Mental Health – If You’re Struggling, Do You Have Any Idea Why? Are you Medically Ill?

Are Mental Health Issues The Same as Everyday, Medical Illnesses? If not, why the hell do we treat them as if they are?

Are issues to do with mental health treatable in the same way as regular, physical illnesses are?

Evidence suggests that treating mental health as you would physical health is the last thing you want to do.  Why?

Well, (long and drawn out) Meds to treat mental ‘ill-health’ (sic) have, as a side effect, the fact that they cause, err,  depression and anxiety, amongst other issues. Oh, and have and do lead to suicidal tendencies and thoughts… in some people …

And I certainly am a long way from being alone in believing that we should NOT ‘… use the language and logic of pathology to frame psychological problems …’ (Thomas & Bracken, in Rapley, Moncrieff & Dillon Eds. 2011 p 13). Especially where pathology is to do with ‘disease’ and the Royal College of Pathologists, who describe pathology as a ‘bridge between science and medicine’, appear to be giving pathology some kind of reified, determinist qualities it doesn’t deserve. We need therefore a different idiom (if that’s what is felt is needed here).  In other words, we should NOT BE USING a medical model to describe or diagnose mental illness (the word ‘illness’ is not attributable to, nor should it have a place within, the psychological lexicon).

However, the use of the medical model, is the one favoured by psycho-therapies currently in use in the NHS, especially where such therapies are ‘evidence based’ (Dallos, in Rapley et al, Eds. 2011). Especially where ‘evidence based’ is taken to mean research and therefore science based and thus forming the bridge between etc., etc., (see above).

In the medical model, in the NHS, my understanding is that such as DSM V (see earlier blog) and the WHO handbook of mental health and disease (earlier blog) are used to provide diagnoses. Which, given that it is our belief that psychological unwell-ness is not biologically determined (of an interior origin) but is rather the result of socio-economic and other environmental factors acting externally, would seem fairly counter-intuitive. If the causes of such unwell-ness, as I’m thinking of it, is external, how is a pill, administered internally and acting upon goodness knows what (the brain) going to help?

Thankfully, there is evidence that it is possible, in “…helping to reveal and resist madness-making (sic) paradoxes and practices of the mental health professions, and … to show how these (paradoxes and practices – my addition) are shaped and maintained by wider regimes of societally based inequality and oppression…’ (Dallos, in Rapley, et al (Eds.) 2011 preface).

As Dallos concludes his preface, he asks a rhetorical question; a question I have been asking asking myself for a good while – as a teacher, as a counsellor and latterly as a certificated clinical hypnotherapist; and I thank Rudi for asking it: “…If professionals like me can so easily be ignored by the medical professions what hope for the many who are less privileged?” (Dallos, R in Rapley et al, Eds., 2011 preface)

Don’t go away – there is more to follow …

Paul