization and commercialization of meditation
(e.g., its adoption by Silicon Valley and the corporate world as an employee wellness offering and
productivity-boosting measure) has been criticized as “McMindfulness,” or the co-opting of Buddhist
spiritual practices as a capitalist commodity.5
People around the world turn to prayer and religion as a source of coping, resilience, solace, and emotional
and social support. Religion and spirituality are positively associated with emotional well-being and better
mental health, and some people see a high level of mental wellness (“flourishing”) as being associated
with the spiritual and mystical concepts of self-transcendence and higher purpose.6 And yet, the mental
wellness field, the wellness movement overall, and the fields of psychology and psychiatry have all tended
to distance themselves from questions of spirituality and religion. This relationship has become even more
challenging as our modern era increasingly demands scientific evidence that different health and wellness
practices are effective – a movement that is antithetical to the very nature of spirituality. Many aspects of
mental wellness are subjective and existential, and they may never be “proven” to the satisfaction of those
who are wedded to the existing methods of scientific inquiry.

Mental wellness products, services, and experiences
permeate the entire economy.
Earlier in this report (Chapter II, Figure 4), we illustrated the multi-dimensional and holistic nature of
mental wellness and summarized the various pathways that can help us build resilience, cope with life’s
challenges, and work toward a flourishing life. The scope of these mental wellness pathways is wide-
ranging, and businesses across the entire economy (not only within the wellness industry) play a role
in delivering products, services, and experiences that can support mental wellness. The reach of mental
wellness is wide: boutique fitness studios that help people de-stress and connect with a social community;
tour operators that offer yoga and meditation retreats; mattress companies that promote better sleep;
real estate developers and urban planners that incorporate biophilic design and green space into
neighborhoods and workplaces; makerspaces that provide a physical location, tools, and collaborative
community for building and creating; pet rescue and pet therapy organizations that help us relax and heal
with animals; spiritual and religious mobile apps that provide daily readings or reminders for prayer and
gratitude. Mental wellness pervades throughout the entire economy because every aspect of our daily
lives can have a profound impact on our mental wellness.
Four sectors are coalescing into an emerging mental

wellness industry.
In this chapter, we narrow the focus from all of the beneficial mental wellness practices and pathways to
the businesses that provide products, solutions, and experiences to consumers specifically for their mental
wellness. We define the mental wellness industry as follows:
The mental wellness industry encompasses businesses whose

primary aim is to help us along the mental wellness pathways of
growth and nourishment and rest and rejuvenation.
To delineate the mental wellness industry, we focus on two pathways: growth and nourishment and rest
and rejuvenation. We do not include activity and creativity in the industry because the category is too
broad (fitness, sports, learning, hobbies), and it already sits solidly in other industries; we also exclude
connection and meaning because these activities are primarily non-commercial (religion, gratitude,
altruism, friends, nature, civic engagement). Our definition of the mental wellness industry is based
on our overall wellness economy framework and is consistent with our understanding, definition, and
measurement of other wellness industry sectors (see Figure 8). Within the growth and nourishment and
rest and rejuvenation pathways, four sectors are coalescing into an emerging mental wellness industry
(see Figure 6):
1. Self-improvement;
2. Meditation and mindfulness;
3. Brain-boosting nutraceuticals and botanicals;
4. Senses, spaces, and sleep.

Figure 6
Delineating the Mental Wellness Industry and Its Subsectors

The identification of these four subsectors as part of the mental wellness industry is based on the
following criteria:
• They include wellness practices, products, and services that are widely recognized and
understood by consumers as being associated with mental wellness (e.g., meditation, self-
help, coaching).
• They include products and services that are proactively positioned, marketed, and branded by
businesses as specifically targeting aims such as reducing stress, building resilience, improving
sleep, preventing cognitive decline, and other mental wellness-enhancing benefits (e.g., sleep
apps, brain training, sound baths, stress-reducing candles, stress toys).
• They include many products and services that are not already defined and classified as being
part of other wellness economy sectors within GWI’s framework (although there is some
overlap between the mental wellness industry and other wellness industries, as noted later in
this chapter).
• They do not include products and services that may be very beneficial for mental wellness,
but whose primary purpose is something else (e.g., fitness, healthy foods, arts and literature,
going to church, pets).
• They do not include products and services that sit in the medical or clinical arena (e.g.,
psychotherapy, sleep labs).

The four mental wellness industry subsectors are defined below. These subsectors are explored in greater
detail in Chapter V.
1. Self-improvement:
Includes a wide range of activities, services, and experiences that are typically associated with self-help
and personal development; these are delivered via many different channels and platforms, and can be
done individually, in groups, and with professional guidance and support. Self-help books have long been
the bedrock of this sector (including print, e-books, and audiobooks) and continue to be a major spending
category with steady growth. Self-help gurus, organizations, and institutes deliver a variety of classes,
workshops, seminars, and retreats that people pay to attend, both in-person and online. Some people
seek out support through self-help organizations and mutual support groups, although many of these
groups go beyond mental wellness and overlap into the mental illness, recovery, and clinical arena, as well
as weight loss, parenting, religion, and other spheres (e.g., Alcoholics Anonymous, Recovery International,
GROW, TOPS, etc.). Many people seek out professional support via personal and life coaches. Others
may pursue professional therapy or counselling to support their mental wellness (although we do not
include these in our market size measurements because they are part of the clinical arena). Cognitive
enhancement and brain training is a small but growing niche that extends from dementia prevention to
brain hacking, and it is delivered via professional clinics; online platforms and apps; high-tech gadgets; and
low-tech books, puzzles, games, and toys. A dizzying array of apps and online platforms now offer self-
help advice; guidance on developing healthy habits; digital journaling, gratitude, and daily affirmations;
brain and memory-enhancing games and puzzles; digital coaching; and digital therapy. Anti-loneliness
efforts are a new niche within self-help, with a growing number of organizations, online platforms, and
apps emerging to help people connect with one another (both in-person and virtually).
Self-improvement is becoming increasingly challenging to quantify as an industry subsector because

it permeates throughout other sectors, and so its scope extends far beyond what can be measured in
dollar figures. For example, most apps are hard to classify as simply “self-help” because they overlap with
meditation and mindfulness, sleep, fitness and weight loss, and the psychotherapy and clinical sphere.
Expenditures on self-help books may only represent a fraction of the true market size, because the genre
is no longer confined to the self-help bookshelf and now appears in social science, business, memoirs, and
other genres (see Appendix C). Self-help gurus and personalities now deliver their advice and content
through a variety of media channels (e.g., Instagram, YouTube, websites, magazines, TED talks, streaming
channels such as Netflix, podcasts), which cannot be measured as a consumer spending category. Likewise,
thousands of self-help and mutual support groups operate on online and social media platforms that are
not quantifiable in terms of expenditures.
2. Meditation & mindfulness:

Includes all forms of meditation practice, and related and spin-off mindfulness practices (e.g., breathwork
and breathing methods, guided imagery, body scan, relaxation exercises, etc.), as well as the many products
and services that support these practices. It is critical to keep in mind that millions of people practice
meditation worldwide (one estimate says between 200 and 500 million7), but only a small fraction of
these people actually spend any money on the practice. Some people spend money on classes, teachers,
retreats, online platforms, apps, books, and videos that provide instruction or guide them through a
meditation practice, including: 1) in-person classes (in dedicated meditation studios, yoga studios, fitness
centers, and many other venues); 2) workshops and retreats (held in ashrams and retreat centers, in
tourism and hospitality settings, etc.); 3) apps, streaming services, and online classes and workshops; and
4) books, videos, and other media.

Meditation accessories include cushions, blankets, mats, benches, and chairs; beads, statues, prayer
wheels, alters, and crystals; and sound and aroma products (e.g., incense and burners, candles, singing
bowls, bells, chimes – which overlap with the senses, spaces, & sleep subsector). A wider and growing
market of mindfulness products includes journals, coloring books, jewelry, and many other consumer
products. In addition to apps, the tech sector offers an exploding array of connected gadgets, trackers,
monitors, headsets, and aids to support meditation (e.g., headbands, headsets, glasses, wearable sensors,
lamps, etc.), many of which build upon biofeedback, neurofeedback, and virtual reality technologies. Note
that meditation and mindfulness techniques are increasingly used in therapy and medical settings (e.g.,
mindfulness-based stress reduction, mindfulness based cognitive therapy) – these activities could also be
considered part of this subsector, although we do not explicitly include them in our market size estimates
(which focus on consumer, non-clinical expenditures).
3. Brain-boosting nutraceuticals & botanicals:

Includes products that we ingest or put into our bodies with the specific aim of improving our mental
health and well-being. This subsector embraces the gut-brain axis and the growing recognition of the
deep connections between food, nutrition, and brain health. While a healthy diet is essential for mental
wellness, we do not measure all healthy foods in this subsector. Rather, we focus on several product
categories that specifically claim to support brain health, better sleep, memory, energy, and overall
mental wellness. A number of natural supplements, herbals and botanicals, and traditional remedies are
believed to have benefits for memory, attention, mood, and sleep (e.g., St. John’s Wort, ginseng, ginkgo
biloba, Omega-3 fatty acids, valerian root, melatonin), although the scientific evidence behind many of
these claims is spotty.8 The food industry markets a wide range of functional foods and beverages that
claim to have brain health benefits, such as products that have naturally occurring or are enhanced with
key ingredients like DHA, choline, L-theanine, taurine, guarana, ginseng, and caffeine. These appear in
nearly every packaged food and beverage category, including waters, teas, juices, milks, yogurts, bars,
chocolates, gums, mints, and much more.9
Recent years have brought growing interest in the potential of cannabis, psilocybin, and other plant-based
and synthetic psychedelic drugs (e.g., ayahuasca, peyote, ketamine, MDMA, LSD)10 for both mental wellness
and medical purposes. We focus on cannabis in our market size estimates for this sector (specifically legal,
over-the-counter/recreational cannabis and its derivatives), because the other drugs are mostly illegal
around the world and/or are primarily being decriminalized and studied for treatment of mental illness
or other medical uses, but not for recreational or self-directed wellness purposes. Psychedelic-assisted
therapy is under study for treating conditions like PTSD, anxiety, and depression (however, these activities
are very new, very small, primarily clinical, and we do not measure them in our market figures). A growing
number of supplements and functional foods and beverages incorporate cannabis, hemp, CBD, THC, and
medicinal mushrooms, although the legality of such products is often unclear. Cannabis and psychedelic
retreats are a small but growing niche in the travel sector, in destinations where these activities are legal.
Note that many of the botanicals, supplements, and functional foods/beverages included in this subsector
are recognized as nootropics (i.e., cognitive enhancers, or substances that can boost brain performance).
However, the category of nootropics is very broad and includes not only botanical extracts/supplements
but also addictive substances and stimulants (nicotine, caffeine), synthetic compounds (piracetam,
noopept), and prescription drugs (Ritalin, Adderall).11 Our market size estimates for this sector do not
include all nootropics, because we do not consider synthetic drugs and off-label use of prescription drugs
to be part of the wellness industry.

4. Senses, spaces, & sleep:
Includes products, services, and design that target our senses and the mind-body connection, based upon
the growing understanding that environmental stimuli have a major impact on our mood, stress levels,
sleep, and mental health and well-being. Sound offerings include sound-healing and relaxation experiences
and instruments (e.g., sound baths, gongs, chimes); products that address noise pollution/disruptions and
related stress (e.g., white noise and sound machines, noise reduction gadgets); and even an emerging
field of “wellness music.”12 Scent offerings include aromatherapy products/services and essential oils used
for relaxation and stress relief, as well as a large sector of home fragrances that are marketed for calm,
comfort, coziness, and mood enhancement (e.g., candles, diffusers, mists, etc.). Light-related products are
expanding rapidly, partly based on better scientific understanding of our circadian cycles.13 These include
circadian or human-centric lighting solutions, as well as a wide range of light therapy devices used by
consumers at home (for mood, sleep, etc.), as well as in medical and treatment settings (e.g., light boxes,
light visors, dawn simulators, etc.). Many popular products and fads target our sense of touch, including
weighted blankets for relaxation, an endless array of stress toys and gadgets (e.g., stress balls, fidget
spinners, worry stones, desk toys), and new high-tech sensory wristbands and wearables. Multi-sensory
experiences are appearing in wellness travel, spas, fitness, and entertainment venues, including forest
bathing, hugging therapy, scream therapy, laughter yoga, cuddle parties, flotation tanks, and more.
Sleep is a large and rapidly growing market sector that overlaps with sensory products for promoting
relaxation and improving our sleep environment (e.g., lighting, white noise, noise cancellation, weighted
blankets, room-darkening window coverings, temperature control devices, etc.). It also includes tech-
based products (e.g., sleep monitors and trackers, sleep ambience gadgets, sleep and jet lag apps, smart
bedding); sleep accessories for home and travel (e.g., eyeshades, travel pillows); and sleep improvement
services (e.g., books, counseling, retreats). Napping is a growing niche that includes nap bars and cafés, as
well as nap pods placed in workplaces, hospitality, and travel spaces. Note that the broader sleep market
also encompasses mattresses, bedding, pillows, and furniture, but we only include smart beds, mattresses,
and pillows in our market size estimates (i.e., products that use technology to enhance sleep and wellness).
There is also a large clinical sector of sleep services, diagnostics, and devices (e.g., sleep labs, CPAP
devices, etc.), but these are in the medical space and are not included in our measurements.
Finally, this mental wellness subsector includes physical spaces, because sensory, stress-reducing, and
mental wellness-enhancing products and solutions are increasingly being incorporated into the design
of our homes, workplaces, and travel destinations. These include sound-proofed windows and circadian
lighting to reduce stress and promote better sleep, as well as biophilic design, natural light, fresh air, and
plants to promote calm and connection to nature. These elements overlap with the wellness real estate
industry – and not all of them can be easily measured from a market size perspective – but it is critical to
recognize the deep connections among senses, sleep, and spaces in relation to our mental wellness.

Mental wellness is a $121 billion global market.
We estimate that the global mental wellness industry was worth $120.8 billion in 2019. This figure represents
consumer expenditures on the four subsectors that we identified and described above, and it focuses on
proactive, wellness-focused, consumer- and private sector-driven activities (that is, things outside of the
psychiatry, psychology, and clinical/medical spheres). These figures are broad, global estimates that we
aggregated based on a wide range of secondary data sources.14
Senses, spaces, & sleep is the largest subsector (at $49.5 billion), followed by brain-boosting nutraceuticals
& botanicals ($34.8 billion) and self-improvement ($33.6 billion), which are similar in size (see Figure 7).
Meditation & mindfulness is the smallest subsector, at $2.9 billion; it is important to keep in mind that
millions of people around the world practice meditation, but only a small fraction of them spend any
money on the practice.
Figure 7
How to interpret these numbers.

Our methodology requires us to measure a full year’s economic activity related to an industry, and therefore
we must look back to the most recent calendar year (2019). In most instances, the prior year’s figure
provides a useful datapoint that can be viewed on a trajectory of growth or decline. Due to the COVID-19
pandemic, 2020 has been an unprecedented year of massive global economic upheaval and uncertainty.
Most economists, industry analysts, governments, and corporations are struggling with collecting and
processing real-time data to assess the current situation and to respond effectively. In this landscape,
the mental wellness industry figures presented above can serve as a 2019 baseline on which to anticipate
the future. Amidst the current uncertainty, several macro-level forces will impact the future growth and
development of the mental wellness industry:

• The human suffering and economic dislocations caused by COVID-19 have negatively impacted our
mental health and well-being, and therefore have increased demand for various mental wellness
pathways and solutions on a global scale. Companies in some segments have reported upticks
in demand, such as meditation apps,15 functional foods and beverages and brain supplements (as
consumers become more concerned with their health and immune systems),16 and candles and
diffusers (increasing comfort and calmness at home).17
• Some tech sector companies have been “winners” during the pandemic, as consumers turn to
apps, digital interfaces, virtual meetings, and contact-free solutions under physical distancing and
social isolation measures. However, it is unclear if all of this COVID-19-induced behavior will stick
for the long-term, or the extent to which people will revert to physical, face-to-face, and in-person
interactions and activities when they become feasible again.18
• By all estimates, global economic activities and consumer confidence have taken a severe hit
in 2020, and consumer spending is shrinking across many industries.19 A decline in disposable
income affects all consumer sectors and services, including those in mental wellness. To the extent
that consumers increasingly see mental wellness as a need and not a want, it may take up a
growing portion of the consumer spending pie, even when the overall pie is shrinking.
• All around the world, inequality of income and wealth is rising. Unfortunately, this trend may have
been accelerated by COVID-19, with the rich enjoying rising wealth (in the form of investment
returns) as they spend less (on travel, recreation, and luxury services and goods) and save more.
Meanwhile, the poor and working class are losing their jobs and incomes on a massive scale, while
the middle class is simply trying to hang on to their status quo. This bifurcated world has persisted
in the economy for some time (and especially in wellness industries), with luxury segments
catering to a small portion of high-income consumers, and other affordable segments targeting
the “mass” middle class. The future opportunities and prospects for businesses will depend upon
how they provide value to their targeted consumer segments. Some businesses may also face
expanded competition from free services and activities that people have learned to do on their
own (e.g., meditating at home without using an app), as well as free and affordable services that
are increasingly being offered by communities, nonprofits, and governments as we realize the
importance of making mental wellness available for all.
In understanding and using these new market figures, it is also important to recognize several important
characteristics of the mental wellness industry:
• Mental wellness is an emerging market sector, and this report represents the first attempt to
define mental wellness as an industry. Here, we only include the products and services that are
most closely associated with the emerging business of mental wellness, but the importance and
scope of mental wellness extends far beyond the four subsectors we include in this new industry
sector.
• By singling out four subsectors, we are not implying that these are the most important or most
effective practices for pursuing mental wellness. They are simply the practices that are most closely
and proactively identified by businesses and consumers as being related to mental wellness. There
are many things we can and should do to support our mental wellness that are not a business
opportunity and do not require spending money (like spending time in nature, joining a spiritual
community, or listening to music).
• As an emerging sector, many mental wellness practices and products have not yet accumulated
extensive clinical evidence when compared to the conventional medical and mental health industries
(e.g., drugs that treat mental disorders), which have benefitted from decades of pharmaceutical
industry investments and clinical research. Currently, the regulation of most mental wellness

businesses is fragmented, especially in the brain-boosting nutraceuticals & botanicals sector. It
is generally left to consumers to determine whether they believe in and find benefit from these
products and services or not. However, a body of evidence is quickly growing – especially for some
modalities, like meditation, light therapy, and circadian science – bolstered by an acceleration of
public and private research investments. Meanwhile, consumers also need to be educated on the
importance of basic healthy habits (exercise, sleep, healthy eating, human connections) for their
mental health and well-being.
• The boundaries across the four mental wellness subsectors are not rigid or clearly defined. For
example, a mindfulness workshop or retreat would fit into the meditation & mindfulness subsector,
while a life coach could also provide guidance on mindfulness practices (which fits in the self-
improvement subsector). Sound healing and aromatherapy products (e.g., gongs, chimes, incense,
candles) fit in the senses, spaces, & sleep subsector, but are also often used as accessories for
meditation & mindfulness. Likewise, many of the apps in the mental wellness space provide a mix
of services that defy easy categorization, including meditation, mindfulness, sleep hygiene, self-
help practices, gratitude, journaling, and even therapy.
• Technology is not a standalone segment within the mental wellness industry, but is pervasive
across all subsectors (as described in detail in Chapter V). Mental health and mental wellness
tech startups have become a major target for investors, receiving massive amounts of funding.
Investment levels reached $750 million in 2019, a five-fold increase over 2014, while funding
has topped $1 billion in the first half of 2020.20 These figures indicate that the perceived growth
potential of this segment is huge. An important development is the merging of traditional
mental health solutions with mental wellness technology platforms to provide preventive and
supplemental care, and some businesses may be seeking to access the resources of a much larger
healthcare market, beyond consumer discretionary spending on mental wellness.21 Finally, these
investment figures reflect flows of startup capital and are not included in our market size figures
for 2019 (which measure consumer expenditures).

