The Medical Model in Mental Health

2019 ◽  
Author(s):  
Ahmed Samei Huda
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Teaching And Learning ◽  
Clinical Decision Making ◽  
Mental Health Problems ◽  
Medical Model ◽  
General Medicine ◽  
Clinical Information ◽  
Clinical Decision ◽  
Mental Health Research

The medical model is a biopsychosocial model assessing a patient’s problems and matching them to the diagnostic construct using pattern recognition of clinical features. Diagnostic constructs allow for researching, communicating, teaching, and learning useful clinical information to influence clinical decision-making. They also have social and administrative functions such as access to benefits. They may also help explain why problems occur. Diagnostic constructs are used to describe diseases/syndromes and also other types of conditions such as spectrums of conditions. Treatments in medicine and psychiatry have several treatment objectives including cure or reducing distress and a variety of mechanisms of action apart from reversing disease/cure. Causation of conditions in medicine and psychiatry are often complex. The medical model allows doctors to assess and offer effective treatments to large numbers of patients and provide emergency cover. Diagnostic constructs in psychiatry and general medicine overlap for attributes such as clinical utility (e.g. predicting likely outcomes) and validity (e.g. lack of boundaries between different diagnostic constructs) and importance of social factors. There is an overlap in effectiveness between psychiatric and general medicine treatments and many general medicine medications do not reverse disease processes. Different mental health classifications have particular strengths and weaknesses for clinical, research, and social functions. Mental health research into understanding causes and mechanisms may need other classifications than diagnosis. As doctors in all specialties encounter mental health problems, there will always be psychiatric diagnostic constructs compatible with their training. Mental health research and service provision will always need to address psychosocial issues.

Final conclusions

2019 ◽  
pp. 305-318
Author(s):  
Ahmed Samei Huda
Keyword(s):  
Mental Health ◽  
Clinical Research ◽  
Health Research ◽  
Mental Health Problems ◽  
Medical Model ◽  
General Medicine ◽  
Mental Health Research ◽  
Psychosocial Issues ◽  
Social Functions ◽  
Large Numbers

The medical model in mental health uses diagnostic constructs with attached useful information (e.g. on prognosis or response to treatments) that often identifies areas of spectrums rather than diseases or syndromes. Diagnostic constructs in psychiatry and general medicine overlap for attributes such as clinical utility (e.g. predicting likely outcomes), validity (e.g. whether boundaries exist between different diagnostic constructs), and importance of social factors. There is an overlap in effectiveness between psychiatric and general medicine treatments, and many general medicine medications do not reverse disease processes. Describing the nature of diagnostic constructs can be done by describing the basis of classification and nature of the classified condition. Different mental health classifications have particular strengths and weaknesses for clinical, research, and social functions. Research in mental health may need classifications other than diagnosis to improve understanding of causes and mechanisms and also to develop better diagnostic constructs. As doctors in all specialties will encounter mental health problems there will always be psychiatric diagnostic constructs compatible with their training. The medical model of mental health allows doctors to assess and offer effective treatments to large numbers of patients and provide emergency cover. Mental health research and service provision will always need to address psychosocial issues.

Criticism of psychiatric diagnosis

2019 ◽  
pp. 89-104
Author(s):  
Ahmed Samei Huda
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Clinical Utility ◽  
Clinical Decision Making ◽  
Mental Health Problems ◽  
Medical Model ◽  
Clinical Decision ◽  
Negative Consequences ◽  
Causative Factors ◽  
Medical Diagnostic

Criticisms of psychiatric diagnostic constructs from a clinical/scientific view have been made on several points: reliability, such as how often two clinicians agree on the same diagnosis; validity, such as clear separation between diagnostic constructs or presence of objective validators; utility, such as predicting outcomes and treatment responses; implying an inaccurate conception of mental health problems as diseases that also minimizes the influence of social causative factors, high rates of co-occurrence, and association with negative consequences such as stigma. Many psychiatric diagnostic constructs lack validity but often have clinical utility. This clinical utility depends on how the clinician works therefore psychiatric diagnostic constructs are well suited to the medical model but may have little utility for other mental health professionals who work differently or for researchers testing hypotheses. Diagnostic constructs have utility for administrative purposes. The criticisms can be used to generate a set of questions to evaluate psychiatric diagnostic constructs. Psychiatric diagnostic constructs are best compared with general medical diagnostic constructs because they are used for similar purposes in clinical decision-making. A comparison will be made to see if there is no overlap, some overlap, or near total overlap between general medical and psychiatric diagnostic constructs.

scholarly journals Green walking groups: A mixed-methods review of the mental health outcomes for adults with mental health problems

