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Mental Health Care Needs to Adopt Perspective Diversity
The once-held consensus among practitioners and policymakers to use a bio-psycho-social approach to what constitutes mental illness is weakening as other views take hold, according to a study published in the Journal of Mental Health.
“Mental health practitioners tend to say that they use a bio-psycho-social model in their everyday work, but our research shows that this model is fracturing,” said study author Jeremy Dixon, a senior lecturer at the University of Bath who holds a doctor of social science degree. “Whilst this field has been dominated by psychiatry and psychology, the perspectives of users of services and other professionals such as nurses and social workers are now beginning to be heard.”
Dr Dixon and lead author Dirk Richter, PhD, of the Bern University of Applied Sciences, came to the finding after conducting a systematic review of 110 publications that referenced mental health or mental illness. They identified 34 different theoretical models used by providers, researchers, and users of mental health services to understand what constitutes a mental health problem.
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Models ranged from biologic (focusing on the body or brain) to psychologic (focusing on mind and behavior) to sociologic (focusing on how social circumstances affect people) to models informed by consumer and cultural considerations (which reflect experiences of people who have received mental health services and how treatments should be adapted to different cultures).
Considering the wide span of models, the authors emphasized the need for clarity on how different—and potentially contradicting—models can be used in practice. The debate, they say, requires input from nonmedical professions and users of mental health services so other preferences are better understood.
“In clinical terms, this leads us to a service model that is based on endorsing perspective diversity,” which also goes by labels such as post-psychiatry or polycontexturality, the authors advised. “Mental health care, according to such a model, should be guided by service user preferences rather than by evidence-based psychiatry. For clinicians, such an approach would require them to develop conceptual competence, in which they become aware of fundamentally different assumptions and concepts so that these are not interpreted as illness symptoms or ‘lack of insight’ in users of mental health services.”
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