Mental wellness is a new “industry bubble” within the
Global Wellness Economy framework.
The Global Wellness Economy Monitor, first published by the Global Wellness Institute (GWI) in 2014,
defines and measures the size of the wellness economy worldwide. The wellness economy encompasses
industries that enable consumers to incorporate wellness activities and lifestyles into their daily lives. To
date, the wellness economy has included ten industries, which we estimated at $4.5 trillion in 2017/2018.22
With a growing share of consumers embracing wellness as a dominant lifestyle value, the wellness economy
has become ever more dynamic and pervasive in all aspects of our lives. Emerging consumer needs drive
business and technology innovations and create new sectors, and mental wellness is just a such a sector.
In defining and measuring mental wellness as an industry for the first time, we are now adding mental
wellness as the 11th industry sector within the wellness economy (see Figure 8). This is a significant addition
to our framework, capturing an important set of economic activities that were not previously included
in our wellness economy measurements (in particular, meditation and mindfulness, self-improvement,
sensory products and services, and sleep).
Figure 8

Figure 8 combines data from 2019 (mental wellness), 2018 (physical activity), and 2017 (all other sectors).
Even though we value the mental wellness industry at $120.8 billion, we are not updating the $4.5 trillion
figure for the wellness economy because we have not updated the figures for the other ten wellness
sectors. In addition, about one-third of the mental wellness industry overlaps with other wellness industry
sectors, such as the following:
• Brain-boosting nutraceuticals & botanicals entirely overlaps with two other wellness industries
(healthy eating, nutrition, & weight loss and traditional & complementary medicine).
• Some products and services in the senses, spaces, & sleep subsector (e.g., circadian and human-
centric lighting, biophilic design) overlap with wellness real estate.
• Some products and services in the senses, spaces, & sleep subsector (e.g., sound healing, gong
baths, aromatherapy) overlap with offerings in the spa and wellness tourism industries.
• Travel and retreats for meditation & mindfulness and self-improvement also overlap with wellness
tourism.
As mentioned earlier, the COVID-19 pandemic has brought unprecedented challenges to the whole world,
affecting every aspect of human welfare, our society, and the global economy. It is crucial to examine how
the wellness economy has evolved since we last published figures for 2017/2018. An update of the global
wellness economy will be the subject for GWI’s upcoming research study in 2021.

Endnotes
1
See: Ingram, M. (2020). Retreat: How the Counterculture Invented Wellness. London: Repeater Books.
2
Wolfe, T. (1976, Aug. 23). The “Me” Decade and the Third Great Awakening. New York Magazine. https://
nymag.com/news/features/45938/index1.html.
3
Potkewitz, H. (2018, Dec. 15). Headspace vs. Calm: The Meditation Battle That’s Anything but Zen. Wall
Street Journal. https://www.wsj.com/articles/headspace-vs-calm-the-meditation-battle-thats-anything-
but-zen-11544889606.
4
McCarthy, J., Bauer, B., et al (2018, April). Wellness in the Age of the Smartphone. Global Wellness
Institute Digital Wellness Initiative. Miami, FL: GWI. https://globalwellnessinstitute.org/initiatives/
initiative-projects/wellness-in-the-age-of-the- smartphone-whitepaper/.
5
See: 1) Purser, R., and Loy, D. (2013, Aug. 31). Beyond McMindfulness. Huffington Post. https://www.
huffpost.com/entry/beyond-mcmindfulness_b_3519289. 2) Safran, J.D. (2014, June 13). McMindfulness:
The Marketing of Well-Being. Psychology Today. https://www.psychologytoday.com/us/blog/straight-
talk/201406/mcmindfulness.
6
See: 1) Vallas, M. (2015, June 3). The Meeting of Spirituality and Mental Health. Psychiatry Advisor.
https://www.psychiatryadvisor.com/home/practice-management/the-meeting-of-spirituality-and-
mental-health/. 2) What Role Do Religion and Spirituality Play In Mental Health? American Psychological
Association. March 2013. https://www.apa.org/news/press/releases/2013/03/religion-spirituality.
3) Dein, S. (2010, Jan 10). Religion, Spirituality, and Mental Health. Psychiatric Times. https://www.
psychiatrictimes.com/view/religion-spirituality-and-mental-health. 4) Cornah, D. (2006). The Impact
of Spirituality on Mental Health: A Review of the Literature. London: Mental Health Foundation. https://
www.mentalhealth.org.uk/sites/default/files/impact-spirituality.pdf.
7
Mindworks (n.d.). How Many People Meditate? https://mindworks.org/blog/how-many-people-
meditate/.
8
See: Harvard Health Publishing, Harvard Medical School (2019, Sept.). Don’t buy into brain health
supplements. https://www.health.harvard.edu/mind-and-mood/dont-buy-into-brain-health-supplements.
9
For more examples of foods and beverages marketed for brain health, see: 1) Hermann, M. (2020).
Functional Foods & Cognitive Health. Today’s Dietitian, 22(6), p. 40. https://www.todaysdietitian.com/
newarchives/JJ20p40.shtml. 2) McHugh, H. (2019, Aug. 21). Consumers have cognitive health on the
mind. Natural Products Insider. https://www.naturalproductsinsider.com/beverages/consumers-have-
cognitive-health-mind.
10
See, for example: McGroarty, B. (2018). Mushrooms Emerge from Underground. 2018 Global Wellness
Trends. Miami, FL: Global Wellness Summit. https://www.globalwellnesssummit.com/2018-global-
wellness-trends/mushrooms/.
See: 1) Brody, B. (2019). What Are Nootropics? WebMD. https://www.webmd.com/vitamins-and-

11
supplements/features/nootropics-smart-drugs-overview. 2) Nootropics. Psychology Today. https://www.

psychologytoday.com/us/basics/nootropics.
See: McGroarty, B. (2020). Wellness Music. 2020 Global Wellness Trends. Miami, FL: Global Wellness
12
Summit. https://www.globalwellnesssummit.com/2020-global-wellness-trends/wellness-music/.

13
See: McGroarty, B. (2020). Focus Shifts from Sleep to True Circadian Health. 2020 Global Wellness
wellness-trends/circadian-health/.
14
The mental wellness industry figures presented in this report are estimates made by the authors. We
draw upon a wide variety of secondary data sources as a baseline, and we develop original estimates
based upon our own economic models and our extensive knowledge of adjacent wellness sectors.
Key sources consulted include: Euromonitor International, World Bank, United Nations, World Health
Organization, U.S. National Center for Complementary and Integrative Health, International Coaching
Federation, Statista, Frost & Sullivan, Arcview Group/BDS Analytics, Prohibition Partners, and a wide
variety of industry-specific organizations, databases, publications, and media sources.
15
Chapple, C. (2020, May 28). Downloads of Top English-Language Mental Wellness Apps Surged by
2 Million in April Amid COVID-19 Pandemic. Sensor Tower. https://sensortower.com/blog/top-mental-
wellness-apps-april-2020-downloads.
16
See: 1) Demeritt, L. (2020, Aug. 5). The role of functional food and beverage in the era of COVID-19.
SmartBrief Industry News. https://www.smartbrief.com/original/2020/08/role-functional-food-and-
beverage-era-covid-19. 2) Lalou, K. (2020, Aug. 20). Targeting COVID-19 stress: Brain health players
discuss nootropics and mood boosters. Nutrition Insight. https://www.nutritioninsight.com/news/
targeting-covid-19-stress-brain-health-players-discuss-nootropics-and-mood-boosters.html.
17
Chia, J. (2020, May 14). How COVID-19 Has Changed the Fragrance Industry — at Least for Now. Allure.
https://www.allure.com/story/fragrance-industry-covid19-pandemic.
Kent, C. (2020, June 22). Will digital mental health solutions thrive after Covid-19? Medical Device
18
Network. https://www.medicaldevice-network.com/features/digital-mental-health-covid-19/.
19
See, for example: 1) Jones, K. (2020, May 2). These charts show how COVID-19 has changed consumer
spending around the world. World Economic Forum. https://www.weforum.org/agenda/2020/05/
coronavirus-covid19-consumers-shopping-goods-economics-industry. 2) JP Morgan (2020, Sept. 24).
How COVID–19 Has Transformed Consumer Spending Habits. https://www.jpmorgan.com/solutions/cib/
research/covid-spending-habits.
20
See: 1) Somauroo, J. (2020, Feb. 24). New Research Shows Global Mental Health Investment Topped
$750 Million in 2019. Forbes. https://www.forbes.com/sites/jamessomauroo/2020/02/24/new-research-
shows-global-mental-health-investing-topped-750-million-in-2019/#5593a3941962. 2) CBInsights
(2020). State Of Wellness H1’20 Report: Investment & Sector Trends To Watch. https://www.cbinsights.
com/research/report/wellness-trends-h1-2020/. 3) Gaussen, E. (2018, July 13). Mapping out the Mental
Health startup ecosystem. Medium. https://medium.com/venture-beyond/mapping-out-the-mental-
health-startup-ecosystem-5cb4db031b54.
21
See: Raphael, R. (2020). Mental Wellness and Technology: Rethinking the Relationship. 2020 Global
global-wellness-trends/mental-wellness-and-technology/.
22
See: 1) Yeung, O., and Johnston, K. (2019). Move to be Well: The Global Economy of Physical Activity.
Miami, FL: Global Wellness Institute. https://globalwellnessinstitute.org/industry-research/global-
economy-physical-activity/. 2) Yeung, O., and Johnston, K. (2018). Global Wellness Economy Monitor
2018. Miami, FL: Global Wellness Institute. https://globalwellnessinstitute.org/industry-research/2018-
global-wellness-economy-monitor/.

V. Mental Wellness Industry Subsectors
Self-Improvement $33.6b
market size
Businesses in this subsector

Services Products
• Coaching • Self-help books (print, e-books,

• Cognitive training audiobooks)
• Self-help advice, gurus & speakers • Brain training books, puzzles, games
(delivered via books, media & other
platforms) Tech
• Self-help classes, workshops, seminars
• Self-help apps & online platforms
& retreats
• Anti-loneliness/connection apps
• Self-help organizations & support groups
• Brain training apps & games
• Holistic/personal development institutes
• Brain stimulation consumer tech
& retreat centers
• Neuro toys
• Anti-loneliness organizations &
nonprofits*
* Not included in the market size number for this subsector. See Chapter IV for more details.
Sample companies & market innovators

Self-Help Gurus & Personalities Self-Help, Coaching, Brain Training
& Therapy Apps
• Tony Robbins • Peak
• Deepak Chopra • Fabulous • Luminosity
• Oprah Winfrey • MakeMeBetter • Elevate
• Esther Hicks • Habitica • AudioJoy
• Mark Manson • Remente • GEIST
• Brené Brown • Shine • CogniFit
• Tim Ferriss • Jour • LIFTiD
• Coach.me • Amen Clinics
Self-Help Organizations & • Woebot
• Youper Anti-Loneliness Apps & Tech
Institutes
• WellTrack
• Esalen Institute • Turn2Me • Meetup
• Omega Institute • 7 Cups of Tea • Patook
• Alcoholics Anonymous • BioBeats • Houseparty
• GROW • HelloMind • Mon Ami
• Recovery International • Rendever
• TED Foundation • EllieQ
• PARO

Background & Evolution
The concept of seeking help for self-improvement is rooted in ancient

literature, philosophy, and religion.
• The idea that we can learn to become a better version of ourselves has its origins in the ancient
genre of “wisdom literature.” Many works by the greatest thinkers and philosophers in history
(Socrates, Plato, Machiavelli, Confucius, Sun Tzu, Rumi) provided maxims and guidance on virtue,
divinity, the meaning of life, social norms, and practical advice on living – wisdom that remains
foundational to self-help, mental wellness, and psychology today. The development of the printing
press launched the modern era of the self-help book. From the 1600s to the 1800s, “conduct
books” proliferated across the Western world, teaching men about ambition, self-reliance, and
success, and advising women on domesticity, marriage, parenting, and “female virtues.” Samuel
Smiles’ bestselling Self-Help (1859) is credited as being the first true “self-help” book, coining the
term “self-help,” and launching the genre in the modern publishing industry. A number of self-
help bestsellers appeared in the early 20th century, such as Dale Carnegie’s How to Win Friends
and Influence People (1936) and Norman Vincent Peale’s The Power of Positive Thinking (1952).
Alcoholics Anonymous was founded in 1935, marking the beginning of the group-based self-help
and recovery movement.
• The concepts of coaching and mentoring also have ancient roots. Sports coaching originated in
ancient Greece, when athletes were supported in gymnasiums by elite former champions. The
first recorded mention of a “mentor” appeared in Homer’s Odyssey, describing a wise and trusted
advisor or friend. The word “coach” was first applied to a person in the 1830s, when students at
Oxford University used it as slang for the tutors who helped them toward their goal of passing
exams.
The self-help industry emerged with modern psychology and the New
Age movement, and was ushered into the mainstream by gurus and
celebrities.
• The 1960s and 1970s (the “Me Decade”) marked the take-off of the self-help industry, as the
narratives of recovery, self-care, and self-actualization started to permeate mainstream culture,
and as self-help began to embrace mysticism, spirituality, and psychology. The popularity of self-
help surged into the 1980s-1990s, and it became increasingly driven by gurus and the media,
People started to replace priests, therapists, and doctors with media celebrities, writers, and
gurus, who dispensed their advice in the form of books, TV shows, and infomercials.
• In the mid-20th century, executive coaching began to permeate business culture, as business
executives looked to psychology to improve their performance and productivity. Interest in
coaching continued to grow with new developments in the psychology field, such as Martin
Seligman’s concept of positive psychology. Since the 1990s, coaching has become a recognized
discipline, with professional associations, peer-reviewed journals, training programs, and university
courses all over the world. As people turn to coaching to boost self-esteem and confidence, it has
expanded from the business arena into all areas of life – e.g., leadership coaching, team coaching,
career coaching, life coaching, personal development coaching, and relationship coaching. The
International Coach Federation estimates that there were 71,000 coach practitioners worldwide
in 2019.1

• In recent years self-help has become one of the most lucrative genres in the book publishing industry,
with approximately 150 new titles published every week.2 The self-help genre has permeated into
other book genres (social science, natural sciences, business, memoirs, etc.), which widens the
credibility, application, and appeal of the concept. While the majority of consumers for self-help
books and advice are female, men are increasingly attracted to self-improvement in the guise
of seeking professional, leadership, business, health, and mental wellness advice. Some major
publishing houses are rebranding the category as “self-improvement,” “personal development,”
and “mind-body-spirit” to expand its appeal among Millennials and a new generation of consumers.3
The rising interest in self-improvement and self-transformation is a global phenomenon. While the
most developed markets are in North America and Europe, the Asian markets are expected to
grow rapidly, especially in China, Japan, and India, as well as in Latin America and the Middle East.
Developments to Watch
Technology and media platforms will continue to expand the mass market
for self-improvement.
• The Internet, social media, apps, and other media platforms are rapidly diversifying the ways in
which consumers can access self-help advice and solutions, either for free or bundled in cable TV
and streaming subscription services – e.g., blogs, podcasts, TED talks, Netflix, YouTube, etc. Some
of the top motivational speakers offer their own apps, and many people pay for online courses,
live webinars, and other proprietary content offered by their favorite gurus and personalities.4
While established self-help celebrities (Oprah, Tony Robbins, Deepak Chopra, etc.) continue to
dominate the market, YouTube self-help channels (e.g., Tedx Talks, Be Inspired, School of Life),
social media (Twitter and Instagram), podcasts, and other platforms have helped to propel
unknown motivational coaches to stardom, bringing a wider array of self-help messages to a
larger, more diverse, and global audience.
• Self-improvement and self-help apps are exploding (in 2018 Apple named “self-care” its app
trend of the year5). These apps provide a wide range of self-improvement advice, aids, tools,
motivation, and tracking, and they are often combined with meditation, mindfulness, journaling,
healthy eating, daily affirmations, seminars, coaching, therapy, and other mental wellness and
general wellness practices. Some apps focus on helping users form new habits or work on specific
goals (e.g., Fabulous, Happify, MakeMeBetter, MotivateMe, HabitBull). Some draw upon tools from
psychology like cognitive behavioral therapy (e.g., What’s Up, Mood Kit, WellTrack), and some
use gamification (e.g., Habitica, SuperBetter, FOCUS On the Go!). Digital journaling apps, such
as Day One and Jour, try to capture users’ attention and improve motivation with reminders,
prompts, and beautiful formats. Technology also helps to make formerly one-on-one services such
as coaching and therapy more accessible, by providing a combination of AI-assisted interaction
and options to connect with human coaches (e.g., Coach.me, Woebot).
• Since the founding of Alcoholics Anonymous in 1935, thousands of group-based self-help and
mutual support organizations have emerged around the world to help people deal with addiction,
bereavement, trauma, anxiety, stress, weight-loss, chronic disease, and other challenges. Most
of these groups sit in a grey area between mental illness, mental wellness, and general wellness.
In the last decade, many well-established self-help groups have started offering online meeting
options, while a host of new online-only self-help communities have emerged. Online self-help
platforms offer both group and one-on-one support, often moderated by trained volunteers and
paid professionals, and even online therapy and counseling – for example, Turn2Me, 7 Cups of Tea,
The Tribe, Daily Strength, Wisdo, and The Dinner Party. Even social platforms like Facebook and

Reddit are a major medium for grassroots online self-help groups and support. A growing number
of online groups target marginalized communities and those underserved by conventional mental
health resources (BIPOC, LBGTQ+, etc.), such as Therapy for Black Girls, Sista Afya, QTPoC Mental
Health, Trevor Space, Asian Mental Health Project, etc.
Self-improvement narratives and wellness practices are converging,

ushering in the golden age of self-transformation.
• While the need and desire for self-improvement have always existed, there have never been so
many options available to access the advice of well-established gurus, celebrities, journalists,
academics, and emerging influencers – who deliver promises to transform us into the best version
of ourselves (i.e., healthier, happier, more successful, more fulfilled, and even more enlightened).
Self-transformation and wellness are converging, as people recognize the holistic nature of their
being and of their lives. No wonder it is difficult to pinpoint what type of advice gurus such
as Oprah, Gwyneth Paltrow, Tony Robbins, Deepak Chopra, or Marie Kondo are dispensing: is it
health, relationship, happiness, self-esteem, housekeeping, fitness, weight-loss, personal finance,
career, or spiritual guidance?
• The tentacles of self-improvement and mental wellness are extending into all facets of life and
personal transformation, from travel and festivals, to gyms and coffee shops. In addition to celebrity
and popular mega events like Coachella, Burning Man, and Wanderlust, smaller retreats, programs,
and classes are increasingly integrating mental wellness practices into personal development and
transformational experiences. Chōsen, for example, offers self-exploration workshops and retreats
for high-performing individuals by leveraging expertise in functional well-being, psychology, and
elite athletics. Digital detox retreats and workshops have been on the rise in the wellness tourism
and spa sectors, helping people to cope with their technology-related stress by taking time away
from it. In urban areas, popular consumer hangouts like coffeeshops and gyms are developing
mental wellness and stress relief offerings – such as “stress cafés” and “nap cafés” in Seoul, anger
rooms like Toronto’s Rage Room and New York’s Wrecking Club, or Taryn Toomey’s boutique
workout “The Class” in New York City (which incorporates screaming).6 Iceland’s latest tourism
marketing campaign, “Looks Like You Need to Let It Out,” responds to widespread COVID-related
stress and encourages people to virtually scream into beautiful Icelandic landscapes.7
• As self-improvement converges with wellness, new products and services are emerging to provide
integrated and holistic solutions that include diet, fitness, relationships, and mental health in a
one-stop shop (e.g., life coaching and motivational apps like Remente, Motivate, Lifehack). For
example, the Fabulous app markets science-based approaches to help users address multiple
concerns by changing behavior and building healthy habits. The Pacifica Neuroscience Institute has
created a Cognitive Fitness Studio program that incorporates both physical exercise and cognitive
stimulation for improved brain health. The GEIST brain training app works on memory and logic,
but also incorporates more meditative techniques to calm the mind. In her wildly popular MOOC
course The Science of Wellbeing, Yale University’s Dr. Laurie Santos draws on scientific evidence
to suggest a variety of techniques and pathways to help people become happier.
New and creative types of self-help organizations, apps, and technologies

are combatting our growing crisis of loneliness and isolation.
• In response to the rise in loneliness and social isolation – and growing awareness of its many
negative impacts on our physical and mental health – new types of organizations are emerging to
help people connect with one another, targeting both younger people and seniors. In Denmark,

Ventilen brings together lonely 15-25 year olds with volunteers for regular activities and outings
to build human connection, and it has identified 21 venues across the country where young people
looking for companionship can meet up.8 In the UK, The Big Lunch brings together millions of
neighbors for a community meal once per year. A number of countries have developed free
phone helplines that provide friendship, conversation, and advice for seniors, such as The Silver
Line (UK), Friends of the Elderly (Ireland), Friendly Phone Program (Canada), and FriendLine
(Australia). In the United States, the Village Model helps seniors to age-in-place by connecting
them with companions, volunteers, and social activities in their neighborhoods.9 Japan has a
unique industry of “rent-a-family” agencies (e.g., Family Romance, Client Partners) that help lonely
people hire companions who can take the place of relatives or provide companionship.10 Based
on growing evidence that social laughter can reduce stress and boost well-being, laughter yoga
combines yoga breathing with laughter exercises; the movement has spawned over 20,000 free
social laughter clubs across 110 countries.11 Another unusual trend developing around the world is
“cuddle parties,” where strangers can meet for an evening of platonic cuddling, human touch, and
hanging out.12
• As an offshoot of the dating apps industry, a growing number of apps help people make new friends
and get to know their neighbors (e.g., Meetup, Patook, Friender, Bumble BFF, NextDoor), or even
rent a friend for a day (e.g., RentAFriend). Apps like Houseparty and Teleparty (formerly Netflix
Party) facilitate virtual activities, like games or movies, with friends – things that have become
much more popular during the COVID-19 pandemic. Some companies are using VR technologies
to create shared virtual experiences that combat isolation (e.g., Alcove VR, Rendever). Some apps,
like Papa and Mon Ami, focus on facilitating in-person connections for seniors. Other companies
are using new robotics technologies to develop AI-driven digital companions and caregivers for
seniors, such EllieQ, PARO, SAM, and Zora.13
Anti-self-help is a new form of self-help.