2019 ◽  
Vol 83 (3) ◽  
pp. 162-171
Author(s):  
Tom Swinson ◽  
Jennifer Wenborn ◽  
Paul Sugarhood
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Health Outcomes ◽  
Clinical Decision Making ◽  
Mental Health Problems ◽  
Clinical Decision ◽  
Evidence Base ◽  
Health Problems ◽  
Mental Health Outcomes ◽  
Natural Environments

Introduction Evidence suggests group walking in natural environments is more beneficial to the general population’s mental health than walking indoors, in urban environments, and alone. Such ‘green walking groups’ have been suggested as an occupational therapy intervention that could be suitable for adults with mental health problems. However, there have been no reviews of the mental health outcomes of participating in green walking groups for this population. Method A mixed-methods literature review was conducted. A range of databases was systematically searched electronically. Papers that met pre-defined inclusion criteria were selected, critically appraised, and qualitative and quantitative data were extracted. Thematic analysis was used to identify key qualitative outcomes. Findings Six papers were included and eight mental health outcomes identified. The evidence suggests participants can experience connections with other people, connections with nature, and a sense of freedom. There is some limited evidence to support improvements to mood, self-esteem, reflection on life tasks, and symptoms of depression, with mixed evidence for experiencing a sense of achievement. Conclusion This review can be used to build the evidence base for the link between occupation and mental health, and inform the clinical decision-making of occupational therapists, who are well-placed to design and implement green walking groups.

scholarly journals Clinical decision making and the challenges of responding to mental health needs

2019 ◽  
Vol 11 (10) ◽  
pp. 434-439
Author(s):  
Trudy Hutchison ◽  
Carolyn Lees ◽  
Robyn Lotto ◽  
Alison White ◽  
Ron Harris
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Mental Health Problems ◽  
Clinical Decision ◽  
Health Needs ◽  
Mental Health Needs ◽  
Opportune Time ◽  
Key Issues ◽  
Specific Education

The paramedic service responds to emergency calls for a variety of reasons, many relating to mental health concerns. This qualitative study aims to explore the views and experiences of student paramedics in relation to clinical decision making for mental health calls. Focus groups were used to investigate the participants' perspectives. Thematic analysis was used to organise data and identify key issues. Findings suggested some disparity between what paramedic students were prepared for and the reality of public need. Clinical decision making in relation to those with mental health problems was significantly influenced by the current provision of mental health services and the lack of mental health-specific education for student paramedics. Current changes to the paramedic programme make this an opportune time for a review of curriculum content.

To The Question of Destigmatization of Psychiatry and Mentally III Persons In The Modern Society

2016 ◽  
Vol 33 (S1) ◽  
pp. S523-S523
Author(s):  
S. Vladimirova ◽  
V. Lebedeva ◽  
E. Gutkevich ◽  
A. Semke ◽  
N. Bokhan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mentally Ill ◽  
Health Research ◽  
Mental Health Problems ◽  
Mental Health Research ◽  
Health Problems ◽  
Mental Health Research Institute ◽  
Mentally Ill Persons

In recent decades, new medications have been developed that entailed possibility of rehabilitation and socialization of mentally ill persons.PurposeTo consider a phenomenon of destigmatization of mentally ill persons on the example of the analysis of screening-questioning in mental health service.MethodsRandomized screening-questioning of participants of Open Doors Day in the clinics of Mental Health Research Institute (Tomsk, Russia) in connection with World Mental Health Day in October, 2015.ResultsOne hundred and forty-six residents of Tomsk and inhabitants of the Tomsk Region as well as other cities visited Mental Health Research Institute. 76,5% of them visited mental health service for the first time. More than a half of visitors (51%) was the most able-bodied age group – 20-50 years old; elderly people – 20%. According to many-year observation of authors of the work, there is a gradual destigmatization of people with mental health problems. Process of destigmatization will develop further, and mass media should also be engaged in it. One more moment should be emphasized – reduction of self-stigmatization. Though people do not still aim to seek for psychiatric help at the appropriate institutions (they prefer to visit the psychiatrist of the catchment area policlinic), they after all started recognizing presence of the problem, understanding the need of its overcoming, and possibility of its correction.ConclusionThe attitude of society towards people with mental health problems and towards psychiatry reasonably changes, and this promotes further development in the field of help to patients and their relatives.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Virtual World Café Method for Identifying Mental Health Research Priorities: Methodological Case Study

2021 ◽  
Vol 19 (1) ◽  
pp. 291
Author(s):  
Michelle Banfield ◽  
Amelia Gulliver ◽  
Alyssa R. Morse
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Health Research ◽  
Virtual World ◽  
Mental Health Problems ◽  
Research Priorities ◽  
Research Process ◽  
Mental Health Research ◽  
Target Number ◽  
Single Room

People with lived experience of mental health problems as both consumers and carers can bring significant expertise to the research process. However, the methods used to gather this information and their subsequent results can vary markedly. This paper describes the methods for two virtual World Cafés held to gather data on consumer and carer priorities for mental health research. Several methodological processes and challenges arose during data collection, including the achieved recruitment for each group (n = 4, n = 7) falling significantly short of the target number of 20 participants per group. This led to departures from planned methods (i.e., the use of a single ‘room’, rather than multiple breakout rooms). Despite this, the participants in the virtual World Cafés were able to generate over 200 ideas for research priorities, but not identify agreed-upon priorities. Virtual World Cafés can quickly generate a significant volume of data; however, they may not be as effective at generating consensus.

