Main Perspectives on Mental Illness
he World Health Organization estimates that about 300 million people around the world are suffering from depression, 60 million from bipolar affective disorder, and 21 million from schizophrenia. These statistics are by no means comprehensive because diagnostic criteria for mental illnesses are constantly revised.
The WHO concludes that one in four people in the world has been or will be affected by some mental or neurological symptom. This means that we ourselves or someone in our closest circle is or will someday be in need of psychological or psychiatric help.
So, What Does it Mean to Be Mentally Healthy?
Mental health is a state of relative emotional, psychological, and social well-being. The concept also covers the ability to cognitively perceive and retain information, adapt successfully to social and physical environments, handle stress, etc. In other words, the quality of our subjective experiences of living and relating to others is at the core of mental well-being.
So, what are the factors that determine the quality of our experiences? Let us have a look at the differences between the dominant perspectives on mental health and compare their practical implications.
Nature vs Nurture
For centuries now, medical and social sciences have been dominated by the Nature vs Nurture debate. It Is already evident, though, that there are no 100% biological, social or historical predictors of human experience or behavior, rather a complex interplay between our bodies, social environment, challenges we face in life and the ways we interpret them in our minds. The goal is to figure out which of the above factors are most influential preventing and treating mental health issues.
Ancient Perspectives on Mental Illness
The oldest perspective on mental illness is now referred to as the spiritual model. Up until the 19th century, it was believed that unusual experiences or actions were the result of spirit possession or other supernatural influences. Depending on culture and the behavior of the «possessed» individual, the society could regard the spirits as good or bad. Good spirits and the people communicating with them were often worshipped. The person inhabited by evil spirits was believed to be inherently sinful and malignant. Therefore, exorcism rituals resembled more of a torture than treatment.
Moral character model explained psychopathology in terms of character deficiencies and lack of virtue. This perspective presumably comes from ancient Greeks who viewed moral integrity as key to healthy and productive life.
Modern Approaches and their Implications
Nowadays, biological or medical model dominates mental health service systems throughout the world and serves as the theoretical basis for psychiatry as we know it. This model views mental conditions as caused by brain abnormalities or chemical imbalances. It implies that mental health conditions are mostly genetically predetermined and cannot be overcome by an individual without drug treatment or other medical interventions.
According to the social model, human behavior is determined by reinforcements of lack thereof from the immediate environment. It implies that there are causal connections between psychopathology and the conditions in which the individual was brought up and lives. This model also emphasizes the role of poverty, inequality and discrimination in producing mental health issues. The social approach implies that by shaping the immediate environment of an individual it would be possible to prevent severe mental disabilities. Though very popular in the past, this approach has several blind spots. First of all, it does not explain why different people react differently to similar situations and social determinants – some of them develop mental conditions and some do not. Secondly, just like the medical model, the social perspective views human psyche as completely conditioned, while the role of personal will remains unexplained.
Psychological model focuses primarily on mental representations that individuals form when interacting with the environment and making sense of the world. This approach does not deny the role of biological and social factors in the development of mental disorders, but the main emphasis is put on understanding the emotional experiences and cognitive patterns of the individual. Non-adaptive behaviors are modified by bringing into awareness and restructuring ineffective mental schemas. Despite broad clinical application, this perspective is often criticized for being too subjective and unscientific.
Biopsychosocial model of mental illness serves as the most popular alternative to medical approach. It views mental disorders as resulting from multiple interrelated factors (biological, psychological, social) and affecting several domains of human existence, not merely intellectual or emotional well-being. The strength of this approach lies in addressing mental disorders as complex phenomena and not reducing human personality to only one dimension. However, such holism breeds practical problems when it comes to choosing specific interventions.
More Questions than Answers
Is the concept of mental illness still valid? If so, what should we address first – medical conditions of the affected individual, their social environment and behavior or maybe cognitive and emotional patterns? What are the boundaries of professional help, given that mental health problems tend to sprawl across the whole life of the affected person?
These questions are still to be answered.