• As the narrative of self-improvement becomes pervasive, it has generated a unique form of
backlash – the anti-self-help movement.14 A new genre of anti-self-help books question the
philosophy of self-help, whether it is really helping people solve their problems, or whether it is
even harmful (e.g., Brinkmann’s Stand Firm: Resisting the Self-Improvement Craze; Cederstrom
and Spicer’s Desperately Seeking Self-Improvement; Manson’s The Subtle Art of Not Giving a F*ck).
Similar sentiments have been expressed in the anti-happiness movement, essentially rejecting the
notion that it is always in our power to improve ourselves and our lives, when so much is beyond
our control. Rather than turning people away from self-help, the anti-self-help movement has
engineered its own messaging and advice, such as: be negative, accept mediocrity, or stop caring.
Authors and speakers like Mark Manson have risen to fame by suggesting that if people stop
caring about self-improvement, they will become happier. Marisa Peer’s Rapid Transformational
Therapy uses hypnotherapy to teach clients that “they are enough.” Ironically, anti-self-help – and
a shift from self-improvement to self-acceptance – has become the latest self-help message.
With brain maintenance and brain hacking gaining consumer interest,

more rigorous research and evidence will be needed to back up the claims
made by businesses.
• Self-improvement also has a physical dimension, in its connection to the brain. Concerns with
mental function extend from prevention and maintenance to enhancement and optimization. On
the one hand, longer lifespans around the world have brought growing concerns with memory
loss, cognitive decline, and the risks of dementia and Alzheimer’s disease. At the other extreme,

there is growing interest among business and tech executives in how to enhance or maximize
cognitive ability for peak mental performance. It is against this backdrop that games, apps, and
programs that claim to enhance brain functioning have found a growing market in recent years.
One study estimated that in 2018, people spent almost $2 billion worldwide on brain training apps
such as Luminosity, Peak, and Elevate.15 Many of these games and apps are marketed from the
health/wellness and education angle, with a promise of better brain performance that can appeal
to professionals and children, as well as seniors. New apps are bringing new technologies into the
cognitive enhancement market – for example, AudioJoy and Hypnobox combine hypnosis with
brain training, mental clarity, and relaxation. Brain training games are even available on video
gaming platforms (e.g., Dr. Kawashima/Brain Age on Nintendo, Brain Challenge on Xbox). There
is also growing interest in classes, studios, and centers (both online and in-person) that provide
cognitive training to all age groups, some of which employ neurofeedback to enhance overall
mental wellness or to address specific brain impairments (e.g., Amen Clinics, Pacific Brain Health
Center, Emory University’s MOOC Biohacking Your Brain’s Health, or the online CogniFit Brain
Training program).
• Too often, businesses are eager to make general claims of cognitive enhancement by using their
products, without adequate proof of their efficacy for specific cognitive domains (e.g., memory,
attention, processing speed, visuospatial skills, or executive functions), whether the results are
temporary, or whether there may be side effects.16 After Luminosity’s 2016 settlement with the
U.S. Federal Trade Commission for making misleading claims about cognitive improvement,17
other companies have been more careful about their promises. For example, BrainHQ claims
that it can help boost brain processing speed but not overall intelligence; Memorando targets
working memory, a measurable goal; CogniFit focuses on specific cognitive impairments. Medical
researchers and academic centers are increasingly collaborating with businesses to build better
services and products with more rigorous scientific evidence behind them. For example, New
York’s Blum Center for Health partners with Field, a neuro technology company, to improve brain
functioning.18 Going forward, there will be more scrutiny from consumers, scientists, and regulators
on the claims made by businesses with respect to brain maintenance, brain hacking, and brain
enhancement.

Meditation & Mindfulness $2.9b
market size

Services Products & Accessories Tech
• In-person classes & studios (medita- • Books, videos, other • Meditation gadgets
tion, mindfulness, breathwork, guided media & aids (headbands,
imagery, body scan, etc.) • Meditation accessories trackers, monitors,
• Apps, streaming services, & online (cushions, benches, VR, etc.)
platforms beads, candles, chimes, • Biofeedback & neuro-
• Retreats & workshops etc.) feedback products &
• Institutes & training centers • Mindfulness products services*
(journals, coloring books,
jewelry, etc.)

Studios/Centers/Teachers Apps Tech
• Inscape • Calm • Core

• MNDFL • Headspace • Muse
• MBSR (Jon Kabat-Zinn) • Insight Timer • Spire
• Transcendental Meditation • Petit BamBou • Breathe 2
• Art of Living Foundation • Buddhify • Mindlightz
• Plum Village • Sattva • TRIPP
• Heartfulness Institute • Breethe • iFeel Labs
• Middle Way Meditation Institute • Aura • Healium
• Tara Brach • eMindful • Flow VR
• Pema Chodron • Mind Labyrinth VR
Dreams
Meditation is an ancient spiritual tradition with roots in all major religions.

Eastern gurus brought meditation to the West in the mid-20th century.
• The types of meditation and mindfulness that are widely practiced today are associated with
Buddhism, although meditation actually originated in ancient Hindu texts (1500 BC) before it was
adapted by Buddhists in China and India (600-400 BC). Lesser known is the fact that Judaism,
Christianity, and Islam all have meditative traditions of their own that date from ancient times or
the Middle Ages.

• Meditation and yoga were first introduced to Western audiences when Eastern spiritual masters
and gurus traveled and migrated to the United States and Europe to give lectures and courses,
and to establish communities of followers. In the 1960s-1970s, Maharishi Mahesh Yogi became
the “guru to the stars,” teaching celebrities like The Beatles and the Beach Boys to meditate and
making “mantra” a household word. In the 1980s and 1990s, many high-profile celebrities and
athletes embraced and popularized meditation and yoga (e.g., Michael Jackson, Madonna, Demi
Moore, Donna Karen, Joe Namath, Phil Jackson, Deepak Chopra, Oprah). Meditation became hip,
and it spread from hippie and fringe culture into the mainstream.
The Westernization and secularization of meditation and mindfulness is

sometimes controversial.
• Secular, Western-style meditation and mindfulness emerged in the 1970s, when Jon Kabat-Zinn
founded his Mindfulness-Based Stress Reduction Clinic at the University of Massachusetts Medical
Center, bringing Buddhist meditation into medicine and Western science; secularizing it; and
connecting it with self-improvement, personal growth, recovery, relaxation, and stress reduction.
The spread of Transcendental Meditation (TM) in the West in the 1960s-1970s, alongside the rise of
yoga as a fitness activity, have also driven the popularity of secularized meditation practices and
the proliferation of mindfulness into business and all aspects of popular culture.
• The rise of secular forms of meditation and yoga have created many controversies among religious
communities around the world. Conservative Muslim clerics in Malaysia and Indonesia (2008),
Egypt (2004), and Singapore (1984) have issued various fatwas against the practice of yoga as
“anti-Islam,”19 while Saudi Arabia banned yoga until 2017. In the United States, many conservative
Christians view meditation and yoga as “anti-God,” or object to teaching mindfulness and yoga
in schools as an intrusion of Eastern religion into education. India, the very birthplace of yoga,
has also seen conflicts between Hindus and Muslims over the practice of yoga in schools and
whether yoga is a religious activity. At the same time, the adoption of meditation and mindfulness
by Silicon Valley and the corporate world as an employee wellness offering and productivity-
boosting measure has been criticized as “McMindfulness,” or the co-opting of Buddhist spiritual
practices for capitalist and profit-making purposes.20
Interest in meditation has accelerated in recent years, as people of all

ages search for ways to cope with stress and anxiety.
• Meditation practices have proliferated rapidly around the world in recent years. One estimate
places the number of individuals worldwide who practice meditation at between 200 and 500
million.21 In North America, meditation has become one of the most popular complementary health
techniques. The U.S. National Health Interview Survey found a dramatic increase in the number
of adults who practiced meditation (in the past 12 months), from 4.1% of respondents in 2012 to
14.2% in 2017.22 Meditation use among U.S. children grew from 1.6% to 7.4% during this same time
period.23 Participation is growing across generational cohorts – from youth to middle age to older
adults – indicating that interest in, and the need for, meditation cuts across age groups. Elsewhere,
a 2018 study found that 26% of adults in the United Kingdom have made use of meditation in the
last five years to improve their mental health.24
• Growing interest in meditation is fueled by rising stress, anxiety, and feelings of sadness or lack
of happiness – and COVID-19 has undoubtedly increased stress and anxiety levels worldwide
this year. People’s reasons for meditating include general wellness, improving energy, and aiding
memory or concentration. Many practitioners believe that meditation and mindfulness techniques
have helped them to reduce stress, relax, sleep better, and enhance their emotional well-being.25

As evidence of their efficacy grows, meditation and mindfulness will be

increasingly adopted as a key part of treatment and patient care in the
medical and mental health fields.
• A growing body of research and a host of anecdotal evidence suggest significant benefits from
meditation in the treatment of a number of health conditions, from pain management for cancer
patients to brain function in Alzheimer’s patients, as well as for many mental disorders such
as depression, anxiety, post-traumatic stress disorder, and insomnia.26 Research has found that
various mental health treatments, such as cognitive behavioral therapy (CBT) and psychotherapy
(talk therapy), work well when used in conjunction with mindfulness and meditation techniques.27
Recognizing the links between mental health and meditation and mindfulness, public health and
mental health professionals are increasingly encouraging patients to adopt these techniques as
part of their treatment plans (e.g., UK’s National Health Service, Mayo Clinic).
Mobile technologies and apps are accelerating consumer adoption of

meditation and mindfulness.
• Mobile apps are a key driver behind the rapid consumer uptake of meditation and mindfulness.
Companies such as Calm, Headspace, Insight Timer, Breethe, and 10% Happier have brought
these modalities within easy reach, often by breaking down the practice into bite-sized, self-
driven, and customized modules, and even infusing music, stories, soundscapes, and games (e.g.,
Happify, SuperBetter) to help with mindfulness, calming, and stress reduction. The ten highest-
earning meditation apps received 57.4 million first-time downloads in 2019, a 26% increase over
the previous year, and generated $195 million in spending.28 While the app market is dominated
by North American companies and consumers (e.g., Calm and Headspace, each with more than
two million subscribers), there is substantial growth potential all over the world, with new entrants
such as MindFi from Singapore rapidly gaining users.
• Some apps offer their users a combination of mental health, self-help, and meditation techniques,
including CBT, journaling, motivational messages, and other mindfulness aides (e.g., Calmer You,
Shine, Moodnotes). Others have launched digital mental health products, using chatbots and
voice analysis to mimic talk therapy and promote meditation and regular mindfulness practices
(e.g., Woebot).
• There are a number of challenges with the growth of app-based meditation and mindfulness,
including questions about whether these apps are truly science- and research-based, whether
they are preying on vulnerable populations for profit, and whether they are protecting users’ data
privacy.29 Some question the use of tracking, gamification, push notifications, and social media
sharing to promote a sense of calm and mindfulness. Other criticisms point out that meditation
apps tend to focus narrowly on coping with daily stress, while ignoring the deeper insights in
Buddhist meditation practices that work toward self-transcendence, greater awareness, and
enlightenment.

Innovative technologies and gadgets are reshaping how consumers
experience, understand, and track the effects of meditation.
• New gadgets and devices that use the latest sensing, monitoring, and haptic technologies are
bringing a science-based edge to meditation – both to give customers a more engaging and
personalized experience, as well as to help them track and understand what happens when they
meditate. Products like Breathe for Apple watch, Core Meditation Trainer, and Aduri Cushion use
haptic technology (touch-based sensations and vibrations) to help users relax, maintain focus,
and control their breathing. Headbands like Muse and Emotiv Insight use sensors and biofeedback
to track brain activity during meditation, while trackers like Spire Stone and Inner Balance monitor
breathing and heartrate.
• Other devices incorporate sound, light, and virtual reality (VR) technologies to provide an
immersive, multi-sensory experience and promote deeper relaxation during meditation (for
example, Mindlightz glasses, Brain Tap headset, and Breathe 2 lamp). VR technologies limit
distractions and create a deeper sense of calm, and they are often combined with biofeedback
and neurofeedback – for example, the TRIPP VR, Healium VR/AR, and Flow VR systems (which
are streamed through Oculus or Pico headsets, Apple watches, and other connected devices).
In the wellness travel space, spas and hotels are incorporating VR-based meditations into spa
treatments and even hotel rooms (e.g., StayWell wellness rooms with VR meditation apps). Other
innovators merge VR, meditation, and gaming to provide a fun new immersive experience (e.g.,
Mind Labyrinth VR Dreams, Microdose VR, SoundSelf, and Marvellous Machine).
Businesses and business models are evolving rapidly to integrate

meditation and mindfulness into the live, work, and travel spheres.
• The range of places and spaces where we can learn and practice meditation is exploding. Secular
centers for meditation are not new; places such as the Esalen Institute, Omega Institute, Kripalu
Center, Middle Way Meditation Institute, Chopra Center, and Institute for Mindfulness-Based
Approaches host in-person and online sessions, sometimes with well-known teachers such as Jon
Kabat-Zinn. Meditation is an increasingly popular wellness tourism offering, with thousands of
retreats and classes offered around the world, sometimes in exotic locations and luxury wellness
resorts (from Jamaica’s seaside cliffs to the Moroccan desert), and even as a combination of
meditation and safari packages in Africa. In some major cities, dedicated meditation studios like
Inscape and MNDFL (New York), Unplug Meditation and The DEN (Los Angeles), Inhere (London),
and Muon (Tokyo) have emerged in recent years to cater to urbanites who are looking for a reprieve
from their stressful daily lives. As interest grows among mainstream consumers, meditation classes
are increasingly offered in yoga studios, at comprehensive gyms and fitness centers, and even at
YMCAs and community centers. Other innovative services bringing meditation and mindfulness
to consumers include mobile meditation studios (e.g., MeditationWorks in Canada, BETime in New
York City, PauseNow in California, Yogi Truck in UAE) and community/mass meditation events
(e.g., The Big Quiet).
• Meditation and mindfulness companies are increasingly partnering with businesses in other
sectors such as travel, especially as marquee brands respond to consumer interest and pivot to
incorporate wellness offerings – for example, Headspace with Virgin Atlantic, Nike, and Hyatt;
Calm with American Airlines and Uber; and Inscape with JetBlue.30 Industry leaders such as Calm
and Headspace are expanding into adjacent spaces as they break out of the confines of being a
“meditation app business.” For example, Calm is now branding itself as a “mental fitness” company,
serving customers at XpressSpa locations and Marks & Spencer’s Sleep Shop, and is considering
hospitality offerings such as a Calm hotel or an island resort.31

• Meditation and mindfulness offerings are growing rapidly in workplaces, as employers begin
to understand the business case for supporting their employees’ mental wellness. Apart from
meeting mental health needs (via counseling or medical referrals), many employers are offering
mental wellness support via apps, free/subsidized classes, and dedicated meditation rooms/pods
in the office. Market leaders like eMindful are rushing to develop specialized products and services
for corporate clients. With the future of workplaces in flux and working from home on the rise due
to COVID-19, virtual delivery of meditation and mindfulness assistance/services will become an
increasingly prominent feature of employee wellness programming.
• The market for accessories to support meditation is diverse and fragmented, including cushions,
blankets, mats, benches, and chairs; beads, statues, prayer wheels, alters, and crystals; sound and
aroma products (e.g., incense and burners, candles, singing bowls, bells, chimes); and clothing.
Mindfulness has become a selling point for almost any type of consumer product imaginable –
including mindfulness calendars and cards, mindfulness jewelry, and even art supplies and office
supplies. Adult coloring books were a major mindfulness fad in the United States between 2015-
2017; while sales have tapered off substantially, the trend has continued.32 And as the general
demand for physical books declines, digital coloring books for mindfulness practice remain
popular. Mindful coloring has been followed by a mindful journaling fad – and both fads have had
a significant impact on overall sales of art and writing supplies.33
As different needs are being noticed and addressed, the market is

diversifying away from the Anglo and cisgender narrative.
• Recognizing that gender identification, culture, and ethnicity shape a person’s mental wellness
needs, entrepreneurs are developing culturally relevant offerings to target more diverse
customers. For example, the Sanity & Self app promotes mindfulness practices for women and
boasts users in over 100 countries. Apps such as Shine and Liberate are developed to help BIPOC
(Black, Indigenous, and People of Color) users combat stress and anxiety. The Ayana app targets
marginalized consumers including members of the LGBTQ+ community and BIPOC. While app
choices for Spanish speakers are still limited, they are growing – for example, Escala Meditando,
Aire Fresco, and Intimind. The introduction of Tawazon has given the MENA region its first Arabic
language mediation and mindfulness app for both adults and children.34
Public organizations and nonprofits are entering the meditation and

mindfulness space as a matter of public health strategy.
• Recognizing the value of mediation and mindfulness for improving mental health and well-being,
public organizations and non-profits are helping to bring these modalities and practices to more
people, including vulnerable populations. For example, the U.S. Department of Veterans Affairs
has designed its own app – Mindfulness Coach – to train current service members and veterans
in mindfulness techniques. UK-based nonprofit Breathworks has partnered with governments to
bring mindfulness training to organizations and people in over 35 nations.

