Towards an Integrative Conceptual Model of Good Mental Health in People with Intellectual Disabilities

People with intellectual disabilities (ID) are characterised by limitations in intellectual functioning and adaptive behaviour. They are also disproportionately affected by health inequalities. Despite strong
normative frameworks, such as the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD), and international commitments to health equity, people with ID are frequently excluded from mainstream health promotion and prevention initiatives and conceptual frameworks of mental health. Consequently, conceptualisations of good mental health for people with ID remain underdeveloped from a theoretical perspective. While recent research increasingly calls for participatory and inclusive approaches,
there is still limited integration of lived experience, professional knowledge, and theoretical perspectives into coherent conceptual frameworks. The present contribution addresses this gap by offering an integrative
synthesis across multiple empirical studies to advance conceptual and theoretical understanding of good mental health in people with ID. We conducted a secondary synthesis across four complementary studies:
a systematic review of the literature (including 37 studies); participatory focus groups with adults with ID (n=20); qualitative interviews with mental health experts (n=12); and an inclusive Delphi study to develop cross-stakeholder consensus (n=60). Findings were comparatively analysed and interpreted in relation to established theoretical approaches. Across data sources, good mental health emerged as a multidimensional and relational construct extending beyond the absence of psychopathology. People with ID emphasised autonomy, belonging, emotional safety, meaningful participation, and respectful relationships. Experts similarly highlighted relational and contextual dimensions but placed greater emphasis on functioning, adaptation, and service-related outcomes. Importantly, the systematic review identified no explicit conceptualisations of good mental health for people with ID; although wellbeing was frequently referenced, good mental health was not defined as a distinct construct, nor were lived-experience perspectives incorporated. Based on this synthesis, we propose a multidimensional conceptual model of good mental health for people with ID foregrounding psychological, relational, environmental, and capability-related dimensions. This model bridges lived experience and professional knowledge and can inform future theory development, inclusive research practices, assessment frameworks, and the design of mental health promotion and support services aligned with the priorities and rights of people with ID