A new review of theoretical models used around the world to assess, diagnose, investigate and treat mental health problems has highlighted the wide range of approaches that exist.
Theoretical models refer to a theory, or set of theories, that seek to explain how a problem should be understood and responded to. A model for mental health problems refers to the causes and characteristics of the condition.
By examining more than 100 publications that referred to “mental health” or “mental illness” in some way, researchers from the University of Bath (UK) and Bern University of Applied Sciences (Switzerland) identified some 34 theoretical models used by professionals, researchers and users of mental health services to understand the nature of mental health problems.
Importantly, they found no criteria that could be used to prioritize why one model might be used over another. This is important, they say, because the way mental health problems are understood has lasting ramifications for the way people with mental health problems are assessed and supported.
These ranged from biological models (focusing on problems with the body or brain), to psychological (focusing on the mind and behavior), to sociological (focusing on how social circumstances affect people), to models that were informed by considerations cultural and consumer (reflecting the experiences of people who have been treated by mental health services and considering how treatments should be adapted to different cultures).
While policymakers and practitioners have previously attempted to reach a consensus on the use of so-called “bio-psycho-social models,” an umbrella term that draws on elements from all the different models, this consensus appears to be fractured. say the researchers.
Posting your review on the mental health magazine, the team says their findings have important implications in light of the sharp rise in diagnosed mental health problems. According to the Mental Health Foundation, in the last week alone, an estimated one in six of us will have experienced a common mental health problem. However, such figures depend on how the mental health problem is understood and measured.
co-investigator, doctor jeremy dixon from the Department of Social and Policy Sciences at the University of Bath and the Center for Social Policy Analysis explains: “Uncertainties about what constitutes a mental health problem have become more pronounced in recent decades due to the increase in the number of identified mental health conditions. in manuals used by general practitioners and psychiatrists.
Professor Dirk Richter, from the Bern University of Applied Sciences adds: “Mental health problems are often presented as something that medicine and psychiatry understand. However, there is still debate about what exactly mental health problems are and how they should be treated. These are not just academics. Questions like, ‘what are mental health problems?’ or ‘what counts as a mental illness?’ have impacts within health systems. They can affect decisions about who can receive a mental health service and how behaviors such as aggression can be interpreted.”
“One way out of this problem could be to ask service users which model they think is most appropriate for them and their treatment. However, the consequence would be that non-medical models could become more important than doctors would be willing to accept.
In view of the wide range of models being used by practitioners, the researchers now call for greater clarity on how different and potentially contractive models of mental health can be used in practice. They argue that this debate needs a greater contribution from non-medical professions and service users.
“Mental health professionals tend to say that they use a biopsychosocial model in their daily work, but our research shows that this model is breaking down. While this field has been dominated by psychiatry and psychology, the perspectives of service users and other professionals, such as nurses and social workers, are now beginning to be heard,” adds Dr. Dixon.
“Mental health services must recognize the wide range of perspectives now held by those who use services. Rather than insist that service users accept biological or psychological perspectives, mental health professionals need to understand and work with people’s preferences,” says Professor Richter.
Reference: Richter D, Dixon J. Models of mental health problems: a quasi-systematic review of theoretical approaches. mental health magazine. 2022;0(0):1-11. do:10.1080/09638237.2021.2022638
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