Models of mental health & illness

SEMINAR
―MODELS OF MENTAL ILLNESS‖

Chairperson : Dr. K. S. Sengar
Presentee : Sudarshana Das Gupta
Discussant : Jaishankar Patel
Venue : Conference Hall
Time : 2:30 pm
Date : 02.08.2012

Presentation will be under the
following headings:
 Introduction
 Concept of Health
 Mental Health
 Concept of Mental Illness
 Mental health, Mental Ill-health and Mental
Illness
 History and significance of Mental Health
 Perspectives of Mental Health
 Criteria for Mental Health
 Models of Mental Illness
 Conclusion

W.H.O.'s definition of Health:

"A state of complete physical, mental
and social well-being and not merely
the absence of disease or infirmity."

Mental Health is defined as

―A state of well-being in which every individual
realizes his or her own potential, can cope
with the normal stresses of life, can work
productively and fruitfully, and is able to make
a contribution to his or her community.‖

Mental Illness is defined as
―Mental illness can be seen in purely sociological
terms, as a deviation from socially approved
standards of interpersonal behaviour, or as an
inability to perform one’s sanctioned social roles. In
social science literature it is generally agreed that
the mental illness refers to dysfunctional
interpersonal behaviour, judged to be dysfunctional
in terms of the norms and values held by the
observer‖ (International Encyclopedia of Psychiatry,
Psychology, Psychoanalysis & Neurology, 1992).

Mental Illness (Cont.)
―An illness with psychological or behavioral
manifestation and/or impairment in functioning,
due to social, psychological, genetic, physical or
biological disturbances.‖ (American Psychiatric
Association).

―Mentally ill person means a person who is in need
of treatment by reason of any mental disorder
other than mental retardation‖(Indian Mental
Health Act, 1987).

Mental health, Mental Ill-health and
Mental Illness
 It is a commonplace to view the
relationship between health and
illness — and, therefore, mental
health and mental illness — as
two ends of the same
Trent (1992),
The Canadian Ministry of
National Health and Welfare
(MNHW),1988
Downie et al (1990)
Groder, (1977)

History
 In the mid-19th century, William Sweetzer was the first to
clearly define the term "mental hygiene", which can be
seen as the precursor to contemporary approaches to
work on promoting positive mental health
 An important figure to "mental hygiene", would be
Dorothea Dix (1802–1887), a school teacher, who had
campaigned her whole life in order to help those suffering
of a mental illness, and to bring to light the deplorable
conditions which they were put it in. This was known as
the "mental hygiene movement".
 At the beginning of the 20th century, Clifford Beers
founded the National Committee for Mental Hygiene and
opened the first outpatient mental health clinic in the
United States of America.

Significance
 Evidence from the World Health Organization
suggests that nearly half the world's population is
affected by mental illness with an impact on their
self-esteem, relationships and ability to function in
everyday life.
 ―There is growing evidence that is showing
emotional abilities are associated with prosocial
behaviors such as stress management and physical
health‖ (Richards, Campania, & Muse-Burke (2010).
 The importance of maintaining good mental health is
crucial to living a long and healthy life.

Perspectives

 Sense of Responsibility
 Sense of Self-reliance
 Sense of Direction
 A Set of Personal Values
 Sense of Individuality
 Mental Well-Being
 Lack of a mental disorder
 Cultural and religious considerations

Maria Jahoda (1963) proposed the following
six characteristics of the mentally healthy
individual —

 Environmental mastery
 Undistorted perception of
reality
 Integration
 Autonomy
 Growth, self-development
and self-actualization
 Attitude towards Self

Models of Mental Illness
 Spiritual Model
 Moral Character Model
 The Statistical Model
 The Disease/ Medical/ Biological Model
— Genetics
— Neuroimaging
— Neurobiology
 Psychological Models
— Psychodynamic Model
— The Behavioural Model
• The Cognitive-behavioural Model
— Existential / Humanistic Model
 The Social Model
 Psychosocial Model
— The Social Learning Model
 Family Therapy Model
 Biopsychosocial Model

Thinking Emotional
Processes Processes

Learned Biological
Behaviours Processes

Spiritual Model

The first and oldest explanatory system for mental illness is spiritual.
From a traditional spiritual perspective, consciousness is seen as
resulting from or deeply connected to some supernatural force.
Usually, there is a religious narrative that explains that there are
good and bad forces in the world, and that suffering is a function of
either being possessed by the bad, or through the idea that the
afflicted have fallen out of favor with the good. This generally occurs
because of sin or related concept of immoral behavior that leads to
some form of badness or contamination.

Moral Character Model

The second explanatory system for mental illness is moral
character. In a nutshell, the position of moral character is that
there are virtues which one must learn, such as courage and
fortitude, honesty and integrity, compassion and grace that
enable on to live the admirable life.

The Statistical Model

Derived more from mathematics than from psychology, the
statistical model concentrates on the definition of abnormality.
According to this approach, abnormality is any substantial
deviation from a statistically calculated average. Those who fall
within the ―Golden mean‖ i.e. in short, those who do what most
people do, are normal, while those whose behaviour differs from
those of the majority are abnormal.

The medical model attributes mental
abnormalities to physiological, biochemical,
or genetic causes and attempts to treat
these abnormalities by way of medically
grounded procedures such as
psychopharmacology (drug therapy),
electroconvulsive therapy (ECT), or
psychosurgery (brain surgery).