Normality, subjectivity and mental health: A genealogy of Danish psychiatry, 1938–2017

2019 ◽  
pp. 136345931987410
Author(s):  
Malene Broch Clemmensen ◽  
Simo Køppe
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Research ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Interdisciplinary Approach ◽  
Mental Health Research ◽  
Health Problems ◽  
The Subject

The increasing prevalence of mental disorders together with the uncertain validity of psychopathological diagnostics challenges psychiatry as the primary home of studying, diagnosing and treating mental health problems and developing mental healthcare. This marks an emerging paradigmatical shift towards ‘alternative’ mental health perspectives. With the ambition of attending authoritatively in definitory practices, contemporary scholars of psychology, sociology, anthropology and philosophy call for an interdisciplinary approach to mental health, with a predominant focus on the subject. We argue that a paradigmatical shift of mental health requires structural–historical considerations of the foundations upon which subjectivity has been and still is manifested through psychiatry. On this basis, we critically investigate fluctuating psychiatric discourses on subjectivity, normality and pathology. We conducted a genealogical analysis of 13 psychiatric sources (1938–2017) focusing on ‘Psychopathy’ as a fluctuating diagnosis. We elucidate how subject concepts in psychiatry develop in parallel to subject concepts in society and culture, exemplified through convincing similarities between psychopathic symptoms and neoliberal ideals. Considerations like these, offer scholars valuable bases for mental health research and debate, and also valuable insights to healthcare professionals.

scholarly journals A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research

2018 ◽  
Author(s):  
Christopher Conway
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Research ◽  
Mental Health Problems ◽  
Psychological Symptom ◽  
Mental Health Research ◽  
Dimensional System ◽  
Dimensional Approach ◽  
Psychological Science ◽  
Research Areas

For over a century, research on psychopathology has focused on categorical diagnoses. Although this work has produced major discoveries, growing evidence points to the superiority of a dimensional approach to the science of mental illness. Here we outline one such dimensional system—the Hierarchical Taxonomy of Psychopathology (HiTOP)—that is based on empirical patterns of psychological symptom co-occurrence. We highlight key ways in which this framework can advance mental health research, and we provide a heuristic for using HiTOP to test theories of psychopathology. We then review emerging evidence that supports the value of a hierarchical, dimensional model of mental illness across diverse research areas in psychological science. These new data suggest that the HiTOP system has the potential to reform the study of mental health problems and to accelerate efforts to assess, prevent, and treat mental illness effectively.

scholarly journals Why psychiatry should engage with the media

2011 ◽  
Vol 17 (2) ◽  
pp. 82-84 ◽  
Author(s):  
Claire Bithell
Keyword(s):  
Mental Health ◽  
News Media ◽  
Media Coverage ◽  
Mental Health Problems ◽  
General Medicine ◽  
Mental Health Research ◽  
Health Problems ◽  
The Media ◽  
The Uk ◽  
Source Of Information

SummaryPsychiatry receives less media coverage than general medicine, and the coverage it does receive is four times as likely to be negatively framed. In addition, coverage of mental health problems is often negative in tone and mental health research tends to be underrepresented in the media. As the media is likely to be a key source of information for the general public about mental health and psychiatry, this is worrying. There are opportunities, however, to change this landscape; the UK national news media are keen to cover more stories about mental health problems and to feature more psychiatrists' comments in their coverage. By engaging with the media, psychiatrists have the chance to create better-informed media narrative.

scholarly journals Ethical challenges in mental health research with focus in Nepal

2018 ◽  
Vol 17 (1) ◽  
pp. 8-11
Author(s):  
Pratik Khanal ◽  
Sajana Maharjan
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Study Design ◽  
Health Research ◽  
Mental Health Problems ◽  
Mental Health Research ◽  
Health Problems ◽  
Vulnerable Population ◽  
Ethical Challenges ◽  
Ethical Guidelines

People with mental health problems are considered as vulnerable population by national ethical guidelines of health research in Nepal. There are different ethical challenges in research involving people with mental health problems. Ethical challenges are related to study design, autonomy, beneficence and nonmaleficence, justice, respect for the environment and consent taking process. Respecting the human rights of those with mental health problems is necessary during research and this requires research stakeholders to be responsible.

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