CRITICAL REVIEW ESSAY (WORD LIMIT = 1500 WORDS +/- 10%)
Critically analyse and evaluate the statement: “The medical model of mental illness disempowers and stigmatises patients because behaviours are pathologised”.
What do I need to do?
This assessment is worth 50 marks and involves each student individually completing a critical thinking essay reviewing and discussing some of the issues surrounding the diagnosis and social construction of mental illness.
In order to complete the Critical Review, you will need to attend the Modules 1 and 2 workshops or watch the Lectures for the online students, read the essential readings for Modules 1 and 2, and watch the “How Mad Are You?” video available on the unit’s Blackboard site in the Critical Review folder in the Assessments section of Blackboard. Once you have done that, you will need to do further research and provide an answer for this statement:
· Critically analyse and evaluate the statement: “The medical model of mental illness disempowers and stigmatises patients because behaviours are pathologised”.
In order to do this you will first need to do some research and take a position as to whether you agree with this statement or not (or part of it). You will then need to justify your position using high-quality credible supporting evidence (such as peer-reviewed journal articles) as well as actively defending your position against non-supporting evidence throughout your paper. You may not sit on the fence as to whether you agree with it or not. You must also use one of the individuals in the “How Mad Are You?” video as an example to illustrate a particular claim or claims you make in your paper.
How do I submit the assignment?
The assignment is to be submitted individually by each student online as a Word or Word compatible (NOT PDF) document using the Turnitin link and is due by 2359hrs (Perth, Western Standard Time) on Wednesday 13/04/2016 (Week 7). DO NOT JUST LOOK AT THE TURNITIN % SCORE – THERE IS NO “SAFE” % SCORE. YOU MUST LOOK AT THE REPORT ITSELF. It is your responsibility to ensure you submit your draft to Turnitin as early as possible before the due date so that you have enough time to act on the Turnitin feedback report in order to meet Curtin University’s Academic Integrity requirements. Please SAVE and PRINT a hardcopy for your records.
Please ensure your Turnitin submission title AND Word document file name is in the following format: StudentID_StudentFamilyName_AssignmentTitle e.g. 12345678_Windsor_CR
It is your responsibility to ensure that you have uploaded the correct document (e.g., not a draft or the wrong file) to the correct submission portal before the due date and time. Please double check on Blackboard that you have actually submitted a document to the submission portal rather than assume that everything must have gone through ok. If you have any problem uploading your assignment (e.g., if Turnitin or Blackboard aren’t working) please email the Unit Coordinator with a copy of your final assignment as soon as possible before the due date and time.
What is a Critical Review?
A critical review essay is a writing task that asks you to critically review, analyse, and evaluate literature related to a topic in order to provide a persuasive answer to a question or issue. Your paper must have a clear argument and position running through your writing that you justify with supporting evidence and defend against non-supporting or counter evidence throughout.
Your paper should:
· definitively and explicitly answer the question
· demonstrate you have critically analysed and evaluated your evidence and read widely
· have a clear argument and position throughout the paper which is explicitly stated in the introduction
· present credible evidence supporting your argument
· present credible evidence not supporting your position and provide a counter-argument and defence against this
· convince the reader that your argument and answer to the question is valid through the use of high-quality, peer-reviewed journal sources
· be critical and persuasive
· not just be a description of relevant literature
· be well structured and organised
Why is critical thinking important for health professionals and how does this assignment help me develop these skills?
Much of our thinking and many of our beliefs are biased, distorted, partial, and uninformed. Critical thinking is the disciplined, intellectual process of ensuring that you use the best thinking you are capable of on the best evidence base you have available in any set of circumstances. It is using and applying skilful reasoning as a guide to your beliefs and actions as a health professional. For health professionals, critical thinking is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe practice and quality care. It is about deeply questioning, investigating, and evaluating the evidence on which you base your beliefs and use to make clinical decisions.
In health care, there is rarely only one “right” answer, intervention, or solution for an issue or problem – there are usually multiple “right” answers, interventions, or solutions. As a health professional, it is your role to determine which answer, intervention, or solution will provide the best outcome for that particular patient at that particular point in time. Developing effective critical thinking skills assists you consistently make the best choices for your patients and provide safe quality care. This assignment allows you to examine your current beliefs about psychopathology and diagnosis by critically analysing and evaluating the relevant research literature. Through developing and justifying and defending your position throughout your assignment, you will be critically evaluating the evidence base on which you hold these beliefs.
