Coping as a central public mental health indicator in times of multiple crises

Abstract Background Adaptive coping is an integral part of the WHO definition of well-being and its promotion is a key public health concern. Due to its diverse and extensive nature, coping is rarely used in national surveillance systems. However, the need for information on the distribution and effectiveness of coping strategies has grown, particularly in face of multiple societal crises. The aim of this research was to develop and integrate a suitable short scale in public health surveillance to derive implications for promotion. Methods Based on an umbrella review, items from existing coping scales were used in two studies with adults living in Germany and the UK (N = 2,613 and N = 1,986, 18-79 years, 50% female) to develop and validate a short coping scale in German and English using factor analyses. The final scales were administered in a national cohort of young adults (16-25 years, N = 3,051) and in a representative survey of adults living in Germany (16-99 years, N = 27,322) to examine direct and indirect associations with various mental health outcomes (MHO). Results Results indicated a good fit for a 16-item and 8-item scale with 8 and 4 factors, respectively (CFI, TLI >.97, RMSEA, SRMR <.04). The strongest positive associations across MHO were found for coping flexibility and active coping, while repression and wishful thinking showed the opposite pattern. Coping explained a significant proportion of the associations between stressors and MHO and revealed differences in the strength of associations across population groups. Conclusions The coping scales were found to be reliable and suitable for population-based assessment and were associated with several MHO. Coping contributed significantly to the understanding of mental health in face of stressors through multiple pathways and provided additional insights into population groups in need of support. Inclusion of coping in regular national surveillance provides essential information for promotion and impact assessment.