Brain-Boosting Nutraceuticals & $34.8b
Botanicals market size

Foods & Beverages Supplements & Herbals Services
• Functional/fortified foods & • Vitamins & supplements for • Cannabis &

beverages for brain health, brain health, memory, energy psychedelic
memory, energy • Natural & traditional sleep retreats*
• CBD/hemp/cannabis-infused remedies (e.g., melatonin) • Psychedelic-
foods & beverages • CBD/hemp/cannabis-infused assisted therapies*
supplements
• Functional mushroom extracts
& supplements for brain
health, memory, focus*

Functional Foods & Beverages for Supplements for Brain Health Cannabis &
Brain Health Psychedelics –
• Moon Juice Drugs & Products
• Recess waters • Gaia Herbs
• Phocus • Nordic Naturals • MindMed
• Koios • Natrol • Compass Pathways
• BrainJuice • Qualia • Champignon
• IQ Bars • Braineffect Brands
• NeuroGum • Apothekary • CiiTECH
• Trubrain • KAMU Labs • Tilray
• Brainiac Kids • Canopy Growth
• Trulieve
Cannabis & Psychedelics –
Natural Sleep Remedies Clinics, Therapies, & Retreats • Green Gorilla
• KIVA Confections
• OLLY • Field Trip Health • CV Sciences
• Nature Made • SoundMind • Charlotte’s Web
• NOW Foods • Synthesis • Rainbo
• Luna Kids • MycoMeditations
• Sugarbear • Atman

Humans have used mind-altering drugs since prehistoric times, for

religious, healing, and recreational purposes.
• Archaeological evidence indicates that plant-based, mind-altering drugs have been used by
humans for as long as 10,000 years. Cannabis was cultivated and used in Central Asia and China
more than 5,000 years ago. Opium (“Hul Gil” or the “joy plant”) was cultivated by the ancient
Sumerians from around 3400 BC. Indigenous cultures around the world have long utilized endemic
plants for their psychoactive and stimulant properties, such as coca leaf in South America, peyote
among Native Americans, nutmeg and betel nut in South and Southeast Asia, blue lotus in ancient
Egypt, mushrooms in Mesoamerica and North Africa, and khat in Africa and the Arabian peninsula.
• For most of history, these drugs were seen as natural, not something to be feared or controlled.
Cannabis, opium, and cocaine were widely used in Western medicine starting in the 19th century
– to treat pain, melancholia, nervous disorders, insomnia, and many other physical ailments.
During the 1950s and 1960s, LSD, psilocybin, and mescaline were used in psychotherapy to treat
thousands of patients. Psychedelics were actively studied by scientists in the United States,
Canada, and Europe, with promising results for treating depression, anxiety, trauma, addiction,
and other disorders. However, medical use and research on psychedelics halted abruptly at end of
the 1960s, when possession and use of LSD and mushrooms were banned by the U.S. government
(and then became listed as Schedule I drugs by the United Nations in 1971), in response to the
widespread recreational use of drugs among the counterculture movement, and rising concern
about drug abuse and its negative impacts.
• The last 20 years have brought a renewed interest and a resurgence of scientific and clinical
research on the potential for cannabis and psychedelic drugs (especially psilocybin, ketamine, and
MDMA), although legal restrictions and socio-cultural sensitivities about drugs continue to put a
damper on widespread research and therapeutic uses. Decriminalization and liberalization of drug
laws across many countries (e.g., legalization of medical marijuana in more than 30 U.S. states)
have also created a rapidly-growing private and grassroots market for recreational and wellness-
driven drug use – for example, an ever-growing array of over-the-counter cannabidiol (CBD)
products; microdosing of psychedelics for boosting energy, creativity, and brain performance;
and even a burgeoning niche market for psychedelic retreats and tourism.
Brain-boosting and sleep-enhancing supplements, foods, and beverages

are a modern industry that emerged to meet modern consumer demand.
• Although the connection between nutrition and our brain health and functioning has been known
for a while, in recent years there is rapidly rising interest among consumers in foods, beverages,
and supplements that support brain health, mood, memory, energy, and sleep. This demand is
supported by the growth of the wellness movement and the consumer quest for more natural
alternatives to popping pills. A growing body of research evidence demonstrates the importance
of a healthy diet for mental health, and is also identifying key nutrients and ingredients (e.g., pre-
and probiotics, polyphenols, Omega-3 fatty acids, choline, flavonoids) and superfoods (e.g., oily
fish, berries, dark chocolate, turmeric, green tea, fermented foods) that improve the microbiome
and support gut-brain health.
• Food companies are capitalizing on this trend by developing vitamins, supplements, and fortified/
functional foods and beverages enhanced with various nutrients that purport to support brain
health and improve sleep. The range of products in the market is broad: naturally-derived and

herbal sleep remedies (e.g., melatonin, valerian root, passionflower); natural supplements for
mood, energy, alertness, and brain health (e.g., St. John’s Wort, ginseng, Ginkgo biloba, Coenzyme
Q10, Omega-3 fatty acids, fish oils); as well as functional foods and beverages enhanced with brain,
memory, and energy-boosting ingredients such as DHA, choline, L-theanine, taurine, guarana,
ginseng, and caffeine (e.g., Koios or Brain Juice beverages, Phocus waters, TruBrain bars and
drinks, Brainiac Kids yogurts, Neuro gum and mints).35
• Rising longevity, along with the risk of cognitive decline and diseases such dementia and Alzheimer’s,
have increased the demand for brain supplements among older populations. In the United States,
more than one-third of the population over age 75 takes brain health related supplements to
maintain/improve mental sharpness or to reverse/delay dementia (including fish oil, Omega-3,
turmeric, Coenzyme Q10, green tea, and Ginkgo biloba).36 Among younger populations, there
is growing interest in functional foods and beverages that may enhance cognitive ability (focus,
attention, stamina), including from executives and professionals who want to improve performance
at work, as well as students for exams and school work. Global surveys conducted by Euromonitor
found that 15-20% of people are highly concerned with their memory, and 35-40% are moderately
concerned, and this is true across age groups.37
• While the market for vitamins and supplements, sleep aids, and caffeinated and energy drinks,
has existed for decades, new products that are marketed from the brain health and brain boosting
angle are proliferating, even when many of these claims have not been validated by rigorous
clinical research. Botanicals, supplements, and functional foods/beverages that are believed to
improve cognitive function in healthy individuals are generally known as nootropics. There are
many types of nootropics, including not only botanical extracts and supplements, but also addictive
substances and stimulants (nicotine, caffeine), synthetic compounds (piracetam, noopept), and
prescription drugs (Ritalin, Adderall). The use of nootropics is controversial, especially the off-
label and illegal use of prescription drugs as a cognitive enhancer in healthy people, and these
kinds of supplements are not regulated in the way that pharmaceuticals are.38
• The Global Council on Brain Health found that very few supplements have been carefully studied
for their effects on brain health; several well-designed studies on the connection between
supplements and brain health found no benefit in people with normal nutrient levels. It is unclear
whether people with nutritional deficiencies can benefit their brains by taking a supplement,
because the research is inconclusive.39 Most experts recommend whole foods and a generally
healthy diet over supplements and functional foods for supporting brain health and mental
well-being.40 Regardless, products with brain-enhancing promises have been one of the fastest
growing niches within the supplements category, while functional foods and beverages with
similar promises are also growing rapidly.
Rising consumer interest will drive the continued growth of cannabis-

based products and services for mental wellness.
• The movement away from prescription drugs and the continuing relaxation of legal restrictions
have led to rising demand for products that include cannabis, hemp, CBD, THC, and other botanicals
(e.g., reishi mushrooms, ashwagandha) for various mental health and mental wellness usages. Of
these, CBD products have most rapidly increased in popularity. A 2019 survey by U.S Consumer
Reports found that more than 25% of Americans have tried CBD, including 40% of people in their
20s and 15% of people 60 and over.41 In the UK, the number of regular CBD users is estimated at
1.3 million (or about 2.5% of the adult population).42 Elsewhere, various studies have estimated

usage of cannabis products to be roughly one in five adults in Israel, 6% in Germany, 15% in Chile,
and 10% in Australia.43 A study in Canada, conducted after cannabis was legalized for recreational
use, found that 59% of Canadians are currently using and/or are interested in using cannabis.44
• Just a few years ago, pain management was the primary medical use for cannabis, often as a
replacement for over-the-counter and prescription drugs. Increasingly, consumers have been
turning to cannabis for mental wellness purposes. A 2019 Canadian study found that 46% of
cannabis users do it for fun, while a greater percentage use it for wellness purposes, such as
to relax (62%), relieve stress/anxiety (54%), improve sleep (42%), and improve mood (39%).45
Similarly, a 2019 U.S. Consumer Reports study found that many Americans use CBD mainly to relax
and to reduce stress and anxiety, and most of them find it to be either extremely or very effective
for this purpose.46 CBD can now be found in hundreds of products, including pills, oils, tinctures,
and gummies; personal care and beauty products such as creams, masks, and cosmetics; and a
variety of food and beverages. Even Martha Stewart has become a CBD enthusiast, launching new
lines of CBD products for humans and pets.47 CBD is also quickly expanding into new categories
such as sleep (e.g., CBD-infused pillows, mattresses, and sheets) and sexual wellness products
(e.g., HerTime and HisTime CBD oils, CBD-infused lubricants).
The regulation of brain-enhancing foods and supplements is loose, and

the legality of plant-based drugs is evolving and unclear, creating both
opportunities and risks in the market.
• This industry segment sits in an extremely fragmented regulatory landscape. Across countries,
foods, beverages, supplements, and herbal remedies marketed for brain health and sleep are
regulated as a special category of food, and not as drugs. In the United States, for example,
dietary supplements are not required to demonstrate safety and effectiveness before they are
sold, contrary to what many consumers believe. A 2019 AARP survey found that the majority of
U.S. adults are concerned with the effectiveness, safety, purity, and thoroughness of government
review of vitamins and supplements, including those sold for brain health.48
• Plant-based drugs like cannabis and psilocybin also have a complicated regulatory landscape,
as the legality of these substances evolves rapidly around the world. Canada and Uruguay have
legalized recreational cannabis use, while Israel has decriminalized it. Other nations, such as Mexico,
the Netherlands, Australia, and Chile, are moving in the same direction.49 In the UK, cannabis is
illegal, while hemp-based CBD is legal as a food supplement.50 The United States has an extremely
confusing array of drug laws. While the U.S. Food and Drug Administration (FDA) has legalized
hemp-derived CBD (as long as it contains less than 0.3% THC), marijuana-derived CBD remains
a controlled substance, and each state has its own laws that govern the sale and recreational use
of cannabis.51 The FDA has recently sent warning letters to companies that market CBD as an
alternative to opioids or as a treatment for opioid addiction and other serious diseases.52 And,
while the FDA has not approved CBD-infused food and beverages or the sale of CBD products
as dietary supplements, these products continue to proliferate in the consumer market, and the
businesses that produce and sell them have been operating in a legal gray zone. Psilocybin is
another plant-based substance that is quickly gaining consumer interest for mental health and
mental wellness purposes, and it is already legalized in a few countries including the Netherlands,
Brazil, Jamaica, and Canada. Access to psilocybin is more limited in the United States; it has been
decriminalized in a handful of cities (e.g., Denver, Colorado and Oakland, California). Oregon is
taking steps toward allowing psilocybin mushrooms for medical purposes, while Washington, DC,
is working toward decriminalization of several psychedelic plants and fungi.53

• Legality issues aside, this fragmented landscape means that there is little regulation on quality,
manufacturing, labeling, safety, and product claims when it comes to products containing CBD,
psilocybin, and other plant-based drugs and supplements.54 Further complicating the picture, while
recreational use of cannabis is being relaxed in some countries, in other countries its possession and
sale can be a serious offense and in some cases is punishable by death (especially in certain Asian
and Middle East countries). For now, consumer demand for these products and experiences will
depend on the location and legality. For example, adventurous consumers may seek psychedelic
treatments in countries with more relaxed regulations, and some tourism destinations are marketing
themselves as such. Psilocybin treatment centers such as the Synthesis (The Netherlands) and
MycoMeditations and Atman (Jamaica) have already attracted many wellness travelers with this
special interest. Magic mushroom wellness retreats are being marketed in destinations such as
the Netherlands, Mexico, and Peru, while Europeans and Americans interested in ayahuasca have
been flocking to Latin American countries such as Costa Rica, Peru, Ecuador, Colombia, and Brazil
for special retreats or treatments.55 Cannabis vacations and retreats are offered in a variety of
destinations, from Uruguay to Canada to Alaska. Thailand is the first southeast Asian country to
legalize medical cannabis, creating a boom for medical cannabis tourism, while liberalization of
hemp and CBD is expected to fuel new wellness tourism offerings.56
Promising research on the medical use of plant-based drugs, along with

a gradual relaxation of regulations, will also increase their use for mental
wellness.
• Many countries make a distinction between the use of various plant-based and psychoactive
drugs for medical versus non-medical purposes, often allowing for specific medical uses but
criminalizing other uses. Currently, several Schedule I drugs – including psilocybin, MDMA,
ketamine, ibogaine, ayahuasca, peyote, and even LSD – have shown promise for treating a variety
of medical conditions, such as PTSD, addiction, depression, seizures, concussions, chronic pain,
and inflammation. The U.S. FDA has authorized CBD to treat epilepsy and has fast-tracked
psilocybin as a treatment for depression. Compass Pathways, a UK company, has already obtained
a U.S. patent for producing psilocybin to treat depression.57 MDMA and other psychedelics, as
well as cannabis, have shown promise for mental health treatments in Israeli government-funded
research, and several companies are exploring their use.58 Some of the leading and most innovative
cannabis and CBD companies operate in Canada, which has developed a clear legal system that
permits their medical and recreational use. In 2019, the Johns Hopkins Center for Psychedelic and
Consciousness Research was established to study medical applications for psychedelics – the
first such research center in the United States and the largest center of its kind in the world.59
Psychedelic-enhanced psychotherapy clinics for treating PTSD and other conditions have opened
in Israel, Canada, and the United States (e.g., Field Trip Health, SoundMind), while a number of
startups are conducting clinical trials on medicines made from a variety of psychoactive drugs
(e.g., MindMed, Champignon Brands, Compass Pathways)60 – although for now these companies
are focused exclusively on medical treatments and not recreational use. The findings from
these ongoing studies and research will influence the process and pace of medical treatment
applications; legalization; private and government investments; potential mental wellness products
and services; as well as consumer acceptance, demand, and future market growth.

Senses, Spaces, & Sleep $49.5b
market size

Services Products & Accessories Tech
• Sound therapy (sound baths, • Sound therapy instruments • Noise cancellation &
gong baths) (chimes, gongs, etc.) white noise devices
• Light therapy for mental • Light therapy consumer • Sound therapy gadgets
wellness devices (lamps, visors, light & apps
boxes) • Circadian lighting & apps
• Aromatherapy
• Aroma & scent products • Sleep trackers &
• Sleep therapy, counseling, &
monitors (wearable &
retreats (essential oils, home
non-wearable)
• Nap bars & cafés fragrances, mists, diffusers)
• Sleep sensory &
• Sensory retreats & experiences • Anti-stress & tactile gadgets
ambience gadgets
(forest bathing, hugging (stress balls, fidget spinners,
• Smart beds, mattresses,
therapy)* worry stones, desk toys)
& pillows
• Sensory-based wellness design • Sleep ambience & • Sleep & jet lag apps
& architecture (biophilic relaxation products (nap • Stress-reducing sensory
design, multi-sensory design, pods, weighted blankets, wearables
human-centric lighting)* specialized pillows, eye
masks, etc.)

Sleep Services & Napping Sleep Monitors & Trackers Sensory Tech & Wearables
• SleepScore Labs • Beddr • Kokoon

• Shleep • Dreem • Lumos
• Casper’s The Dreamery • Oura • Somnox
• Mr. Healing (Korea) • Beddit • Hatch
• MetroNaps • ZeeQ
• GoSleep Sleep & Sensory Apps • Eight Sleep
• Apollo
• Sleepio
Sensory Products & Services • Embr
• Sleep Cycle
• Xen
• Phillips • Pillow
• N.O.W. tone therapy
• Brilli • Slumber
• NeoRhythm
• Aromatherapy Associates • Pzizz
• NuCalm
• doTERRA • Timeshifter
• Young Living • Uplift
Sensory Spaces
• Revive • Somryst
• Bearaby • Endel • Terrapin Bright Green
• Gravity Blanket • Portal • Intl. Living Future
Institute

Senses and spaces have long been believed to improve mental and
physical well-being and to awaken spiritual consciousness.
• Indigenous cultures and spiritual traditions around the world have long used sound in healing
ceremonies: drumming, handclapping, singing, chanting, Tibetan singing bowls, Australian
didgeridoo, Peruvian whistling vessels, West African djembe, gongs, rainsticks, bells, and so on.
Ancient Egypt is considered the birthplace of aromatherapy and essential oils; they used fragrances
and perfumes in festivals and religious ceremonies, and used aromatic herbs for embalming. Since
ancient times, the Indian Ayurvedic system has incorporated herbs and aromatic plants as an
essential component. Light, color, and gemstones have been used in healing for thousands of
years, and light therapy was practiced in ancient Egyptian and Greek temples. The word “crystal”
is derived from the Greek word “krustallos,” because ancient Greeks believed that clear crystals
were eternal ice sent from the heavens. The Chinese used stress objects as early as the Han
Dynasty (202 BC-220 AD), when warriors would squeeze walnuts and balls carved from stone
and metal to stay focused during battle. Worry stones and beads have long been used in cultures
around the world, from Native American tribes, to Ireland, to Greece, to Tibet.
• Sensory-based healing was first explored by science in the 1600s-1800s, when European scientists
made a variety of new discoveries about the nature of light and color (e.g., refraction, polarization
of light, and infrared and ultraviolet radiation) – helping to bring light therapy into the modern
age. European and American sanatoria treated patients with sun baths (heliotherapy) in the late-
19th and early-20th centuries. Aromatherapy and essential oils were studied by European scientists
at the beginning of the 20th century and were used to treat soldiers during WWI and WWII.
Music therapy began in the United States in the 1940s, when it was used as a recovery treatment
for soldiers after WWII. But with the development of modern medicine in the 19th century, most
sensory-based healing modalities – especially for mental health and wellness purposes – largely
fell out of favor for many decades.
The modern wellness industry has played a leading role in reintroducing

many sensory healing modalities to consumers.
• Sensory healing had its resurgence in the 1970s, when the hippies and the New Age movement
brought a new wave of interest in alternative therapies, natural medicine, and ancient traditions
such as sound healing, energy healing, crystals, worry stones, essential oils, and aromatherapy.
However, even as the ability of scientists to study these practices has improved, most of them
(with the exception of light therapy) have remained on the fringes of the medical establishment.
In recent years, the modern wellness industry has played a key role in bringing sensory healing to
a wider, mainstream audience, mostly in the spa and hospitality setting, by offering experiences
such as sound baths, LED light treatments, aromatherapy and crystals in massage and spa
treatments, and reiki and energy healing treatments. Consumer interest in these therapies has
risen dramatically, coinciding with a growing body of research evidence on the mental and physical
health benefits of sound, light, aroma, energy, and touch.

Sleep looms large in senses and spaces.

