Week 3: Social Factors in mental health and The Recovery Model of Mental Health

Describe a range of biological, psychological and social factors generally accepted as contributing to mental health

Through 60s and 70s Shift from psychiatry and field of medicine to BIOMEDICAL model to BIOPSYCHOSOCIAL model

-Biopsychosocial model is superior to biomedical model because =

• More holistic

• Less stigmatizing

• More room for diverse perspectives

• Broader range of professionals to work in mental health

what are some common critiques of the Biopsychosocial model

• Recent advances in genetics and brain research suggest that biology is a much stronger factor than the biopsychosocial model acknowledges

• Other common critiques=

           -Significant overlap between categories

           -Psychosocial factors on theories seen as unscientific or fluffy

           -TOO BROAD

           -No specific unifying model of treatment

Micro-social factors which have an impact on mental health?

• Absence or presence of friends/social networks

• Connection to cultural or religious communities

• Level of social involvement

• Social resources

• Influence of friends/social norms/peer pressure

Who focuses on the micro-social factors? 

counsellors/therpaists

Macro-social factors

12 key social determinants of health Created by Raphael et al (2008)

who focuses on Macro-social factors

Those who study population mental health area

what are the 12 determinants of mental health?

1. Income and its distribution

2. Access to housing

3. Access to education

4. Early life living conditions

5. Gender

6. Employment and working conditions

7. Unemployment and employment security

8. Aboriginal status

9. Social equity

10. Social safety net

11. Food security

12. Health care services

what do the 12 key social determinants of health look at

-The more inequity there is within a society the more mental health and addictions issues will tend to arise

• Security/insecurity has a significant impact on mental health

• Sense of agency/helplessness has a huge impact on mental health

• Health, security, and education in early chidlhood has a major impact on mental health

what do the 12 social determinants of health impact?

• impact both individuals and populations/communities

• have a greater impact on health than behavioural risk factors for most individuals

Social-ecological view of mental health 

have arisen from social-work/systemic ways of thinking about mental health and addiction

• So problems and solutions are seen as arising from various points within the individual’s ecological system

• Mental health treatment models from this view focus as much or more on changing the systems surrounding the individual, rather than focusing all efforts on the individual

What are the interventions that have arisen from the socio-ecological view?

Policy = Develop more effective systems for measuring and tracking mental health

Community = campaigns /education to reduce stigma

Organizational/Institutional = Embedding mental health services within non-traditional service points like jails and places of employment

Interpersonal/Family = Psycho-education for family members to help increase understanding of mental health

Individual = Try to take pressure of change of individual and put pressure for change on the environment around them

Recovery model?

• Was developed as an alternative to a purely medical/biological model

• Recovery model is more aligned with the social-ecological approaches to mental health treatment

• Focuses on, “living a satysfying, hopeful and contributing life, even when the person may be experiencing ongoing symptoms of mental health problem or illness (addictions too)

• Built on concepts of “Hope, Dignity, Self-determination, and responsibility”

6 primary dimensions of recovery oriented practice? 

1. Creating a culture of language

• What is still possible while you are living with these mental health issues

• What is still possible while an individual is still currently using 

2. Recovery is personal 

• Developing a unique approach to recovery for each individual

3. Recovery occurs in the context of one’s life 

• Most of a person’s recovery journey occurs outside of the mental health system

• Important to integrate family, peers, and community support into treatment

4. Responding to the diverse needs of everyone living in canada

• Offering treatment and services which meet the needs of diverse cultural backgrounds, gender identities/sexual orientations and developmental stage

5. Working with the First Nations, Inuit, and metis 

6. Recovery is about transforming services and systems 

• Ways to reduce barriers to services by creating more efficient systems for treatment delivery

Recovery oriented practice =

-An approach to mental health care which encompasses principles of self-determination and personalized care

• Emphasize hope, social inclusion, community participation, personal goal setting, and self-management

• Partnership between people accessing mental health services and mental health professionals

Role of the consumer/survivor movement in mental health treatment

• “people who have been, or were in the past, in direct contact with the psychiatric institutions or mental health system as a patient, client or consumer.”

• focus on self-advocacy, peer-support, self-help, self-determination and freedom of choice for those living with mental health symptoms.

• Most Survivor/Consumer movements occur outside of formal settings, but some hospitals such as CAMH have experimented with Survivor/Consumer led (or co-led) groups

• Some community Survivor/Consumer groups will allow ‘allies’ who work as professionals in the field to work with them