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Definition of Mental Health:

It took me a really long time to get to post, but I reallywanted to give the issue of Mental Health, Health and Illness a great deal ofthought before I committed anything to writing.

I want to start of by saying that I really began by feelinga great deal of sympathy to Paul’s position. Having studied psychology, Ibelieve that the DSM is really a very bad way to think about Mental Health andIllness. Furthermore, it seems there are a lot of places in the field of mentalhealth that are poorly served by the medical model. I think Paul made thosepoints quite well. Yet I was still somewhat uneasy with the idea that there isnot such thing as illness when related to mental health.

I spent some time talking to a couple different people inthe field and also re-reading some old articles and these are my conclusionsfor the time being.

First I think that its easy to pick on the illness model, becauseit’s actually a limited model even in medicine. As Paul lays out the medicalmodel, the lack of complexity seems to apply well to a broken arm but not to acase of diabetes or heart disease. Diabetes or heart disease, seem tocorrespond better to Paul’s description of mental illness.  They have complex causes and I think theywould best be seen through more complex lenses than medicine currently tends totreat them.

There are ofcourse many holistic approaches that have beenbecoming more popular that deal with illness in a broader context and give “cures”that involve lifestyle on a whole.

So to a certain extent I think the illness model is a bit ofa paper tiger.

But I also had another critique of the model that came outof talking with my father who is a psychologist that works with schizophrenics. I asked my father whether he thoughtthat it helped schizophrenics think about their condition as an illness. Hethought that it was actually quite helpful and did not need to be stigmatizing.

He pointed out that to begin with as a society we tend toview mental health in much more stigmatizing ways than as an illness.  For most of our recent history mental illness(or difference) has either been criminalized, treated as demonic or dismissedas just crazy. In contrast to these, the idea of illness is actually a verycompassionate and meaningful advance.  Wedon’t stigmatize people for having cancer and we are less likely to stigmatizethem for mental illness. 

The Illness model can also help people think about theirconditions from a disease management perspective. A diabetic knows that theyneed to monitor their diet and educate themselves about the feelings that goalong with different levels of blood sugar. In the same way a schizophrenic caneducate themselves about brain differences that accompany schizophrenia and thedifferent ways that this differences can affect their lives.

Having said all of that I feel that the problems of thedisease model extend throughout the field of mental health. For example, is itreally helpful for us to think about ADD from a disease perspective.  Here it really seems that we are stretchingthe boundaries of disease into very murky waters indeed.

After a lot of thought, my conclusion is:

1.      The disease model is usefulbut limited for both mental health and physical health. All health and lack ofhealth has the potential to be very complex. We should always honor and seek tounderstand diversity as it effects human health.

2.      The division betweenphysical and mental is a very problematic one. All mental phenomena have aphysical correlate and vice versa. Back pain (and pain in general) is a mentalphenomena. We must remember this both in the treatment of mental health andphysical health.

3.      We need to think deeplyabout a good definition of health and illness that deals with both on aholisitic level, without stigmatizing, but still opening up our ability toreally help each other.