• People all around the world are plagued by inadequate and poor sleep, and the search for better
sleep is driving a rapidly expanding market for sleep services and solutions. In the United States
alone, 50-70 million people complain of sleep deprivation or suffer from a sleep disorder61; in the
UK, it is estimated that one in three people suffer from insomnia.62 Stress and sleep are closely
related. In a 2019 study of more than 11,000 adults worldwide, 54% said that worry and stress affect
their sleep.63 In North America, consumers have been shifting away from relying on prescription
and over-the-counter medications toward softer, alternative, and more natural solutions like apps,
wearables, monitors, specialized bedding, and mattresses. The sleep market is also seeing strong
growth and a lot of innovations in the Asia Pacific region.64 Non drug-based sleep services and
solutions are growing in both the medical and wellness arenas. Medical sleep centers have gained
in popularity as consumers begin to regard poor sleep as a condition that needs to be addressed,
and as more people understand the connections between sleep and physical/mental health. In
the wellness arena, offerings include pay-to-nap services, sleep ambience and bedding products,
sleep apps, and tech-based gadgets; many of these offerings rely on external sensory stimuli
to promote relaxation and better sleep environments. There are even “sleep influencers” and
Instagram accounts that focus solely on sleep.65
• Pay-to-nap spaces are gaining interest in hectic urban centers around the world (e.g., London’s
Pop & Rest, Madrid’s Siesta & Go, Tokyo’s Nescafe Sleep Café, New York’s The Dreamery and
ReCOVER). South Korea is home to dozens of themed nap cafés that cater to stressed-out, sleep
deprived workers on their lunch breaks; some of the largest brands have 50+ outlets across the
country (e.g., Best Sleep Healing Café, Mr. Healing), while even movie theaters offer daytime
napping services.66 In 2017, a UK gym chain introduced a “napercize” group class that involves a
45 minute nap.67 Nap pods are being installed in workplaces, airports, and spas worldwide. In a
recent U.S. survey conducted by Mindbody, more than half of respondents said they are interested
in trying a nap facility.68
• Tech-based sleep solutions will continue to drive market growth. These include a wide array of
sleep tracking devices that use the latest sensing and monitoring technologies to assess and
improve the quality of sleep and track progress. The most popular wearable activity trackers (e.g.,
Apple watch, Fitbit, Garmin) have expanded from fitness tracking to sleep tracking, while many
dedicated sleep trackers have also entered the market, including headbands (Dreem 2, Philips
SmartSleep, Sleep Shepherd), rings (Oura, THIM), forehead sensors (Beddr SleepTuner), and
nonwearable mats, pillows, and monitors (Withings Sleep, Beddit, Beautyrest Sleeptracker, Circa
clock, iSense Sleep Smart Pillow). Many of these solutions combine hardware with sleep coaching
apps/programs that are sold as a subscription. Some tracking devices also incorporate sensory
stimuli like music and noise cancellation (Kokoon headphones) and light and circadian science
(Lumos and Neuroon eye masks) to promote relaxation and improve sleep quality. For consumers
who do not like wearables, new sleep coaching apps use a cell phone’s listening function and
accelerometer to track nightly breathing and movement and to create a detailed record and a
customized, routine adjustment plan for better sleep (Sleep Cycle, SleepScore, Pillow). Other sleep
coaching apps and online programs connect with users’ general activity trackers and wristbands
(Sleepio), or draw upon cognitive behavioral therapy techniques for insomnia (Somryst, CBT-i
Coach).

• Some tech-based sleep gadgets use multi-sensory stimuli – drawing on the latest technology in
neuroscience, haptics, sound, aroma, and light therapy – to create better sleep environments. For
example, Sleepace offers an aromatherapy light that emits red light, herbal scents, and soothing
sounds to raise melatonin levels and induce sleep, and the Somnox Sleep Robot tracks breathing
and uses sounds and vibrations to promote relaxation. Sensory stimuli are also being incorporated
into high-tech mattresses and pillows, often combined with sleep tracking. The Eight Sleep Pod
mattress uses cooling technology and sensors to regulate temperature and track sleep, while
smart pillows and pillow pads (ZeeQ, Moona, DreamPad) incorporate temperature control, sound,
and vibration technologies. A variety of sleep apps use psychoacoustic principles, white noise,
soundscapes, and even soothing bedtime stories to induce relaxation and create better sleep
routines (Pzizz, Noisli, Slumber, Sleepiest). Many in-person sleep and nap studios have incorporated
these sensory components (scents, sounds, special lighting) into environments that induce rest
and a calm awakening (e.g., MetroNaps pods, Casper’s The Dreamery nap bar).
• The reach of the sleep market extends far beyond high-tech sensors, trackers, and gadgets.
Every product that appears in a bedroom is now being redesigned and marketed around better
relaxation and sleep, including aromatherapy diffusers; sleep lights; white noise and sound
machines; weighted blankets; temperature regulating mattresses, pillows, and mattress pads; anti-
snoring pillows; cooling and weighted masks; light-blocking shades and curtains; and much more.
The science of light and circadian rhythms is driving a new market for
healthier and human-centric lighting solutions.
• Among the sensory healing modalities, light therapy has seen the most integration into modern
psychiatry and medicine, especially for treatment of depressive disorders, seasonal affective
disorder (SAD), sleep disorders, and various skin conditions. In recent years, there has been a
surge of interest in circadian science and how light exposure can affect our mood, our sleep, and
even how we metabolize food. Human-centric lighting is an emerging and fast-growing sector
focused on improving people’s well-being, mood, comfort, productivity, and health by adjusting
directions, color temperatures, and illuminance levels of light – it includes circadian lighting
products and systems like Philips Hue, Ketra, Brilli, and Lighting Science.69 The wellness real estate
and architecture field is also bringing greater attention on the importance of natural daylight
inside our homes, workplaces, and other indoor spaces.70 While the light therapy market overlaps
with medical and clinical applications, demand for portable and consumer-oriented light products
is on the rise, especially for boosting energy and addressing symptoms of SAD (e.g., light boxes,
floor and desk lamps, light visors, dawn simulators).
Stressed out consumers are looking for multi-sensory solutions to bring

calm and comfort.
• As noted above, sensory healing using sound, scent, light, color, and touch has been around since
ancient times, and these practices have been reintroduced to modern consumers by the spa
and wellness sector. The type of sensory healing that is most sought after by today’s consumers
reduces daily stress, worry, and anxiety, and their deep desperation has spurred a growing market
for calming and destressing products. Many of these solutions are simple and low-tech, including
scented candles, essential oil diffusers and mists, healing crystals, fidget spinners, stress balls,
putty and slime toys, mood music, etc. Lifestyle fads such as the Danish concept of hygge, or
KonMari decluttering principles, have heightened awareness of the mental wellness impact of
our daily living environments. Many consumers are now willing to spend hundreds of dollars on
products like weighted blankets and vagus nerve oils, which are marketed for their potential to
induce relaxation and regulate stress.

• Outside of our homes, there is growing interest in multi-sensory experiences and treatments
such as sound/gong baths, floatation tanks, salt caves, forest bathing, hugging therapy, scream
therapy, laughter yoga, and cuddle parties – these offerings are increasingly found in spas, resorts,
retreats, yoga and meditation studios, and other venues all around the world. And, technology
companies are incorporating these kinds of sensory stimuli into all types of meditation and sleep
gadgets and apps (as described elsewhere in this chapter), other consumer wearables aimed at
stress relief (e.g., TouchPoints, Doppel, and Apollo vibrating wristbands; Embr Wave temperature
control wristband), sound therapy tech gadgets (e.g., N.O.W. tone therapy system, Xen earbuds,
Plantwave), and even wellness music channels and generative music apps (e.g., Endel).71
Senses, spaces, and sleep offerings are increasingly integrated with

wellness travel and workplaces.
• Hospitality businesses, especially spas and wellness resorts, were early adopters in recognizing
the importance of senses, spaces, and sleep to our mental wellness. In particular, the hospitality
sector has embraced mental wellness and sleep in the design of spaces and physical environments.
For example, many hotel brands tout their calming and sleep-friendly rooms and amenities,
including sound-proofed windows, light-blocking curtains, special pillows and beds, circadian
lighting systems, meditation programming on demand, and biophilic design. With so many sleep-
deprived people, sleep vacations are on the rise worldwide. Some hotels and resorts offer sleep
programs and retreats that include sleep tracking, sleep consultations, and various sleep-focused
sensory modalities (e.g., Six Senses, Hyatt, Canyon Ranch, Enchantment Resort, Swiss Hotels,
Kamalaya). Between jet lag, stress, and changes in routines and time zones, sleep has always been
in peril during travel. Sleep-enabling travel products and services have expanded from specialized
travel pillows, eye shades, and noise cancelling headphones, to airport sleeping pods, to apps that
address jet lag (such as Timeshifter, Entrain, and Uplift).
• Workplaces and co-working facilities have also been evolving toward multi-sensory and spatial
features that enhance mental wellness: natural light, biophilic design, fresh air, pro-social design,
meditation rooms, sleeping pods, etc. Many of these investments are made with the aim of
financial returns in the form of higher employee productivity. Some employers are turning to sleep
products and services as part of their employee wellness offerings. In fact, many sleep companies
(e.g., SleepScore Labs, Shleep, Beddr, Dreem, GoSleep) are working with corporate clients to
help employees get better sleep through apps, assessments, and customized sleep programs.72 In
Japan, many companies are starting to encourage workers to take nap breaks at work, supported
by health ministry recommendations emphasizing the importance of sleep and taking a 30-minute
nap every afternoon, as well as the cultural concept of inemuri (“sleeping while present”).73

Endnotes
1
International Coaching Federation (2020). 2020 ICF Global Coaching Study – Executive Summary.
https://coachfederation.org/app/uploads/2020/09/FINAL_ICF_GCS2020_ExecutiveSummary.pdf.
2
Blum, B. (2020, Jan. 29). When Did Self-Help Books Become Literary? The Literary Hub. https://lithub.
com/when-did-self-help-books-become-literary/.
3
Booth, H. (2017). How Self-Help Is Getting a Millennial Makeover. Stylist. https://www.stylist.co.uk/
books/best-self-help-books-anxiety-wellness-depression/130168.
4
Vigo, J. (2019, Feb. 19). Self-Help in the Age of New Technology. Forbes. https://www.forbes.com/sites/
julianvigo/2019/02/19/self-help-in-the-age-of-new-technology/#45899e764ed1.
5
See: https://www.apple.com/newsroom/2018/12/apple-presents-the-best-of-2018/.
6
See: 1) Friedman, U. (2018, Oct.) South Koreans Love Their ‘Stress Cafés.” The Atlantic. https://www.
theatlantic.com/magazine/archive/2018/10/stress-cafes/568297/. 2) Green, P. (2017, Aug. 9). Anger
Rooms Are All the Rage. Timidly, We Gave One a Whack. New York Times. https://www.nytimes.
com/2017/08/09/style/anger-rooms-the-wrecking-club.html. 3) Marikar, S. (2017, Feb. 20). Taryn Toomey
Will Make You Scream. The New Yorker. https://www.newyorker.com/magazine/2017/02/27/taryn-
toomey-will-make-you-scream.
7
See: https://lookslikeyouneediceland.com/.
8
See: Anderson, J. (2019, April 16). The world’s happiest people have a beautifully simple way to tackle
loneliness. Quartz. https://qz.com/1591563/the-danish-have-designed-a-simple-way-to-cope-with-
loneliness/.
9
See: 1) Abbit, L. (2017, Oct. 30). The Village Model: A Neighborly Way to Age in Place. Senior Planet.
https://seniorplanet.org/the-village-model-a-neighborly-way-to-age-in-place/. 2) Village to Village
Network, https://www.vtvnetwork.org/.
10
See: 1) Batuman, E. (2018, April 23). Japan’s Rent-A-Family Industry. The New Yorker. https://www.
newyorker.com/magazine/2018/04/30/japans-rent-a-family-industry. 2) Morin, R. (2017, Nov. 7). How to
Hire Fake Friends and Family. The Atlantic. https://www.theatlantic.com/family/archive/2017/11/paying-
for-fake-friends-and-family/545060/.
11
See: 1) https://laughteryoga.org/. 2) Welsh, J. (2011, Sept. 14). Why Laughter May Be the Best Pain
Medicine. Scientific American. https://www.scientificamerican.com/article/why-laughter-may-be-
the-best-pain-medicine/. 3) Manninen, S., et al (2017, June 21). Social Laughter Triggers Endogenous
Opioid Release in Humans. Journal of Neuroscience, 37(25), 6125-6131. https://doi.org/10.1523/
JNEUROSCI.0688-16.2017.
12
See: Canales, K. (2020, Jan. 19). I cuddled with strangers at a San Francisco cuddle party alongside
other members of the city’s intimacy-starved workforce. No, it wasn’t that weird. Business Insider.
https://www.businessinsider.com/san-francisco-cuddle-party-organized-intimacy-2020-1.
13
See: Samuel, S. (2020, Sept. 9). You can get a robot to keep your lonely grandparents company.
Should you? Vox. https://www.vox.com/future-perfect/2020/9/9/21418390/robots-pandemic-loneliness-
isolation-elderly-seniors.

14
See, for example: 1) Alford, H. (2017, March 11). I’m Not O.K. Neither Are You. Who Cares? New York
Times. https://www.nytimes.com/2017/03/11/style/anti-self-help-books.html. 2) Sinclair, M. (2019, Feb.
24). Why the Self-Help Industry Is Dominating the U.S. Medium. https://medium.com/s/story/no-please-
help-yourself-981058f3b7cf.
15
See: 1) Weiss, S. (2019, Oct. 6). Brain training apps don’t really work. So why do we love them? Wired.
https://www.wired.co.uk/article/nintendo-brain-training-switch. 2) Toy, S. (2019, Aug. 16). People spent
$1.9 billion last year on apps to keep their brains sharp as they age — here’s what actually works. Market
Watch. https://www.marketwatch.com/story/older-americans-spent-19-billion-last-year-on-apps-to-keep-
their-brains-sharp-heres-what-actually-works-2019-05-24.
16
See, for example: 1) Grothaus, M. (2017, Aug. 21). This Is the Only Type of Brain Training That Works,
According to Science. Fast Company. https://www.fastcompany.com/40451692/this-is-the-only-
type-of-brain-training-that-works-according-to-science. 2) Dresler, M., et al (2019). Hacking the Brain:
Dimensions of Cognitive Enhancement. ACS Chemical Neuroscience, 10(3), 1137-1148. https://doi.
org/10.1021/acschemneuro.8b00571.
See: https://www.ftc.gov/news-events/press-releases/2016/01/lumosity-pay-2-million-settle-ftc-
17
deceptive-advertising-charges.
18
Whitby, M. (2019, Oct. 23). New York’s Blum Center offers brain optimization programme. Health
Club Management. https://www.healthclubmanagement.co.uk/health-club-management-news/New-
York%E2%80%99s-Blum-Center-offers-brain-optimisation-programme-/343423.
19
See: 1) Kremer, W. (2013, Nov. 21). Does doing yoga make you a Hindu? BBC. https://www.bbc.com/
news/magazine-25006926. 2) Ramstedt, M. (2011). A Fatwa against Yoga: Mitigating Conflict in the Face
of Increasing Fundamentalism in Indonesia. Interreligious Dialogue. https://irstudies.org/index.php/jirs/
article/view/65/81. 3) Nir, S.M. (2012, April 8). Seeking to Clear a Path Between Yoga and Islam. New York
Times. https://www.nytimes.com/2012/04/09/nyregion/in-queens-seeking-to-clear-a-path-between-
yoga-and-islam.html. 4) Anand, S. (2015, June 9). Is Yoga Religious? In India, It’s a Vexed Question. Wall
Street Journal. https://blogs.wsj.com/indiarealtime/2015/06/09/is-yoga-religious-in-india-its-a-vexed-
question/. 5) Vitello, P. (2010, Nov. 27). Hindu Group Stirs a Debate Over Yoga’s Soul. New York Times.
https://www.nytimes.com/2010/11/28/nyregion/28yoga.html.
20
See: 1) Purser, R., and Loy, D. (2013, Aug. 31). Beyond McMindfulness. Huffington Post. https://www.
huffpost.com/entry/beyond-mcmindfulness_b_3519289. 2) Safran, J.D. (2014, June 13). McMindfulness:
The Marketing of Well-Being. Psychology Today. https://www.psychologytoday.com/us/blog/straight-
talk/201406/mcmindfulness.
Mindworks (n.d.). How Many People Meditate? https://mindworks.org/blog/how-many-people-

21
meditate/.
22
Clarke, T.C., et al (2018, Nov.). Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18
and over. National Center for Health Statistics Data Brief, No. 325. Washington, DC: Centers for Disease
Control and Prevention. https://www.cdc.gov/nchs/data/databriefs/db325-h.pdf.
23
Black, L.I., et al (2018, Nov.). Use of Yoga, Meditation, and Chiropractors Among U.S. Children Aged
4-17 Years. National Center for Health Statistics Data Brief, No. 324. Washington, DC: Centers for Disease
24
Bupa (2019, Jan. 29). Meditation is Brits’ most popular wellbeing therapy. https://www.bupa.com/
newsroom/news/meditation-brits-favourite-wellbeing-therapy.

25
Cramer, H. (2016, Nov.). Prevalence, patterns, and predictors of meditation use among US adults: A
nationally representative survey. Scientific Reports, 6, 36760. https://doi.org/10.1038/srep36760.
26
See, for example: 1) National Center for Complementary and Integrative Health (n.d.). Meditation: In
Depth. https://www.nccih.nih.gov/health/meditation-in-depth. 2) Powell, A. (2018, April 9). When science
meets mindfulness. The Harvard Gazette. https://news.harvard.edu/gazette/story/2018/04/harvard-
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(2013, Apr. 26). Meditation, Mindfulness Exercises Reduce PTSD Symptoms. Medscape. https://www.
medscape.com/viewarticle/803175.
27
See, for example: 1) Harvard Health Publishing, Harvard Medical School (2014, March). Meditation
in psychotherapy. https://www.health.harvard.edu/newsletter_article/Meditation_in_psychotherapy.
2) Hofmann, S.G., and Gómez, A.F. (2017, Dec.). Mindfulness-Based Interventions for Anxiety
and Depression. Psychiatric Clinics of North America, 40(4), 739-749. https://doi.org/10.1016/j.
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28
Sensor Tower (2020, Jan. 31). Mobile Users Spent $195 million in Meditation Apps Last Year, up 52%
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See, for example: 1) Tlalka, S. (2016, Aug. 24). The Trouble with Mindfulness Apps. Greater Good
Magazine. https://greatergood.berkeley.edu/article/item/the_trouble_with_mindfulness_apps. 2)
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Meditation apps might calm you – but miss the point of Buddhist mindfulness. The Conversation.
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https://observer.com/2019/11/jetblue-inscape-partnership-flight-meditation-mindfulness-app-streaming-
content/.
31
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32
VanRy, N. (2019, Nov. 6). What Happened to Adult Coloring Books? Charting the Boom and Bust. Book
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33
See: 1) Phelan, H. (2018, Oct. 25). What’s All This About Journaling? New York Times. https://www.
nytimes.com/2018/10/25/style/journaling-benefits.html. 2) NPD Group (2018, June 26). Bullet Journaling
Trend Lifts Sales of Notebooks and Writing Instruments, Reports NPD. https://www.npd.com/wps/
portal/npd/us/news/press-releases/2018/bullet-journaling-trend-lifts-sales-of-notebooks-and-writing-
instruments-reports-npd/.
34
MENA Catalyst Foundation (2019, Oct. 10). Tawazon – In Conversation with Founder Suna Zoabi-
Othman. https://www.menacatalyst.ps/startups/4662.html.