Genetic models of mental disorder suggest
that psychopathology is inherited from
parents, and there is certainly evidence for
the familial transmission of many disorders.

The Medical Model (Cont.)

Neuroimaging

This system explains causation of mental illness in
terms of structural changes in different parts of
brain. It suggest that in various mental illness certain
ventricular atrophy, volumetric changes, reduction in
cortical volume can be seen which may be one of the
various contributory factors behind the causation of
illness.

The Medical Model (Cont.)
Neurobiology

• Here the belief is that the human is an
organism that consists of natural
functions designed by nature (i.e.,
natural selection operating on
genetics) and mental illness is the
breakdown of such functions. Thus,
just as a heart attack is a biological
disease characterized by the
breakdown of the functioning of the
circulatory system, mental illness
stems from malfunctioning
neurophysiological processes.

Psychological Models
 An important explanatory system for
mental illness is psychological in
nature. The general model here is that
the individual develops along a path
and attempts to adapt to their
environment. However, if the
individual fails to learn certain crucial
elements or learns the wrong
responses to new situations or adopts
short term solutions that have long
term maladaptive consequences, then
suffering and dysfunction result.

 Psychodynamic Model
 The Behavioural Model
 The Cognitive-behavioural Model
 Humanistic / Existential Model

Psychodynamic Model

 The core assumption of this approach is that the
roots of mental disorders are psychological.
They lie in the unconscious mind and are the
result the failure of defence mechanisms to
protect the self (or ego) from anxiety. Problems
are determined by the history of a person’s
prior emotional experiences, especially the
childhood ones or to be more specific, the
negative childhood experiences.

The Behavioural Model
This system believes that, only the study of directly observable
behavior, the stimuli and reinforcing conditions that control it
could serve as a basis for understanding human, behaviour,
normal or abnormal. The behavioural perspective is organized
around a central theme: the role of learning in human behaviour.

 The Cognitive-behavioural Model

The cognitive model understands mental disorder as being a
result of errors or biases in thinking. It explains how thoughts
and information processing can become distorted and leads to
maladaptive emotions and behaviour. Our view of the world is
determined by our thinking, and dysfunctional thinking can lead
to mental disorder. Therefore to correct mental disorder, what is
necessary is a change in thinking.

Humanistic / Existential Model
The humanistic model sees mental health problems as a
signal that an individual is failing to reach his or her potential
and that psychological growth has stopped.The humanistic
perspective views human nature as ―basically good‖. It
emphasizes present conscious processes – paying less
attention to unconscious processes and past causes – and
places strong emphasis on each person’s inherent capacity
for responsible self-direction. Its emphasis is thus on growth
and self-actualizing rather than on curing diseases or
alleviating disorders. The humanistic model does not believe
in labeling people by diagnosing them as having specific
mental disorders.

The Social Model

The social model suggests that the ways in which societies are
organized, not just biological and psychological characteristics of
individuals, must be considered as causal factors in mental illness. It
does not argue that people should not be held responsible for their
behaviour because they are victims of ―society‖, but they do suggest
that social structure imposes restrictions on behaviour as surely as
biological inheritance and that the effects of social conditions on
mental illness need to be understood, to explain both individual
distress and how that distress might be related to larger forces. The
social model regards social forces as the most important determinants
of mental disorder.

Psychosocial Model

This model explains the causation of mental illness due to the
effect of interaction of psychological and social factors.
Psychosocial factors are those developmental influences that
may handicap a person psychologically, making him or her
less resourceful in coping with social events.

Psychosocial Model (Cont.)

There are four basic categories of psychosocial
causal factors:
 Early deprivation or trauma
 Inadequate parenting styles
 Marital discord and divorce
 Maladaptive peer relationship
 The Social Learning Model:

Family Therapy Model

Laing & Esterson (1964) were among the first British writers to express the view
that individuals with mental illness were the victims of a pathological family
process. Family therapy usually begins by an approach that encourages all
members of the family to work together in resolving the conflict. The process is
designed to identify and change relationships where necessary. Attention is paid
to family interactions, especially to alignments and discord and the engagement
and disengagement of the different group members.

 Double Bind
 Schisms and Skewed Families
 Pseudomutual and Pseudohostile Families
 Expressed Emotion

Biopsychosocial Model

 Integration of:
 Biological
 Social
 Psychological (Esp. cognitive & behavioral)
 Abnormality caused by:
 Interaction of these factors – no one cause
 Relative importance of each factor depends on
individual and environment

Biopsychosocial Model
Feedback Loops
Psychological
Biological Emphasis on
Emphasis on psychological
biological factors, such as early
processes (e.g., childhood
genetics) experience and self-
concept

Feedback Loops Feedback Loops
Social
Emphasis on
interpersonal
relationships and
social environment

Biopsychosocial Model (Cont.)

 Explanations of mental illness:
Diathesis / Stress
 Physiological, sociocultural or genetic
predisposition to develop disorder

 Stressor that triggers manifestation of
disorder

MODELS OF ABNORMALITY
Behavioural Thinking & emotional processes Biological
processes processes
Conscious Unconscious

Learning
of
behaviour Faulty thinking
& perception
Repressed
memories
& emotions
Genetics
Structural
damage
Chemicals

Conclusion
 Current trends in delivery of care emphasize a
collaborative team approach
 The diverse explanations provide a range of
models that influence and direct current
approaches in the treatment and management
of people with mental health problems. The
dominance of the biomedical model is
increasingly being challenged by other
professional groups.

Models of mental health & illness

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