Chapter 1 - Conceptualizing Mental Health and Illness

Disease

with biological cause

Disorder

dysfunction that is mental in nature whatever the cause

Social determinants of health

-health care access and quality, education access and quality, economic stability, social and community context, neighbourhood and built environments

World Health Organization (WHO)

defines mental health as a state of well being where individual can cope with normal stressors of life and work productively by making a contribution to their community

Diagnostic and Statistical Manual of Mental Disorders (DSM)

defines mental health as the disturbances in cognition, emotion, or behaviour attributed to mental functioning and usually associated with distress or disability

Types of Models of Mental Health and Illness

Biomedical, psychological-behavioural, social, biopsychosocial

Biomedical Model

• assumes binary division (either mentally ill or healthy)

• suggests mental illnesses have specific cause

• no biomarkers

• treatments: psychopharmaceuticals. ECT, genetic interventions

Psychological-behavioural model

• mental disorders considered to be patterns of thinking, feeling, and behaving that are harmful to individual

• assumes symptoms exist on a scale

• practices within model: freudian psychoanalysis, psychodynamic approaches, behaviourism, humanism

• all support that illness is result of personal experience (ex. childhood)

• treatment: CBT, psychodynamic treatment, humanistic therapies, existential approaches to therapy

• Social Model

• mental health result of social product

• less emphasis on individual characteristics and focus more in context of social environment, power and culture leading to labelling of people experiencing marginalization like mentally ill

• social interventions suggested as response to improve mental health (ex. supported housing, demedicalization)

Demedicalization

de classifying mental illness and looking at social causes rather than individual causes of mental health

Biopsychosocial Model

suggests biological factors, social conditions, and individual experiences all conribute to person's mental health (perspective from all four models)

Diagnostic tools determining mental health and illness

DMS: description of diagnosis with symptom checklist

ICD: includes all diagnostic criteria and health conditions, guiding professionals as they diagnose mental illness

Clinical Scales: measure mental state through standard questions determining severity of condition (ex. hamilton depression rating scale)

Bias in diagnosis

Patient characteristics: race, class, size

Clinician characteristics: training, race, gender

Diagnostic criteria: some individuals more likely to be diagnosed with particular conditions

lack in committee diversity which can lead to diagnostic criteria reinforcing cultural norms

• Why does mental health matter?

• influences how we experience world (challenges in navigating based on state of mental health)

• understand and explain behaviour

• social meaning and identity

• public health goal to decrease suffering

• diagnosis helps treat but can also lead to stigmatization, mistreatment, and involuntary treatment