35
For more examples of foods and beverages marketed for brain health, see: 1) Hermann, M. (2020).
Functional Foods & Cognitive Health. Today’s Dietitian, 22(6), p. 40. https://www.todaysdietitian.com/
newarchives/JJ20p40.shtml. 2) McHugh, H. (2019, Aug. 21). Consumers have cognitive health on the
mind. Natural Products Insider. https://www.naturalproductsinsider.com/beverages/consumers-have-
cognitive-health-mind.
36
AARP (2019). 2019 AARP Brain Health and Dietary Supplements Survey. https://doi.org/10.26419/
res.00318.001.
37
Euromonitor International (2019, Nov.). Nootropics: Brain health across food, beverages, and consumer
health. https://www.euromonitor.com/nootropics-brain-health-across-food-beverages-and-consumer-
health/report.
38
See: 1) Brody, B. (2019). What Are Nootropics? WebMD. https://www.webmd.com/vitamins-and-
supplements/features/nootropics-smart-drugs-overview. 2) Nootropics. Psychology Today. https://www.
psychologytoday.com/us/basics/nootropics.
39
Global Council on Brain Health (2019). The Real Deal on Brain Health Supplements: GCBH
Recommendations on Vitamins, Minerals, and Other Dietary Supplements. https://www.aarp.org/
content/dam/aarp/health/brain_health/2019/06/gcbh-supplements-report-english.doi.10.26419-
2Fpia.00094.001.pdf.
40
See, for example: 1) Global Council on Brain Health (n.d.). Nutrition and Brain Health. https://www.aarp.
org/health/brain-health/global-council-on-brain-health/nutrition.html. 2) Harvard Health Publishing,
Harvard Medical School (2019, Sept.). Don’t buy into brain health supplements. https://www.health.
harvard.edu/mind-and-mood/dont-buy-into-brain-health-supplements. 3) Mayo Clinic (2019, July 31).
Nutrition and healthy eating: Improve brain health with the MIND diet. https://www.mayoclinic.org/
healthy-lifestyle/nutrition-and-healthy-eating/in-depth/improve-brain-health-with-the-mind-diet/art-
20454746.
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41
cbd/cbd-goes-mainstream/.
42
Gibbs, B., et al (2019, June). CBD in the UK. Centre for Medicinal Cannabis. https://hempindustrydaily.
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Euromonitor International (2019, March). The Cannabis Index: Where and How Legalisation Will Move
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44
Upshall, E. (2020, Feb. 26). Mintel reveals edibles are leading Canada’s legal cannabis market.
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market/.
45
Upshall, E. (2020, Feb. 26).
46
Gill, L.L. (2019, April 11).
47
Marikar, S. (2020, Sept. 20). Martha Stewart, Blissed Out on CBD, Is Doing Just Fine. New York Times.
https://www.nytimes.com/2020/09/17/style/martha-stewart-at-home.html.
48
AARP (2019).

49
Euromonitor International (2019, March).
What is CBD oil and is it legal in the UK? The Week. Oct. 17, 2019. https://www.theweek.co.uk/99068/
50
what-is-cbd-oil.
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See: 1) U.S. Food & Drug Administration (2020, Oct. 1). FDA Regulation of Cannabis and Cannabis-
Derived Products, Including Cannabidiol (CBD). https://www.fda.gov/news-events/public-health-focus/
fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd. 2) Akpan, N., and
Leventhal, J. (2019, July 12). Is CBD legal? Here’s what you need to know according to science. PBS News
Hour. https://www.pbs.org/newshour/science/is-cbd-legal-heres-what-you-need-to-know-according-to-
science. 3) BDS Analytics and Arcview Market Research (2020). The State of Legal Cannabis Markets:
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update-executive-summary/.
52
See: https://www.fda.gov/news-events/press-announcements/fda-warns-companies-illegally-selling-
cbd-products-treat-medical-conditions-opioid-addiction/
53
See: Lopez, G. (2020, Oct. 20). 2020’s psychedelic drug ballot measures, explained. Vox. https://www.
vox.com/future-perfect/21509465/psychedelic-magic-mushrooms-psilocybin-medical-legalization-
decriminalization-oregon-washington-dc.
54
See, for example: 1) Jaeger, K. (2020, July 9). FDA Updates Congress on CBD Product Labelling
Accuracy. Marijuana Moment. https://www.marijuanamoment.net/fda-updates-congress-on-cbd-product-
labelling-accuracy/. 2) Mull, A. (2020, Jan. 1). America Loves Its Unregulated Wellness Chemicals. The
Atlantic. https://www.theatlantic.com/health/archive/2020/01/why-cbd-took-over-america/604327/.
55
See, for example: 1) Nouril, P. (2020, Jan. 6). Trip of a Lifetime? The Rise of Magic Mushroom Wellness
Retreats. Vice. https://amuse.vice.com/en_us/article/a3myv8/magic-mushroom-retreats. 2) Magner,
E. (2018, March 22). Are Mind-Altering Magic Mushroom Retreats the Future of Wellness Travel?
Well+Good. https://www.wellandgood.com/magic-mushroom-retreats-wellness-travel-trend/.
56
Ng, Y. (2020, March 4). Relaxed Rules on Medicinal Marijuana Could Create a Buzz for Thailand
Tourism. Skift. https://skift.com/2020/03/04/relaxed-rules-on-medicinal-marijuana-could-create-a-buzz-
for-thailand-tourism/.
57
Bromwich, J.E. (2020, Feb. 28). The Capital That Ate Wellness Is Going to Eat Your Mushrooms. New
York Times. https://www.nytimes.com/2020/02/28/style/venture-capital-psychedelics.html.
58
See: 1) Cannabis and psychedelics: Gatherings to accelerate plant-based medicine. Health Europa.
Feb. 21, 2020. https://www.healtheuropa.eu/cannabis-and-psychedelics-gatherings-to-accelerate-plant-
based-medicine/97962/. 2) Israel Is At the Forefront of Medical Cannabis Research. Cibdol. March 9,
2020. https://www.cibdol.com/blog/692-israel-is-at-the-forefront-of-medical-cannabis-research.
59
Jones, H. (2019, Sept. 4). Johns Hopkins launches center for psychedelic research. Hub. https://hub.jhu.
edu/2019/09/04/hopkins-launches-psychedelic-center/.
60
See, for example: 1) Gunther, M. (2020, April 28). Psychedelics Inc. Medium. https://medium.
com/the-psychedelic-renaissance/psychedelics-inc-e0dc9d62dfe. 2) 7 Psychedelic Therapy
Companies Addressing Mental Health. Nanalyze. March 2020. https://www.nanalyze.com/2020/03/
psychedelic-therapy-companies-mental-health/. 3) Yakowicz, W. (2020, Oct. 7). Field Trip
Health, Another Psychedelic Therapy Company, Goes Public. Forbes. https://www.forbes.com/
sites/willyakowicz/2020/10/07/psychedelic-therapy-company-field-trip-health-goes-public-
to-revolutionize-mental-health-treatments/#2f3d64d079a5. 4) Yakowicz, W. (2020, Sept. 25).

Psychedelic Drug Company MindMed Applies for Nasdaq Up-Listing. Forbes. https://www.forbes.
com/sites/willyakowicz/2020/09/25/psychedelic-drug-company-mindmed-applies-for-nasdaq-up-
listing/#799db5da6cf7.
Colten, H.R., and Altevogt, B.M. (Eds.) (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public
61
Health Problem. Washington, DC: National Academicies Press. https://doi.org/10.17226/11617.
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health/insomnia.
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63
master/experience/smartsleep/world-sleep-day/2019/2019-philips-world-sleep-day-survey-results.pdf.
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See: 1) Roy, S. (2020, June 23). Sleep Market Innovators Are Investing in “Soft” Sleep Solutions,
According to a New Industry Report. Sleep Review. https://www.sleepreviewmag.com/sleep-health/
prevailing-attitudes/future-of-sleep/sleep-market-innovators-invest-soft-sleep-solutions/. 2)
Euromonitor (2017, July). Global Trends in Sleep Aids and Stress Management. https://www.euromonitor.
com/global-trends-in-sleep-aids-and-stress-management/report.
65
See: McKinney, K. (2020, Aug. 6). Why We Buy Into the Big Business of Sleep. Time. https://time.
com/5876810/sleep-products-and-treatments/.
66
See: 1) Steger, I., and Jung, S.K. (2017, Sept. 27). Time-stretched Koreans are turning to “fast healing”
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rise-of-nap-pods-reflects-koreans-attempt-at-self-care-and-wellness/. 2) Jin-hai, P. (2017, June 26).
Nap cafes flourish in sleep-deprived Korea. The Korea Times. https://www.koreatimes.co.kr/www/news/
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Appendix A: Understanding Key
Terminologies – Mental Illness, Mental
Health, Mental Well-being, and Happiness
One reason it is challenging to understand the concept of mental wellness is because the terminologies
used to talk about it are poorly defined and used inconsistently. Most people know what mental illness is.
But there is little to no understanding or agreement on the differences between mental wellness, mental
health, mental well-being, and happiness.
Mental Illness: According to the American Psychiatric Association (APA), mental illnesses are diagnosable
mental disorders or health conditions that involve “significant changes in thinking, emotion, and/or
behavior,” and that are “associated with distress and/or problems functioning in social, work, or family
activities.”1 The APA’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) contains
the diagnostic criteria and symptom checklists used to define, classify, and identify mental illnesses (e.g.,
depression, anxiety, personality disorders). Note that cognitive decline and dementia are considered to
be neurological or neurocognitive disorders, but not mental illnesses or psychiatric disorders (although
this distinction has become controversial in recent years).2 Mental illness is associated with a pathogenic
approach to health: understanding, diagnosing, and treating disease, and focusing on acute and chronic
conditions and their risk factors.3
Mental Health: “Mental health” has become an extremely problematic term.

• Traditionally, psychologists, psychiatrists, and academics/researchers in these fields have used the
term mental health to mean a holistic and positive approach to mental well-being (completely separate
from mental illness). This usage is associated with the salutogenic approach of preventing illness,
maintaining good mental health, and pursuing optimal mental well-being. Three important definitions
of mental health are listed below; these definitions talk about mental health as a positive state that is
separate from mental illness. This usage of mental health is the same as what we call mental wellness
in this report.
• World Health Organization: “Mental health is a state of well-being in which an individual
realizes his or her own abilities, can cope with the normal stresses of life, can work productively
and is able to make a contribution to his or her community. Mental health is fundamental to
our collective and individual ability as humans to think, emote, interact with each other, earn a
living and enjoy life. On this basis, the promotion, protection and restoration of mental health
can be regarded as a vital concern of individuals, communities and societies throughout the
world.”4
• U.S. Surgeon General: “Mental health” is “the successful performance of mental function,
resulting in productive activities, fulfilling relationships with other people, and the ability to
adapt to change and to cope with adversity; from early childhood until late life, mental health
is the springboard of thinking and communication skills, learning, emotional growth, resilience,
and self-esteem.”5
• Corey Keyes: Keyes says that “mental health can be operationalized and measured in terms of
the presence and absence of positive feelings towards one’s life and the presence and absence
of positive functioning in various facets of functioning in life.”6 Keyes says that mental health
and mental illness are two entirely separate (but correlated) dimensions, and he presents them
on his dual-continuum model (as discussed in Chapter II).

• However, people in the United States and English-speaking world (i.e., consumers, media, businesses,
and others outside of academia) now use the term mental health as a euphemism for mental illness
(e.g., “mental health issues,” “mental health disorders,” “poor mental health”) – mainly in an attempt
to avoid stigmatizing mental illness by using terms that feel negative, like “illness” or “disorder.”
Similarly, the term “mental health professionals” refers to psychotherapists, psychologists, clinicians,
and counseling professionals; one would never call a meditation teacher or life coach a “mental health
professional.”
Given the contradictory usages of the term mental health, we advocate for use of the term mental
wellness to refer to the positive, salutogenic approach to mental well-being that is separate from mental
illness (as elaborated in Chapter II of this report). In adapting Corey Keyes’ dual-continuum model, we
have renamed the vertical “mental health axis” as the “mental wellness axis” in order to clarify the
terminology and reinforce this distinction.
Mental Well-being: There is no universally understood definition for the term well-being, but it is generally
used in a positive and holistic sense to encompass both good physical health and good mental health.
When people use the term mental well-being they are generally referring to the salutogenic concept
described above in the WHO, U.S. Surgeon General, and Corey Keyes definitions.7 According to Keyes,
mental well-being or positive mental health is measured by looking at a combination of several types of
well-being: emotional/subjective well-being, psychological well-being, and social well-being (see Appendix
B for a more detailed explanation). In our interpretation, mental well-being is generally synonymous with
mental wellness.
Happiness: There are many definitions of happiness; most refer to having positive emotions and a sense
of satisfaction with one’s life.8 In psychology, happiness is associated with the concept of “subjective well-
being,” which involves three components according to Ed Diener’s well-known model: frequent positive
affect/emotions, infrequent negative affect/emotions, and life satisfaction.9 Corey Keyes elaborates
13 factors that can be used to measure mental wellness; among those, only two factors are related to
happiness or subjective/emotional well-being (see Appendix B for a more detailed explanation). Therefore,
happiness is a component of mental wellness, but mental wellness is broader than happiness.

Endnotes
1
American Psychiatric Association (2018). What Is Mental Illness? https://www.psychiatry.org/patients-
families/what-is-mental-illness.
2
See, for example: 1) Rettew, D. (2015, Dec. 2). Psychiatric vs. Neurological: Can the Brain Tell?
Psychology Today. https://www.psychologytoday.com/us/blog/abcs-child-psychiatry/201512/psychiatric-
vs-neurological-can-the-brain-tell. 2) Fitzgerald, M. (2015, June). Do psychiatry and neurology need a
close partnership or a merger? BJPsych Bulletin, 39(3), 105-107. https://doi.org/10.1192/pb.bp.113.046227.
3) Regan, M. (2016). The interface between dementia and mental health: An evidence review. London:
Mental Health Foundation. https://www.mentalhealth.org.uk/sites/default/files/Dementia%20paper.pdf.
3
For more information on pathogenesis vs salutogenesis, see: 1) Bhattacharya, S., et al (2020, Jan.).
Salutogenesis: A bona fide guide towards health preservation. Journal of Family Medicine and Primary
Care, 9(1), 16-19. https://doi.org/10.4103/jfmpc.jfmpc_260_19. 2) Mittelmark, M.B., et al (Eds.) (2017).
The Handbook of Salutogenesis. Cham, Switzerland: Springer. https://doi.org/10.1007/978-3-319-04600-
6. 3) Fries, C.J. (2020). Healing Health Care: From Sick Care Towards Salutogenic Healing Systems.
Social Theory & Health, 18(1), 16-32. https://doi.org/10.1057/s41285-019-00103-2. 4) Jonas, W.B., et al
(2014). Salutogenesis: The Defining Concept for a New Healthcare System. Global Advances in Health &
Medicine, 3(3), 82-91. https://doi.org/10.7453/gahmj.2014.005.
4
World Health Organization (2018, March 30). Mental health: Strengthening our response. WHO Fact
Sheet. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response.
5
Satcher, D.S. (1999). Mental Health: A Report of the Surgeon General – Executive Summary. https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC1308561/pdf/pubhealthrep00023-0091.pdf.
6
Keyes, C.L.M. (2014).
7
See, for example: 1) U.S. Centers for Disease Control and Prevention (2018, Oct. 31). Well-Being
Concepts. https://www.cdc.gov/hrqol/wellbeing.htm. 2) World Health Organization, Regional Office for
South-East Asia (n.d.). Promotion of mental well-being. http://origin.searo.who.int/entity/mental_health/
promotion-of-mental-well-being/en/. 3) Davis, T. (2019, Jan. 2). What Is Well-Being? Definition, Types,
and Well-Being Skills. Psychology Today. https://www.psychologytoday.com/us/blog/click-here-
happiness/201901/what-is-well-being-definition-types-and-well-being-skills.
8
See, for example: Whitbourne, S.K. (2014, May 3). How Should Psychology Define Happiness?
Psychology Today. https://www.psychologytoday.com/us/blog/fulfillment-any-age/201405/how-should-
psychology-define-happiness.
9
See: Diener, E., et al (2009). Subjective Well-Being: The Science of Happiness and Life Satisfaction. In
S.J. Lopez and C.R. Snyder (Eds.), Oxford Handbook of Positive Psychology, 2nd edition (pp. 187-194).
New York: Oxford University Press. https://doi.org/10.1093/oxfordhb/9780195187243.013.0017.

Appendix B: Measuring Individuals’
Mental Wellness
Mental health professionals diagnose mental illness by looking for clusters of symptoms, behaviors, and
feelings that correspond with mental disorders catalogued in the Diagnostic and Statistical Manual of
Mental Disorders, 5th edition (DSM-5). According to Corey Keyes, our mental wellness can be evaluated
similarly, by looking for clusters of symptoms that correspond with positive feelings (subjective well-
being), positive functioning (psychological well-being), and positive relationships (social well-being). As
shown in Figure 9, Keyes identifies 13 symptoms or outward signs of mental wellness that can be measured
and used to “diagnose” whether an individual is languishing or flourishing, drawing upon the work of
other notable psychologists in this field (e.g., Ryff’s 6-factor model of psychological well-being,1 Diener’s
tripartite model of subjective well-being,2 etc.).3
In recent years, measures of “happiness” have received significant attention in public policy circles and in
popular media, most notably from the annual United Nations World Happiness Report.4 Measurements of
happiness (including in the UN report) typically focus on emotional or subjective well-being – specifically,
positive affect (being cheerful, interested in life, in good spirits, happy, full of life) and life evaluation (being
satisfied with life overall or domains in life). These measurements focus narrowly on hedonic well-being,
or having positive emotions towards one’s life. As shown below, Keyes’ proposed measures of mental
wellness are much broader than just happiness, because they also incorporate eudaimonic well-being, or
positive psychological and social functioning in life.
Figure 9
Keyes’ 13 Factors for Measuring Mental Wellness5
Hedonic Eudaimonic
Emotional/subjective Psychological Social well-being
well-being well-being
• Social acceptance
• Positive affect • Self-acceptance
• Social actualization
• Personal growth
• Avowed quality of • Social contribution
life (life satisfaction/ • Purpose in life
• Social coherence
evaluation) • Environmental mastery
• Social integration
• Autonomy
• Positive relations with
others

Endnotes
1
Ryff, C.D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-
being. Journal of Personality and Social Psychology, 57(6), 1969-1081. https://doi.org/10.1037/0022-
3514.57.6.1069.
2
Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95(3), 542-575. https://doi.
org/10.1037/0033-2909.95.3.542.
3
See: 1) Keyes, C.L.M. (2002). 2) Keyes, C.L.M. (2005). 3) Keyes, C.L.M. (2007). Promoting and protecting
mental health as flourishing: A complementary strategy for improving national mental health. American
Psychologist, 62(2), 95-108. https://doi.org/10.1037/0003-066X.62.2.95.
4
See: https://worldhappiness.report/.
5
See: 1) Keyes, C.L.M. (2002). 2) Keyes, C.L.M. (2005). 3) Keyes, C.L.M. (2007).

