The importance of mental health as a determinant raises a number of questions. Firstly, there is a need for a greater understanding of why mental health is so significant: what are the key pathways through which mental health and wellbeing influence so many different dimensions of the lives of individuals and communities and how do these intersect with other determinants? Secondly, what conditions are necessary to create optimum mental health and wellbeing and what policy initiative and interventions will produce these conditions? Some of the factors to consider in assessing the significance of mental health relative to other influences are evident in reflecting.