Biomedical Vs Social Approaches to Mental Health Difficulties To explore the contrast between the biomedical and social approaches to mental health. To appreciate that there are a range of view points regarding the approach to mental health

In 1845 one of the motivating beliefs was that medicine would cure insanity.

Drug Treatment The film ‘One flew over the cuckoo’s nest’ demonstrates the way in which drugs are handed out like ‘smarties’ – merely to keep the patients subdued. In the film the same type of drug is given to every patient with no regard for the individual’s case history or symptoms.

One flew over the cuckoo’s nest - Medication time (4.28mins) https://www.youtube.com/watch?v=RGRD6JBnHrU One flew over the cuckoo’s nest - Medication time (4.28mins)

Does ‘doctor’ really know what’s best? Health educators take on the responsibility of telling people what to do and what not to do Their expert led activity reinforces the authority of medical and health professionals Health promoters get people to comply and cooperate with treatment They can be authoritarian – threatening or negative in tone They assume people behave rationally and follow instructions

Strengths of the biomedical approach It has given insight into the causes of some conditions, such as Alzheimer's disease, an organic condition causing confusion in the elderly. The sickness label has reduced the fear of those with mental disorders. Historically, they were thought to be possessed by evil spirits or the devil – especially women who were burned as witches!

Anti-psychotic drug treatment has long been established as a relatively cheap effective treatment, which rapidly reduces symptoms and enables many people to live fairly normal lives (Van Putten, 1981)

Weaknesses The treatments have serious side-effects, for example ECT can cause memory loss, and they are not always effective. Drugs may not 'cure' the condition, but simply act as a chemical straitjacket. There are also ethical problems in labelling someone mentally ill – Thomas Szasz (1974) says that, apart from identified diseases of the brain, most so-called mental disorders are really problems of living. Labelling can lead to discrimination and loss of rights.

The medical model has been the one that has been most influential in determining the way that mentally disturbed people are treated, but most psychologists would say that at best, it only provides a partial explanation, and may even be totally inappropriate.

Pro’s & Con’s Between 50 – 65% of patients benefit from drug treatment Patients welcome drug therapy, as it is quicker, easier and less threatening than talk therapy Drug treatment is usually superior to NO treatment Relapse is likely when drugs are discontinued Drugs do not deal with the cause of the problem, they only reduce the symptoms Anti-psychotics can produce a range of side effects, including motor tremors and weight gain (this can lead to pt’s discontinuing treatment) Can cause dependency

Points to discuss… Does drug therapy work? How much does it cost the NHS? Why are the numbers increasing not decreasing? What if people don’t have the time for talking therapies? Do the government initiatives help? Are MH difficulties just ‘problems of living?’

Psychiatry is a fraud and all about control…(9.05 minutes) https://www.youtube.com/watch?v=BhC6hUZJIJ0

What’s wrong with the medical approach? Doesn’t promote positive health Ignores social and environmental dimensions of health Ignores other factors which affect people’s beliefs and values which influence health related behaviour Is the expert always right? ECT treatment? Ignores the need to motivate people

Electro-Convulsive Therapy Electro Convulsive Therapy (ECT) began in the 1930’s after it was noticed that when cows are executed by electric shocks they appear to convulse as if they are having an epileptic shock. The idea was extrapolated to humans as a treatment for schizophrenia on the theoretical basis that nobody can have schizophrenia and epilepsy together, so if epilepsy is induced by electric shock the schizophrenic symptoms will be forced into submission!

ECT side effects include impaired language and memory as well as loss of self esteem due to not being able to remember important personal facts or perform routine tasks. There is a debate on the ethics of using ECT, primarily because it often takes place without the consent of the individual and we don’t know how it works!

Clips on mental health attitudes https://www.youtube.com/watch?v=QW0ZTPNZESY

Preparation for the guest speaker Margaret Mental Health Therapy What is it? What is available? Who will benefit the most?

References Breggin, P. R. (1979). Electroshock, Its Brain-disabling Effects. New York: Springer Publishing Company. Van Putten, T., May, P. R., Marder, S. R., & Wittmann, L. A. (1981). Subjective response to antipsychotic drugs. Archives of General Psychiatry, 38(2), 187-190 Szasz T.S. (1974) The myth of mental illness. In: Ideology and Insanity. Penguin, Harmondsworth