Some readers of Mad in America may be aware that Scientific American published a short blog by me on 17th November 2014 – Why We Need to Abandon the Disease-Model of Mental Health Care. This blog was rather wonderfully (and slightly embarrassingly) described by Phil Hickey on his website, Behaviorism and Mental Health, as “an important milestone.”
My blog attempts to summarise many of the key points of a perspective widely shared on Mad in America:
“We need radical change, not only in how we understand mental health problems, but also in how we design and commission mental health services.”
“It’s all too easy to assume that mental health problems — especially the more severe ones that attract diagnoses like bipolar disorder or schizophrenia — must be mystery biological illnesses, random and essentially unconnected to a person’s life. But when we start asking questions about this traditional disease-model way of thinking, those assumptions start to crumble.”
“We need to place people and human psychology central in our thinking. Psychological science offers robust scientific models of mental health and well-being, which integrate biological findings with the substantial evidence of the social determinants of health and well-being, mediated by psychological processes.”
“We must stop regarding people’s very real emotional distress as merely the symptom of diagnosable ‘illnesses’.”
“It is important that we are able to define, identify and measure the phenomena we are attempting to study and the problems for which people seek help. But we obfuscate rather than help when we use the language of medical disease to describe the understandable, human and indeed normal response of people to traumatic or distressing circumstances.”
“… we should replace traditional diagnoses with straightforward descriptions of problems.”
“A simple list of people’s problems (properly defined) would have greater scientific validity and would be more than sufficient as a basis for individual care planning and for the design and planning of services.”
“This is an unequivocal call for a revolution in the way we conceptualize mental health and in how we provide services for people in distress, but I believe it’s a revolution that’s already underway.”
Phil’s contention is that we have reached a welcome milestone when ideas such as this are presented in Scientific American; with nearly 4 million visitors to its website each month, and with its status as the planet’s leading mainstream scientific publication. Phil’s hope is that such publication will help ideas such as this reach a wider and important audience. I hope he’s right. And I think Phil is suggesting that the acceptance of these kinds of arguments in a forum such as this indicates their increasing acceptance in the scientific community. I hope he’s right.
I have some reason to be gently pleased. The article has been widely circulated on social media (it’s been “liked” two thousand times, and it remains one of the “most read” blogs on the Scientific American website.
On the other hand … one commentator (herself a widely-read journalist) commented that my piece was “… a bunch of blather … embarrassing … the lowest of the low …” written by “ … a nincompoop with an ax to grind.”
I guess we can conclude that I haven’t been able to persuade everybody — yet.