Mental health Discussion about mental health tends to focus on mental health conditions, rather than what constitutes good mental health. According to the World Health Organisation (WHO), mental health is a ‘state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community’. Many people with Down syndrome experience positive mental wellbeing and do not exhibit signs of poor mental health. However, there are certain factors that may make people with Down syndrome more susceptible to poorer mental health. Certain biological differences, as well as everyday stresses that people with Down syndrome may find harder to deal with, may make people with the condition more susceptible to mood, emotional and other mental health problems. People with Down syndrome often find life changes difficult to deal with. Being aware that this can be an issue and preparing and informing the person with Down syndrome in advance of change may lessen stress levels and prevent problems. Sometimes a behavioural change may be an attempt to communicate physical or psychological discomfort. For example, there is evidence to suggest that many people with Down syndrome have a delayed response to bereavement and grief. As people with Down syndrome may struggle to verbally express the pain or illness they are experiencing, they may feel upset, anxious or have low moods. If low moods persist or if symptoms of depression develop it is important to seek specialist advice. Depression is not part of the condition but is one of the most frequently diagnosed psychiatric disorders for people with Down syndrome. Poor mental health is not inevitable for people with Down syndrome. However, mental health conditions in people with Down syndrome may still be overlooked because of ‘diagnostic overshadowing’, i.e. the assumption that their behaviour is caused because they have Down syndrome.