Do I need a cover page / title page / contents page for the Critical Review?
Do not include an assignment cover page / title page / contents page for the Critical Review assignment. Don’t attach the marking rubric. These pages adversely influence the Turnitin report.
Why does the Critical Review need to be submitted as a Word document?
This is so we can give you lots of feedback and comments on your assignment using the track changes function in Word. It is much more difficult to add this sort of feedback on a PDF. You don’t need to specifically use Microsoft Word to do the assignment – you can use any other word processing software you like. As long as the document you submit is in a compatible format that Word can open (e.g., .doc, .docx, .rtf, .odt) then we can add feedback. If you are using a Mac then please make sure that your document can be opened by a PC.
Where can I find articles for my Critical Review?
I can’t seem to find any. Before I chose the essay question, I ran several literature searches and know that there are many relevant articles to help you answer the question. Make sure you are using article databases such as PsycINFO, MEDLINE, and CINAHL (these are all clickable links and will take you to the library links for these resources) to run your searches. PsycINFO is likely to find you the most relevant articles for this assignment and all assignments within the behavioural stream. Just using Google or Google Scholar will NOT find you the articles you need. Also, make sure that the search terms you are using will give the databases the best chance of returning the articles you want – use a variety of search terms. Perhaps try using a thesaurus to get synonyms for your search terms and try them instead. The library has a good guide that can also help you with your literature searches – libguides.library.curtin.edu.au/paramedicine and libguides.library.curtin.edu.au/nursing-and-midwifery
How old can my references be?
I rarely set a limit for the publication date of references in my assignments. This is because, at this level in your degree, students need to exercise their own judgement regarding whether a reference is an appropriate and valid source of information and evidence for a claim you are making in your paper. There are some very good references which fall outside the somewhat arbitrary 5-10 year limit I know Foundations suggests and whose information and findings are still valid. There is no publication date limit of references in the Critical Review assignment; however, if you choose to use an old article you will need to tell your reader why its findings are still valid and reliable in 2016 or your specific purpose in choosing to use an old article when newer research exists.
How many references do I need?
The minimum number of references you need for this assignment includes:
1) at least 2 references from any of the Module 1 and/or Module 2 essential readings, AND
2) 1 of the participants in the “How Mad Are You?” video as an example to illustrate a particular claim or claims being made in the paper, AND
3) a minimum of 8 additional peer-reviewed journal articles/studies sourced by you (not including the module readings)
Using only the minimum number of references for this assignment would score you in the “Needs Improvement” category of the rubric. You will need to find more peer-reviewed journal article references in order to score well in this rubric criterion (please see the rubric for more advice regarding using your literature). I strongly advise against using internet sources as evidence for your claims unless you explicitly provide a credibility evaluation of the source as part of your claim.
Where can I get some ideas for how to critique studies?
There are three articles on eReserve that will help you in critiquing your studies:
Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: Quantitative research. British Journal of Nursing, 16(11), 658-663. http://dx.doi.org/10.12968/bjon.2007.16.11.23681
Ingham-Broomfield, R. (2014). A nurses’ guide to the critical reading of research. Australian Journal of Advanced Nursing, 32(1), 37-44. Ryan, F., Coughlan, M., & Cronin, P. (2007). Step-by-step guide to critiquing research. Part 2: Qualitative research. British Journal of Nursing, 16(12), 738-744. http://dx.doi.org/10.12968/bjon.2007.16.12.23726
Chapter 6 of the NURS3001 textbook also has some very good ideas for critiquing research studies – Barkway. P. (2013). Research for health professionals. In P. Barkway (Ed.), Psychology for health professionals (2nd ed., pp. 130-155). Chatswood, NSW: Churchill Livingstone.
What’s included in the Critical Review’s 1500-word word limit (+/-10%)?
The word limit of 1500 words (+/- 10%) refers only the content within the paper itself and NOT to the citations, references, contents pages, and/or any cover page you might include (cover and contents pages etc. are not to be included).
What is the penalty if I go over the 1500-word word limit (+/-10%)?
We will stop reading at 1650 words. Any content words you include after this point will not be read or included in marking. Your reference list will still be read and assessed. It is important that you use your words wisely. Have a look at the “Writing Tips for Advanced Students” document in the Assessments section of Blackboard. It has lots of hints and tips for reducing your number of words without losing any important content.
