On November 17, Scientific American published on its MIND blog website Why We Need to Abandon the Disease-Model of Mental Health Care, by Peter Kinderman, PhD.
Here are some quotes:
“The idea that our more distressing emotions such as grief and anger can best be understood as symptoms of physical illnesses is pervasive and seductive. But in my view it is also a myth, and a harmful one. Our present approach to helping vulnerable people in acute emotional distress is severely hampered by old-fashioned, inhumane and fundamentally unscientific ideas about the nature and origins of mental health problems. We need wholesale and radical change, not only in how we understand mental health problems, but also in how we design and commission mental health services.”
“It’s all too easy to assume that mental health problems — especially the more severe ones that attract diagnoses like bipolar disorder or schizophrenia — must be mystery biological illnesses, random and essentially unconnected to a person’s life. But when we start asking questions about this traditional disease-model way of thinking, those assumptions start to crumble.”
“But things are changing. Over the past 20 years or so, we’ve seen a very positive and welcome growth of the user and survivor movements, where people who have experienced psychiatric care actively campaign for reform, and signs of more responsible media coverage. We are just starting to see the beginnings of transparency and democracy in mental health care. This has led to calls for radical alternatives to traditional models of care, but I would argue that we do not need to develop new alternatives. We already have robust and effective alternatives. We just need to use them.”
“This also means we should replace traditional diagnoses with straightforward descriptions of problems. We must stop regarding people’s very real emotional distress as merely the symptom of diagnosable ‘illnesses’. A simple list of people’s problems (properly defined) would have greater scientific validity and would be more than sufficient as a basis for individual care planning and for the design and planning of services.”
“This is an unequivocal call for a revolution in the way we conceptualize mental health and in how we provide services for people in distress, but I believe it’s a revolution that’s already underway.”
Dr. Kinderman is Professor of Clinical Psychology at the University of Liverpool. He has been an ardent critic of psychiatry’s medical model, and has argued cogently and consistently for a genuinely psychosocial approach.
What is particularly noteworthy and gratifying is that Dr. Kinderman’s excellent article appeared on the website of Scientific American, a reputable, mainstream science magazine for the past 66 years.
For decades psychiatry has been very successful in selling the fiction that their concepts and practices are firmly grounded in empirical science. With the help of their pharma allies, they marketed themselves as rigorous scientists delivering evidence-based treatment for every conceivable problem of thinking, feeling, and/or behaving.
But the reality has overtaken the spin. And the publication in a mainstream scientific outlet of an article like Dr. Kinderman’s is a milestone to be noted and celebrated.