Appendix C: History of Modern Mental
Wellness Practices
Meditation is an ancient spiritual tradition with roots in all major religions.
Meditation has always been a spiritual practice, with ancient roots in all of the world’s major religions. While
it is most often associated with Buddhism, the first written records of meditation appeared around 1500
BC in the Vedas (sacred texts of Hinduism). Between 600-400 BC, Chinese Taoists and Indian Buddhists
developed their own styles of meditation. Over the next millennium, Buddhism spread along the Silk
Road throughout Asia, and meditative practices developed different forms as they adapted to different
cultures across the continent – such as the spread of Zen Buddhism and Zazen (seated meditation) in
Japan between 600-1300 AD. But meditation is not just an Asian tradition. In Judaism, the Torah describes
an ancient meditative practice of “lasauch” in a field, and the Hebrew Bible contains many indications of
Jewish meditation. During the Middle Ages, meditative practices developed among Jewish philosophers,
mystics, and Kabbalists, while Sufism (Islamic mysticism) incorporated meditative techniques like breath
control and repeating of mantras. During this era, Christianity also developed its own meditative practices
of prayer, scripture reading, and contemplation, such as the “hesychasm” in the Eastern Orthodox mystical
tradition and “Lectio Divina” in the Western Christian monastic tradition.
Eastern religion and meditation first reached the West during the 1700s-1800s AD, with advances in
communications and transportation, along with the translation of major Eastern texts into European
languages (e.g., Bhagavad Gita, Buddhist Sutras, Upanishads). It remained the domain of intellectuals
and philosophers (e.g., Voltaire, Shopenhauer, Transcendentalists like Thoreau and Emerson) until the
20th century, when Eastern spiritual masters and gurus (e.g., Swami Vivekananda in the late-19th century;
Paramahansa Yogananda in the 1920s; Swami Rama, Thich Nhat Hanh, and Maharishi Mahesh Yogi in the
1960s-1970s; Sri Sri Ravi Shankar in the 1980s) traveled and migrated to the United States and Europe to
give lectures and courses, and to establish communities of followers (e.g., Vivekananda’s Vedanta Societies,
Rama’s Himalayan Institute, Amrit Desai’s Kripalu Institute, Shankar’s Art of Living). In the 1960s-1970s,
Maharishi Mahesh Yogi brought his discipline of secular Transcendental Meditation (TM) to the West.
Maharishi became the “guru to the stars.” He taught celebrities like The Beatles and the Beach Boys to
meditate, and he made the word “mantra” a household word – sparking Life Magazine to call 1968 the
“year of the guru,” while Time featured TM as “a drugless high” in 1975.
The hippies, New Age, and counterculture movements embraced Eastern religions and practices, and
these practices spread via television and media. For example, in the 1960s and 1970s, millions of Americans
were introduced to yoga and meditation via the television, with pioneering programs such as Richard
Hittleman’s “Yoga for Health” and “Yoga and Meditation.” As Eastern spirituality put down roots in the West
into the 1980s and 1990s, many high-profile celebrities and athletes embraced and promoted meditation
(e.g., Michael Jackson, Madonna, Demi Moore, Donna Karen, Shirley MacLaine, Joe Namath, Phil Jackson,
Deepak Chopra, Oprah). Meditation shed its hippie associations and became increasingly hip, secularized,
and accessible to a mainstream audience.
In 1979, Jon Kabat-Zinn founded the Mindfulness-Based Stress Reduction Clinic at the University of
Massachusetts Medical Center, bringing Buddhist meditation into medicine and Western science;
secularizing it; and connecting it with self-improvement, personal growth, recovery, relaxation, and stress
reduction. Kabat-Zinn, along with the many meditation centers and ashrams that popped across the United
States in the 1960s-1970s, laid the groundwork for proliferation of a secular meditation and mindfulness
movement in the West, as well as the application of these techniques in medicine and psychotherapy

(e.g., mindfulness-based cognitive therapy, mindfulness-based pain management). Science, medicine, and
research started paying more attention to the practice, and it was increasingly promoted as scientific and
health-enhancing. The first physiological studies of meditation took place in the 1950s-1960s, and the first
clinical studies followed in the 1970s. Great strides have been made in recent decades in demonstrating
meditation and mindfulness’s effectiveness on cognitive abilities, neuroplasticity, attention, memory,
resiliency to stress, mood, emotional regulation, depression, anxiety, and a variety of other mental and
physical disorders.1
In the last two decades, the proliferation of yoga as a popular exercise and wellness activity has helped
to introduce millions of Western consumers to secularized meditation techniques, and meditation is an
increasingly common offering in gyms, fitness centers, spas, and dedicated studios. Silicon Valley and
the corporate world have latched on to mindfulness as an employee wellness offering and productivity-
boosting measure – a phenomenon that some criticize as “McMindfulness,” or the co-opting of Buddhist
spiritual practices as a capitalist commodity. Apps and social media are also playing a major role in
spreading awareness of and access to meditation practices in countries around the world. For a relatively
low monthly cost, and even for free, these apps provide convenient content that is accessible to those who
may be new to meditation and mindfulness practices. Partnerships between major apps and on-demand
services (e.g., Calm, Headspace, Insight Timer, eMindful) and major companies across dozens of industries
are now delivering their content through corporate wellness programs, insurance programs, in schools, on
airplanes, in hotels, and even through media platforms like Spotify, HBO, and Netflix.
Self-help is rooted in ancient literature, philosophy, and religion.

Nearly every major civilization has produced their own version of “wisdom literature” or “conduct books,”
in which sages and intellectuals provided maxims and guidance on virtue, divinity, the meaning of life,
social norms, and practical advice on living. The earliest version of self-help is ancient Egypt’s “sebayt,”
a genre of pharaonic literature that contained teachings on ethical behavior and self-control (between
3000-1000 BC) – such as the Instructions of Kagemni or the Maxims of Ptahhotep. Some of the oldest and
most famous examples of wisdom literature are found in the Hebrew Bible and Christian Old Testament
(the books of Job, Psalms, Proverbs, Ecclesiastes, Song of Solomon, etc.). Ancient Greek and Roman
philosophers produced meditations, aphorisms, proverbs, and maxims on personal ethics, the power of
the human mind, and the nature of life – from Plato, Aristotle, and Socrates, to the Greek Stoics and Marcus
Aurelius’ Meditations. In India, ancient Sanskrit literature is full of verses and epigrams on morals, ethics,
and conduct, while the Bhagavad Gita is seen as a practical guide for implementing Vedic wisdom in
everyday life. China is rich with its own ancient wisdom traditions and philosophers (Confucius, Lao-Tzu)
and texts (e.g., I Ching, Tao Te Ching). In the Middle Ages and Renaissance, “mirror-of-princes” texts told stories
of leaders whose behavior should be imitated or avoided (the most famous being Machiavelli’s The Prince).
The development of the printing press launched the modern era of the self-help book. From the 1600s to
the 1800s, “conduct books” (which derived many concepts from ancient wisdom literature) proliferated
across the Western world, teaching men about ambition, self-reliance, and success, and advising women
on domesticity, marriage, parenting, and female virtues. In 1859, Samuel Smiles’ Self-Help became the
best-selling book other than the Bible. Smiles’ book is credited with coining the name of the “self-help”
genre and set the tone for its potential in the publishing industry (selling over a quarter of a million copies
by 1904). A number of self-help bestsellers appeared in the early 20th century, including James Allen’s As
A Man Thinketh (1903), Dale Carnegie’s How to Win Friends and Influence People (1936), Napoleon Hill’s
Think and Grow Rich (1937), and Norman Vincent Peale’s The Power of Positive Thinking (1952). By this
point, self-help diverged from literature and became its own genre – in fact, self-help was rejected by
academics and researchers as not being “original work” and for merely recycling text and concepts from

other writers and philosophers. Alcoholics Anonymous was founded in 1935, marking the beginning of the
group-based self-help and recovery movement.
The 1960s and 1970s (the “Me Decade”2) mark the take-off and golden age of self-help. The narratives of
recovery, self-care, and self-actualization started to permeate mainstream culture, and self-help shifted
away from pragmatic “how-to-ism” and started to embrace mysticism, spirituality, and psychology. In
the United States, the hippies and Baby Boomers embraced holistic philosophies and health, Eastern and
occult spirituality, alternative lifestyles, and humanistic psychology. During this era, the Human Potential
Movement developed as a “counter-cultural rebellion against mainstream psychology and organized
religion. It is not in itself a religion… but a psychological philosophy and framework, including a set of
values that have made it one of the most significant and influential forces in modern Western society.”3
The Human Potential Movement built upon and spread Abraham Maslow’s and Carl Rogers’ concepts of
self-actualization, the pursuit of fulfillment, the untapped potential that lies in all people, and an emphasis
on healthy people over pathological behavior. The movement and its champions (such as California’s
Esalen Institute) had a major influence in bringing Eastern spirituality, meditation, mind-body concepts,
self-improvement, personal development, and other “fringe” mental wellness practices into mainstream
culture; into workplaces and corporate training (bringing a new emphasis on human capital and creativity);
into the self-help genre; and also into the fields of psychology, therapy, and social work.
As the popularity of self-help surged into the 1980s-1990s, it became increasingly guru-driven. People
started to replace priests, therapists, and doctors with media celebrities, writers, and gurus (e.g., Tony
Robbins, Stephen Covey), who helped give them names to their problems and translated elite knowledge
and esoteric theories into bite-sized and accessible concepts. Some self-help gurus built up millions of
followers via TV broadcasts – for example, Tony Robbins’s “Personal Power” infomercial gave him worldwide
exposure and reached 100 million Americans from 1988-1991. Oprah’s media empire has played an outsized
influence in bringing pop psychology and self-improvement concepts to a mainstream audience worldwide,
turning a number of personalities into best-selling self-help gurus (e.g., Suze Orman, Dr. Phil, Deepak
Chopra). The recent rise of social media and wellness/self-help “influencers” (e.g., Gwyneth Paltrow) has
taken this guru phenomenon to a new level, and even TED Talks have become a new medium for self-help
advice. Established self-help personalities and gurus now deliver their teachings not only through books
and classes, but through web channels, social media, streaming apps, speaking engagements, workshops,
retreats, television channels, and more.
The rise of digital media has not squashed the enduring popularity of the self-help book. In recent decades,
self-help has become one of the most lucrative genres in the publishing industry, with approximately 150
new titles published every week.4 In both books and media, self-help concepts have become so pervasive
that they are no longer confined to a designated “self-help” category: “Today, every section of the store
(or web page) overflows with instructions, anecdotes, and homilies. History books teach us how to lead,
neuroscience how to use our amygdalas, and memoirs how to eat, pray, and love. The former CEO of
CNN writes the biography of an ornery tech visionary and it becomes a best seller on the strength of
its leadership lessons. The Nobel-laureate psychologist Daniel Kahneman writes a subtle analysis of our
decision-making process and soon finds his best seller digested and summarized in M.B.A. seminars across
the country. Philosophical essayist Alain de Botton launches a series of self-help books called ‘The School
of Life,’ whose titles will all begin with ‘how to.’ Even before books are written, their advances are often
predicated on strong ‘takeaways’ targeted to proven demographics.”5 The merging of self-help into social
science, science, business, memoirs, and other genres helps bring credibility to the field and expands
its appeal to those who would not usually read the genre (e.g., men). Some major publishing houses
are creating new imprints focused on self-help, and are rebranding the category as “self-improvement,”
“personal development,” and “mind-body-spirit” to expand its appeal among Millennials and a new
generation of consumers.6

Coaching originated in the 20th century, based in organizational
development, psychology, and sports.
Coaching also has some ancient roots, although it did not take shape as a discipline until the late-20th
century. The concept of “coaching” from a sports perspective originated in ancient Greece, when athletes
were supported in gymnasiums by elite former champions. The concept of “mentoring” also has roots
in ancient Greek philosophy: the first recorded mention of a “mentor” appeared in Homer’s Odyssey,
associating the word with a wise and trusted advisor or friend. The word “coach” was first applied to
a person in the 1830s, when students at Oxford University used it as slang for the tutors who helped
them toward their goal of passing exams. But from the 1860s onwards, the word was almost exclusively
associated with sports coaching.
The concept of “business coaching” or “life coaching” emerged in the 20th century. In the 1930s-1960s,
U.S. businesses became interested in using psychology to improve performance and productivity. They
hired organizational and occupational psychologists to counsel their senior executives, helping them to
overcome obstacles and improve performance. As the field of organizational development and psychology
grew in the 1960s and 1970s, leadership programs, assessment centers, and books emerged to support
businesses in these endeavors. During this time, the growth of humanistic psychology and the Human
Potential Movement (which built upon Maslow and advocated for humans’ ability to unleash their untapped
potential) started shifting businesses’ focus toward treating people well and expanding their potential,
rather than just productivity and performance improvements.
In the 1970s-1980s, sports coaching played a major role in the emerging field of business and life coaching.
Tim Gallwey’s 1974 book, The Inner Game of Tennis, revolutionized the coaching discipline with the idea
that a player’s inner psychological attitude is just as important as his outer physical skills. This concept was
embraced by the business world, who brought in Gallwey to provide training for employees; in the UK it was
adapted by Graham Alexander and John Whitmore into the GROW model, which became a foundational
model for most coach training programs today. American financial planner Thomas Leonard is credited with
developing life coaching as a modern profession. In 1992, Leonard founded the first formal coach training
program, Coach U, which remains one of the leading professional coach training schools in the world.
Leonard also founded the International Coach Federation in 1995, the first body to set industry standards
and ethics, provide coach credentialing, and accredit coaching schools. Over the last couple of decades,
coaching has had an explosion of interest and has built upon new developments in the psychology field,
such as Martin Seligman’s positive psychology. It has become a recognized discipline, with professional
associations, peer-reviewed journals, and training programs and university courses all over the world.
Coaching has expanded from the business arena into all areas of life, with specialized disciplines such
as leadership coaching, team coaching, career coaching, life coaching, personal development coaching,
relationship coaching, and so on.
The link between physical and sensory materials and mental wellness and
healing has been understood since ancient times.
Ancient civilizations and spiritual traditions from all corners of the globe have made connections between
the sensory world, mental and physical healing, the human condition, and the divine. Sensory stimuli – via
sound, light, aroma, touch, and energy – have long been believed to improve mental and physical well-
being and to awaken spiritual consciousness.

• Belief in the power of sound has existed since the beginning of recorded history, and most
cultures’ creation myths begin with some type of sonorous event. Indigenous cultures and spiritual
traditions in all corners of the globe have used sound in their healing ceremonies (e.g., drumming,
handclapping, singing, chanting, Tibetan singing bowls, Australian didgeridoo, Peruvian whistling
vessels, West African djembe, gongs, rainsticks, bells, etc.). Recent research has found that many
ancient temples and spiritual sites around the world (e.g., Egyptian pyramids, Greek temples
and sanatoria, Gothic cathedrals, Islamic mosques) have been built with acoustical resonance
properties and vibrating frequencies that promote calmness and mental composure and harness
the healing energies of sound.7 The Chinese character for medicine (藥) incorporates the character
for music (樂) – and the character for music also refers to the concepts of happiness, pleasure,
and enjoyment – an indication that the Chinese have recognized the connection between music,
happiness, and healing since ancient times.8
• Light and color have been used in healing for over 4,000 years. The Chinese attach symbolic
meanings to different colors and believe that color is a cosmic energy (Qi) that can shape humans’
energy and destiny. In Ayurvedic medicine, the chakras, or internal energy centers, are associated
with different colors. Light and color therapy was practiced in ancient Egyptian temples. Heliopolis,
the Greek “city of the sun,” was famous for its healing temples that broke sunlight into the color
spectrum, with different colors used for treating different ailments. Hippocrates wrote the first
texts on the benefits of sunlight for mood and mental health; he prescribed sunbaths and built a
solarium to be used for treating various maladies.
• Many ancient cultures used aroma for religious and healing purposes. In prehistoric times,
people burned aromatic herbs, woods, and barks (“smoking”) to drive the evil spirits out of sick
people. Ancient Egypt is considered the birthplace of aromatherapy and essential oils; they used
fragrances and perfumes in festivals, used aromatic herbs in embalming, and burned incense to
honor their gods. Around the same time, herbs and aromatic plants were incorporated as an
essential component of the Indian Ayurvedic system. The ancient Greeks and Romans used herbs
and essential oils for aromatic hot water and vapor baths, to soothe the nerves and treat fatigue
and other ailments. Hippocrates studied the properties of 200 herbs and incorporated them into
healing baths, massage, and other physiotherapies.
• Crystals and gemstones were first used in spiritual and healing ceremonies in ancient Sumeria
(4000-2000 BC) and in traditional Chinese medicine (beginning around 3000 BC). In ancient
Egypt, people wore certain gemstones in jewelry for protection and health, to promote wisdom
and knowledge, to honor the gods, and to purge evil spirits. Ancient Greek beliefs play a large
role in our modern understanding of healing stones; the word “crystal” is derived from the Greek
word “krustallos,” because they believed that clear crystals were eternal ice sent from the heavens.
The use of healing stones continued into the Middle Ages and Renaissance, when Lapidaries were
compiled to explain the properties and uses of various stones and gems – including not just
physical properties, but also metaphysical, spiritual, and astrological properties (from warding off
diseases to promoting particular mental states).
• Fidget and stress objects primarily originated in China. During the Han Dynasty (202 BC-220
AD) and Song Dynasty (906-1279 AD), warriors would squeeze walnuts and balls carved from
stone and metal to stay focused during battle. Baoding balls, or Chinese medicine balls, appeared
during the Ming Dynasty (1368-1655 AD) – the first time an object was mass-produced and sold
specifically for meditative and stress relief purposes. Made of iron, jade, or stone, Baoding balls
were decorated with designs that encouraged relaxation, harmony, and health, and they were rolled
in the hands to make a soothing sound. Worry stones (rubbed between the thumb and forefinger
to promote relaxation) have been used in cultures around the world, from Native American tribes,
to Ireland, to Tibet. Prayer beads are believed to have originated among the Hindus in India, but

have spread to every major religion (e.g., Buddhist japamala, Islamic misbahah, Catholic rosary)
and are used for counting prayers, meditation, and maintaining focus. Komboloi (worry beads)
have long been used in Greek and Cypriot culture. While they may have derived from prayer
beads, they have no religious or ceremonial significance today and are used for relaxation, passing
the time, and to guard against bad luck. Modern stress balls were developed and mass marketed
in the 1980s, followed by many other fidget toys and fads (such as fidget spinners around 2015).
Sensory-based healing was first explored by science in the 1600s-1800s, when European scientists made
a variety of new discoveries about the nature of light and color (e.g., refraction, polarization of light, and
infrared and ultraviolet radiation) – helping to bring phototherapy and chromotherapy into the modern
age. European and American sanatoria treated patients with sun baths (heliotherapy) in the late-19th and
early-20th centuries. Aromatherapy and essential oils were studied by European scientists at the beginning
of the 20th century and were used to treat soldiers during WWI and WWII. Music therapy began in the
United States in the 1940s, when it was used as a recovery treatment for soldiers after WWII. But with
the solidification of modern medicine and modern psychology – and their emphasis on drugs over natural
remedies, treatment over prevention, and matter over energy – these types of sensory and energy-based
healing modalities largely fell out of favor until the mid-20th century.
Sensory healing had its resurgence in the 1970s with the the New Age movement. The hippies’ interest
in alternative therapies, natural medicine, and ancient traditions brought a new wave of interest in sound
healing (e.g., chanting, singing bowls, vibro-acoustic furniture), energy healing, crystals, worry stones,
essential oils, and aromatherapy. Around the same time, the ability of scientists to study these practices
improved, and today there is a growing body of research evidence on the mental and physical health
benefits of sound, light, aroma, energy, and touch. Light therapy has been most validated and integrated
into modern psychiatry and medicine (e.g., for depressive disorders, seasonal affective disorder, sleep
disorders, skin conditions, etc.), while most other sensory healing modalities have remained on the fringes
of conventional medicine and psychology (although they are now seeing a new wave of attention from
the scientific community9). The modern wellness industry – especially hospitality and spas – have played a
leading role in bringing sensory healing to a wider, mainstream audience, such as using color, light, music,
and aroma to create healing and stress-relieving environments, and developing treatments and classes
based upon sensory modalities (e.g., sound baths, LED light treatments, aromatherapy and crystals in
massage and spa treatments, reiki and energy healing treatments, etc.).
Humans have used mind-altering drugs since prehistoric times, for

religious, healing, and recreational purposes.
According to Michael Pollan, “There is not a culture on earth… that doesn’t make use of certain plants
to change the contents of the mind, whether as a matter of healing, habit, or spiritual practice… plants
and fungi with the power to radically alter the consciousness have long and widely been used as tools
for healing the mind, for facilitating rites of passage, and for serving as a medium for communicating
with supernatural realms, or spirit worlds.”10 Archaeological evidence indicates that mind-altering drugs,
including mushrooms, opium, and cannabis, have been used by humans for as long as 10,000 years.
Psychoactive plants have played a role in the very foundations of many religions and have been at the
center of religious and sacramental rituals for millennia (such as their use by priests and shamans to induce
dissociative trances). For example, Soma (a hallucinogenic ritual drink) is mentioned more than 100 times
in the Rigveda, the oldest foundational sacred text of Hinduism. From ancient to modern times, opium
and cannabis have been the most commonly-used drugs throughout the world, for both recreational
and healing purposes. Cannabis was cultivated and used in Central Asia and China more than 5,000
years ago. Opium was cultivated by the ancient Sumerians from around 3400 BC, and they referred to

