Evaluation - clinical psychology

Strength Deviation from ideal mental health - A comprehensive definition

• The ideal mental health criterion is highly comprehensive. Jahoda's concept of 'ideal mental health' covers most of the reasons why we might seek (or be referred for) help with mental health.

• An individual's mental health can be discussed with a range of professionals who might take different theoretical views, e.g. a medically-trained psychiatrist might focus on symptoms whereas a humanistic counsellor might be more interested in self-actualisation.

• This means that ideal mental health provides a checklist against which we can assess ourselves and others and discuss psychological issues with a range of professionals.

Limitation Deviation from ideal mental health - May be culture-bound

• Different elements are not equally applicable across a range of cultures.

• Some of Jahoda's criteria for ideal mental health are firmly located in the context of the US and Europe generally.

• The concept of self-actualisation would probably be dismissed as self-indulgent in much of the world. Different European countries have different ideas about how important it is to be independent e.g. high in Germany, low in Italy.

• This means that it is difficult to apply the concept of ideal mental health from one culture to another.

Strength of Deviation from social/cultural norms - Real-world application

• Deviation from social/cultural norms is useful.

• Deviation from social/cultural norms is used in clinical practice.

• For example, the key defining characteristic of antisocial personality disorder is a failure to conform to culturally acceptable ethical behaviour, i.e. recklessness, aggression and deceitfulness.

• Deviation from social/cultural norms also play a part in the diagnosis of schizoptypal personality disorder (described as pronounced difficulties with relationships due to the belief that others harbour negative thoughts about them).

• The thinking of such individuals is often characterised as 'odd' or 'eccentric'.

• This shows that the deviation from social/cultural norms criterion has value in psychiatry.

Limitation of Deviation from social/cultural norms - Love of the familiar

• Deviation from social/cultural norms allows people to impose a narrow range of acceptable behaviours on others.

• Chappell and Jeppsson (2023) suggest that people are reassured by 'typical behaviour' and disturbed by deviations (a 'fear of weirdness").

• It is problematic if clinicians impose their own social/cultural norms on clients because of their own love of the familiar and fear of weirdness.

• The clinician is then disregarding that person's own judgement of their well-being and imposing other people's standards on their client.

• This means that the concept of deviation from social/cultural norms as a criterion for judging mental health may limit personal freedoms.

Strength of Failure to function adequately - Represents a threshold for help

• The failure to function criterion represents a sensible threshold for when people need professional help.

• Most of us show symptoms typical of one or more mental health conditions to some degree at some time.

• According to the mental health charity Mind, around 25% of people in England will experience a mental health problem in any given year.

• Many people ignore severe symptoms and continue with their daily lives

• It tends to be at the point that we cease to function adequately that people seek professional help or are noticed and referred for help by others.

• This criterion means that treatment and services can be targeted to those who need them most.

Limitation of Failure to function adequately - Discrimination and social control

• Failure to function is open to abuse.

• In practice it can be very hard to say when someone is really failing to function and when they have simply chosen to deviate from social/cultural norms.

• For example people who favour high-risk leisure activities or people with alternative lifestyles who choose to live 'off-grid'.

• This means that people who make unusual choices are at risk of being diagnosed with a mental health condition and their freedom of choice may be restricted.

Strength of statistical infrequency - Real-world application

• Statistical infrequency is useful.

• Statistical infrequency is used in clinical practice, both as part of formal diagnosis and as a way to assess the severity of an individual's symptoms.

• For example a diagnosis of intellectual disability disorder requires an IQ of below 70 (bottom 2%).

• An example of statistical infrequency used in an assessment tool is the Beck depression inventory (BDI). A score of 30+ (top 5% of respondents) is widely interpreted as indicating severe depression.

• This shows that the value of the statistical infrequency criterion is useful in diagnostic and assessment processes.

Limitation of statistical infrequency - Unusual characteristic can be positive

• Infrequent characteristics can be positive as well as negative.

• For every person with an IQ below 70 there is another with an IQ above 130.

• Yet Nobody thinks it's a negative to be super intelligent by having an IQ above 130.

• Similarly, we would not think of someone with a very low depression score on the BDI (depression test) as lacking good mental health.

• So, being unusual or at one end of a psychological spectrum does not necessarily equate to 'lacking good mental health'.

• This means that, although statistical infrequency can form part of assessment and diagnostic procedures, it is never sufficient as the sole basis for defining mental health.