it as “Hul Gil” or the “joy plant.” Indigenous cultures around the world have long utilized endemic plants
for their mind-altering and psychoactive properties, such as coca leaf in South America, peyote among
Native Americans, nutmeg in South and Southeast Asia, blue lotus in ancient Egypt, and mushrooms in
Mesoamerica and North Africa.
For most of history, these drugs were seen as natural, and not something to be feared or controlled.
They were just another part of a plant that could be used for healing, to enhance human emotion and
consciousness, or to connect with the divine. Use of psychedelics, stimulants, and other types of drugs
with mental effects has long been a common cultural practice across many parts of the world – such
as hashish in the Middle East, khat in Africa and the Arabian peninsula, kava in the Pacific region, and
betel nut across South and Southeast Asia, as well as ubiquitous use of alcohol, nicotine, and caffeine
throughout the world. While incidences of drug abuse have been recorded since ancient times, it was not
until the 1700-1800s that addiction started to be recognized as a public health problem, and attempts to
control or ban certain drugs became more widespread (e.g., government measures to restrict sale and use
of opium in the 18th-19th centuries). Today, drug abuse disorders are widespread (an estimated 35 million
people globally) – with serious health, social, and economic implications – and production, distribution,
sale, and non-medical use of psychoactive drugs are widely banned throughout the world.11
Cannabis, opium, and cocaine were widely used in Western medicine starting in the 19th century, to treat
pain, melancholia, nervous disorders, insomnia, and many other physical ailments. Modern scientists
started to pay attention to the potential of psychedelic drugs in the mid-20th century, after Swiss scientist
Albert Hofmann first synthesized LSD (1938) and discovered its psychoactive properties (1943). During
the 1950s and 1960s, LSD, psilocybin, and mescaline were used in psychotherapy to treat thousands of
patients. Psychedelics were actively studied by scientists in the United States, Canada, and Europe, with
promising results for treating depression, anxiety, trauma, addiction, and other disorders. However, medical
use and research on psychedelics halted abruptly at end of the 1960s, when possession and use of LSD
and mushrooms were banned by the U.S. government (and then became listed as Schedule I drugs by the
United Nations in 1971), in response to the widespread recreational use of drugs among the counterculture
movement, and rising concern about drug abuse and its negative impacts.
The last 20 years have brought a renewed interest and a resurgence of scientific and clinical research on
the potential for cannabis and psychedelic drugs (especially psilocybin, ketamine, and MDMA), although
legal restrictions and socio-cultural sensitivities about drugs continue to put a damper on widespread
research and therapeutic uses. Decriminalization and liberalization of drug laws across many countries
(e.g., legalization of medical marijuana in more than 30 U.S. states) have also created a rapidly-growing
private and grassroots market for recreational and wellness-driven drug use – for example, an ever-
growing array of over-the-counter cannabidiol (CBD) products; microdosing of psychedelics for boosting
energy, creativity, and brain performance; and even a burgeoning niche market for psychedelic retreats
and tourism.

Endnotes
1
See, for example: 1) Powell, A. (2018, April 9). When science meets mindfulness. Harvard Gazette.
https://news.harvard.edu/gazette/story/2018/04/harvard-researchers-study-how-mindfulness-may-
change-the-brain-in-depressed-patients/. 2) National Center for Complementary and Integrative
Medicine, National Institutes of Health (2016, April). Meditation: In Depth. https://www.nccih.nih.gov/
health/meditation-in-depth.
2
3
Puttick, E. (2004). The Human Potential Movement. In C. Partridge (Ed.), Encyclopedia of New
Religions (p. 399). Oxford, UK: Lion Publishing.
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Kachka, B. (2013, Jan. 4). The Power of Positive Publishing. New York Magazine. https://nymag.com/
health/self-help/2013/self-help-book-publishing/.
6
Booth, H. (2017). How Self-Help Is Getting a Millennial Makeover. Stylist. https://www.stylist.co.uk/
books/best-self-help-books-anxiety-wellness-depression/130168.
7
See, for example: 1) Wijesiriwardana, R., et al (2017). Structural Acoustic Coupling Resonance of
Hindu Temples. Proceedings of 54th IASTEM International Conference, Kuala Lumpur, Malaysia. https://
www.worldresearchlibrary.org/up_proc/pdf/845-15000088551-5.pdf. 2) Ancient Temple Architects
May Have Been Chasing a Buzz From Sound Waves. PR Web. Dec. 1, 2009. https://www.prweb.com/
releases/ancient_temples/archaeology/prweb3243374.htm. 3) Jahn, R.G., et al (1996). Acoustical
resonances of assorted ancient structures. The Journal of the Acoustical Society of America, 99(2),
649-658. https://doi.org/10.1121/1.414642. 4) Debertolis, P., and Gullà, D. (2016). Vibrations and natural
phenomena in ancient sites affecting the brain activity How to study the mind in the archaeological
sites. Proceedings of International Conference: “Ancient Greece and the Modern World – The Influence
of Greek Thought on Philosophy, Science and Technology,” Greece. https://pdfs.semanticscholar.org/
de8d/5ae52424d940f801578493c91fc67c1e7463.pdf. 5) Cook, I.A., et al (2013). Ancient Architectural
Acoustic Resonance Patterns and Regional Brain Activity. Time and Mind, 1(1), 95-104. https://doi.
org/10.2752/175169608783489099. 6) Boyle, A. (2012, Feb. 16). Scientists revive ancient sounds. NBC
News. https://www.nbcnews.com/science/cosmic-log/scientists-revive-sacred-sounds-flna6C10402460.
8
Chinese Characters for Music: Yīn Yuè 音樂. The Epoch Times. Sept. 26, 2019. https://epochtimes.today/
chinese-characters-for-music-yin-yue-%E9%9F%B3%E6%A8%82/.
9
See: 1) McGroarty, B. (2020). Energy Medicine Gets Serious. 2020 Global Wellness Trends Report.
Miami, FL: Global Wellness Summit. https://www.globalwellnesssummit.com/2020-global-wellness-
trends/energy-medicine-gets-serious/. 2) McGroarty, B. (2020). Wellness Music. 2020 Global Wellness
Trends Report. Miami, FL: Global Wellness Summit. https://www.globalwellnesssummit.com/2020-
global-wellness-trends/wellness-music/. 3) McGroarty, B. (2020). Focus Shifts from Sleep to True
Circadian Health. 2020 Global Wellness Trends Report. Miami, FL: Global Wellness Summit. https://
www.globalwellnesssummit.com/2020-global-wellness-trends/circadian-health/. 4) Cavanah, C., and
McGroarty, B. (2019). Mediscent: Fragrance Gets a Wellness Makeover. 2019 Global Wellness Trends.
trends/medi-scent-fragrance-makeover/. 5) Moorefield, R. (2020, Feb. 10). Breathe for Wellbeing. Global
Wellness Brief. https://globalwellnessinstitute.org/global-wellness-institute-blog/2020/02/10/april-2020-
breathe/.

Pollan, M. (2018). How to Change Your Mind: What the New Science of Psychedelics Teaches Us About
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Consciousness, Dying, Addiction, Depression, and Transcendence. New York: Penguin Books.
United Nations (2019). World Drug Report 2019. United Nations publication, Sales no. E.19.XI.8. https://
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wdr.unodc.org/wdr2019/.

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Appendix E: Acknowledgements
The mental wellness economy – an industry category defined for the first time in this report – is a subject
that requires multidisciplinary exploration and thinking. As such, this study has benefitted from the
expertise and advice of many individuals, as well as a broad array of academic, scientific, and business
publications. In particular, we want to express our gratitude to Gerry Bodeker, Lawrence Choy, and
Cassandra Vieten for their help in creating a new definition for mental wellness and outlining various
pathways. We want to thank the Global Wellness Institute’s Mental Wellness Initiative members for their
invaluable work in producing the white paper, Mental Wellness: Pathways, Evidence and Horizons, which
informs this study. We thank the following individuals for providing insightful review and feedback on this
report: Gerry Bodeker, Lawrence Choy, Susie Ellis, Sheila Josephson, Beth McGroarty, Katherine Muller,
Cassandra Vieten, and Susan Wenze.
We sincerely thank the following experts and industry leaders who shared their time, expertise, data, and
research with us. This study is much richer because of them.
Anna Bjurstam, Founder and Owner, Raison d’Etre; Vice President of Spa and Wellness, Six Senses, Sweden
Gerry Bodeker, PhD, Chair, Mental Wellness Initiative, GWI; Member, Green Templeton College, University
of Oxford, United Kingdom
Lawrence Choy, MD, Co-Founder and Medical Director, Elite Focus Clinic, United States
Patty David, Director, Personal Fulfillment Research, AARP, United States
Susie Ellis, Chairman and CEO, Global Wellness Institute and Global Wellness Summit, United States
Melisse Gelula, Co-Founder, Well+Good, United States
Alina Hernandez, Co-Founder, the First 1000 Days of Wellness, Germany
Sheila Bloom Josephson, PhD, LCSW, Clinical Social Worker/Therapist, Institute for Contemporary
Psychotherapy, United States
Mia Kyricos, President and Founder, Kyricos & Associates, United States
Liza Lichtinger, Owner, Future Design Station; Founder, MindfulExistenC, United States
Mary Anne Malleret, Author, Director, Monthly Barometer, France
Thierry Malleret, PhD, Co-Founder, Monthly Barometer; Co-Founder, Well Intelligence, France
Beth McGroarty, Director of Research and Public Relations, Global Wellness Summit, United States
Renee Moorefield, PhD, CEO, Wisdom Works, United States
Katherine L. Muller, PsyD, ABPP, Director, Valley Center for Cognitive Behavioral Therapy, United States
Martin Polanco, MD, Founder and Medical Director, Crossroads Ibogaine Treatment Center, Mexico

Rina Raphael, Health and Wellness Journalist, Executive Editor, Calm, United States
Cassandra Vieten, PhD, Executive Director, John W. Brick Mental Health Foundation, United States
Susan J. Wenze, PhD, Associate Professor and Licensed Clinical Psychologist, Lafayette College, United
States

Industry Research Sponsors
HYATT
Holistic wellbeing is at the core of Hyatt’s purpose, to care for people so they
can be their best, across all of our brands and stakeholders. We continue
to prioritize the need and desire for our colleagues and guests to practice
mental wellbeing and self-care with initiatives like our Headspace partnership,
which brings meditation and mindfulness content to colleagues and guests;
digital experiences from our wellbeing brand Exhale; and wellbeing services
like digital mindfulness programming at Miraval. Visit: www.hyatt.com.
BIOLOGIQUE RECHERCHE
Through our involvement with the Global Wellness Institute’s Mental Wellness
Initiative, we encourage all of you to become part of its mission to help
empower and communicate mental wellbeing to those around you. The
Mental Wellness Initiative believes that through the exchange of knowledge,
we can promote and support lifelong growth, happiness, creativity, inner
peace, compassion and wisdom. This can be achieved collectively through
individual actions. Visit: www.biologique-recherche.com
OSTEOSTRONG
OsteoStrong is a biohack that helps you strengthen the foundation of your
body – the skeletal system. The skeletal system is arguably one of the most
critical systems of the human body. By implementing Osteogenic Loading to
strengthen it, many experience improved bone density, posture and balance
plus less joint and back pain. OsteoStrong Centers are opening worldwide
for people of all ages and levels of activity. For locations and franchising
opportunities please visit www.osteostrong.me.
AROMATHERAPY ASSOCIATES
When our founders created Aromatherapy Associates 35 years ago, their
vision was to improve wellbeing through the natural power of aromatherapy.
Our founders were also passionate about fulfilling a greater need and doing
good in the world. Now with BCorp certification, we represent the highest
standards of environmental and social impact. For Aromatherapy Associates,
it’s not about just being the best in the world, but also the best for the world.
Visit: www.aromatherapyassociates.com.

DELOS
As the pioneer of Wellness Real Estate™, Delos is transforming our homes,
offices, schools and other indoor environments by placing health and wellness
at the center of design and construction decisions. Delos helps create spaces
that actively contribute to human health, performance and wellbeing by
marrying the best innovations in technology, health, science and real estate.
The Delos platform includes programming, consulting, research, and an array
of innovative products and technologies that research suggests may improve
occupant wellbeing. Visit: www.delos.com.
EMINDFUL
eMindful delivers evidence-based mindfulness programs for everyday
life and chronic conditions. With 12+ years of data-driven insights and
consistent results at improving health, productivity and healthcare costs,
eMindful partners with Fortune 500 employers and leading health plans to
help individuals make every moment matter with the skills for greater focus,
creativity and purposeful decisions. Published research and outcomes are
available at emindful.com.
JOHN W. BRICK MENTAL HEALTH FOUNDATION

The John W. Brick Mental Health Foundation is changing the way the world
treats mental health. Our purpose is to integrate holistic approaches such as
exercise, nutrition and mind-body practices into the mental healthcare delivery
system. We do this by funding and promoting evidence-based research on how
exercise, nutrition and mind-body practices benefit mental health resilience,
supporting initiatives that integrate evidence-based holistic approaches into
mental healthcare, and advancing a collaborative roadmap for an integrated
approach to mental healthcare. Visit: www.johnwbrickfoundation.org
KOHLER
Your very own way to well begins in the Village of Kohler, WI, a welcoming
community with the only five-star experiences in the state. Guests escape here
to enjoy world-class yoga, indoor cycling, the Kohler Waters Spa, 500 acres of
unspoiled wilderness, tranquil gardens and miles of biking paths. Destination
Kohler features unmatched hospitality and a variety of accommodations with
countless, authentic opportunities to connect to a higher sense of physical,
emotional and personal wellness. Visit: www.kohler.com.
MINDBODY
MINDBODY is the leading technology platform for the fitness, beauty and
wellness services industries. Local entrepreneurs worldwide use MINDBODY’s
integrated software and payments platform to run, market and grow their
businesses. Consumers use MINDBODY to more easily find, engage and
transact with fitness, wellness and beauty providers in their local communities.

For more information on how MINDBODY is helping people lead healthier,
happier lives by connecting the world to fitness, beauty and wellness, visit
www.mindbodyonline.com.
RANCHO LA PUERTA
Founded in 1940, Rancho La Puerta Fitness Resort and Spa in Tecate, Baja
California, Mexico, pioneered the concept of a true destination spa, for both
its guests and employees. Over 440 employees and their families are part
of the Employee Wellness Program, which provides daily fitness classes,
complimentary medical services, and healthy living workshops. Visit: www.
rancholapuerta.com.
RANCHO MISSION VIEJO

Rancho Mission Viejo, a 23,000-acre master planned community in south
Orange County, California, is intentionally developed on a foundation of
wellness. The Ranch promotes living well with incomparable access to nature,
amenities, people and programs that make pursuing all dimensions of wellness
a part of every age and stage of life. The land is our brand – 17,000 acres of
it are permanently preserved through the Reserve at Rancho Mission Viejo,
ensuring it remains so, forever. Visit: www.ranchomissionviejo.com
SIX SENSES
Six Senses Hotels Resorts Spas are discovered in some of the world’s most
beautiful places. They are synonymous with a unique style – authentic,
personal and sustainable, and in harmony with individual surroundings; local,
yet in tune with the wider world. They are intimate, offering an emotionally
intelligent approach to anticipative service, which supports delightful and
unexpected surprises. Crafted guest experiences stimulate, energize and
revitalize the human spirit; spa and wellness programming is all pervasive. All
aspects of Six Senses’ operations, including the Evason brand, embrace these
values, which define the brand and the enduring Six Senses mission: To help
people reconnect with themselves, others and the world around them. Visit
Six Senses at www.sixsenses.com.
UNIVERSAL COMPANIES
Founded in 1982 by Marti Morenings, Universal Companies is the leading
single-source supplier to more than 56,000 spa professionals in 47 countries.
Continuously innovating, we’ve developed a robust educational platform,
exclusive brand partnerships, and customer retail strategies. Spa development
and expansion are core components of our service offerings. With innovative
wellness equipment becoming increasingly important to spa operations, our
team researches and develops the latest technologies and seamlessly integrates
them into new or existing operations. Visit: www.universalcompanies.com.

WE ACKNOWLEDGE AND THANK OUR
2020 INDUSTRY RESEARCH SPONSORS
WHO MADE THIS REPORT POSSIBLE:
Hyatt
Biologique Recherche
OsteoStrong
Aromatherapy Associates
Delos
eMindful
John W. Brick Mental Health Foundation
Kohler
MindBody
Rancho La Puerta
Rancho Mission Viejo
Six Senses
Universal Companies
333 S.E. 2nd Avenue, Suite 2048

Miami, FL 33131
WWW.GLOBALWELLNESSINSTITUTE.ORG
11302020

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Defining the Mental

Quotation of, citation from, and reference to any of

I. Mental Wellness Takes Center Stage.......................................................... 3

II. Defining Mental Wellness............................................................................. 9

III. Personal Agency Versus Collective Responsibility................................. 25

IV. The Mental Wellness Economy................................................................... 31

V. Mental Wellness Industry Subsectors....................................................... 47

About the Global Wellness Institute

About the Authors

Global Wellness Institute | i

This study will offer a definition for mental wellness; clarify

Global Wellness Institute | iii

Defining the Mental Wellness Economy – November 2020 | iv

Global Wellness Institute | v

Defining the Mental Wellness Economy – November 2020 | vi

Mental wellness can help address the rising cost burden of

Global Wellness Institute | vii

Defining the Mental Wellness Economy – November 2020 | viii

Global Wellness Institute | ix

How to interpret these numbers.

Defining the Mental Wellness Economy – November 2020 | x

Global Wellness Institute | xi

Defining the Mental Wellness Economy – November 2020 | xii

Global Wellness Institute | xiii

Defining the Mental Wellness Economy – November 2020 | xiv

Global Wellness Institute | xv

Global Wellness Institute | 1

Global Wellness Institute | 3

Mental wellness offers a path forward to meet widespread

Defining the Mental Wellness Economy – November 2020 | 4

This study will offer a definition for mental wellness; clarify

Global Wellness Institute | 5

Defining the Mental Wellness Economy – November 2020 | 6

Bloom, D.E., et al (2011). The Global Economic Burden of Non-communicable Diseases.

Geneva: World Economic Forum. http://www3.weforum.org/docs/WEF_Harvard_HE_

Global Wellness Institute | 7

What is mental wellness?

Mental wellness is an internal resource that helps us think, feel,

• Mental: How we think; how we process, understand, and use information.

• Emotional: How we feel; how we manage and express our emotions.

• Social: How we connect; our relationships with others.

Global Wellness Institute | 9

Defining the Mental Wellness Economy – November 2020 | 10

1. Mental wellness is more than just the absence of mental illness.

Global Wellness Institute | 11

Defining the Mental Wellness Economy – November 2020 | 12

2. Mental wellness is an active process of moving from languishing,

Global Wellness Institute | 13

4. Mental wellness grows out of a grassroots, consumer-driven

Defining the Mental Wellness Economy – November 2020 | 14

Global Wellness Institute | 15

Defining the Mental Wellness Economy – November 2020 | 16

Activity and Creativity:

Growth and nourishment:

Global Wellness Institute | 17

Rest and rejuvenation:

Defining the Mental Wellness Economy – November 2020 | 18

Global Wellness Institute | 19

Defining the Mental Wellness Economy – November 2020 | 20

Religions (p. 399). Oxford, UK: Lion Publishing.