Do I need to in-text reference for the Critical Review?
Yes. You must provide APA (6th edition) references for your content in the Critical Review whether it is paraphrased or quoted. Please note: you MUST give the page number (or paragraph number for an online source without identifiable page numbers) and enclose the text in quotation marks if you are directly quoting verbatim or copying from your source. Without both the page/paragraph number and quotation marks it is plagiarism and you can be referred to the academic misconduct panel for this. You don’t have to give the page/paragraph number if you are adequately paraphrasing from your source. I remind you that you can only use references for articles and books etc. which you have personally accessed and read yourself. You cannot use a reference if you have not read the original source – if you want to use a reference for something you have not read then you need to secondary cite this as per the example here: www.apastyle.org/learn/faqs/cite-another-source.
If you do not indicate that you are copying from your source (e.g., by failing to put a page number [or paragraph number for online sources without identifiable page numbers] and APA reference next to the copied material) AND/OR fail to also place this material in quotation marks AND/OR inadequately paraphrase your source material then you are plagiarising from your source and Academic Integrity proceedings will be instigated.
Here is the link to the most recent updated Curtin guide to APA referencing:
libguides.library.curtin.edu.au/c.php?g=202308&p=1332729
Also, here is the link to the APA manual which is available on reserve in the library: link.library.curtin.edu.au/p?CUR_ALMA2189023410001951
The APA itself also has a free online tutorial to assist you master referencing: www.apastyle.org/learn/tutorials/basics-tutorial
How do I format the Critical Review?
The Critical Review should be in critical persuasive/argumentative essay format. There is a template available on Blackboard called “Example Critical Review Essay Outline” in the Critical Review folder which will help you plan and draft your essay – it is only to help you draft your essay and you will need to submit your Critical Review in full sentence and paragraph format.
Some general academic writing and formatting APA requirements which are relevant to this assignment are:
· At least 11 point readable font (no Wingdings or swirly fonts)
· 1.5 line spacing throughout
· In full sentences (no dot points unless otherwise specified)
· Contractions (e.g., doesn’t, wouldn’t, couldn’t etc.) should not be used in academic writing
· Numbers under 10 should be in written format (e.g., ‘five’)
· Numbers over 10 should be in numeric format (e.g., ‘20’)
· All numbers (no matter how big) at the very beginning of a sentence should be in written format (e.g., “Thirty-five participants were interviewed.”
· E.g. and i.e. should only be used when in parentheses (AKA brackets). When outside parentheses use “For example,” for e.g. and “that is” for i.e.
· The word prove or its variants (such as proven, proves, or proved etc.) should not appear in your writing. Research hypotheses are only supported or not supported within defined terms of reference.
· Always try and paraphrase from your source rather than quote as it demonstrates that you have understood the material.
· Rather than asking question in your essays, you should be answering them for your reader.
· Please carefully proofread your paper and at least run the spelling and grammar check before submission.
Where can I get some ideas in how to write more critically, concisely, and effectively and improve my academic writing skills?
We’ve put together a document for you with some writing hints and tips called “Writing Tips for Advanced Students”. It is available in the Critical Review folder in Blackboard. We strongly recommend you read it – it is the standard of writing by which you will be assessed.
Curtin University also has some very good FREE online programs to help you with your academic writing skills: studyskills.curtin.edu.au
Here are some informative and funny guides to using apostrophes:
theoatmeal.com/comics/apostrophe, using semicolons: theoatmeal.com/comics/semicolon, and some commonly misspelt words: theoatmeal.com/comics/misspelling
Solution 1 of 3
Medical Model of Mental Illness Disempowers and Stigmatizes Patients because Behaviors are Pathologies
Introduction
The medical model stipulates that mental disorders are physically originative and hence need to be dealt with using medical approaches. Hence the diagnosis of mental illnesses using medical procedures by psychiatrists and the prescription of medication for patients as commonly observed in the health care setting. The practicability of this notion is highly questionable considering the fact that mental disorders take place in the mind and hence are exhibited through behavioral changes as opposed to physiological changes. This paper argues that the medical model of mental illness disempowers and stigmatizes patients because behaviors are pathologized. This paper first discusses the claimed physicality of the mental illnesses, then reviews the criteria used to diagnose the mental illnesses, and thirdly the medicalization of behavior by mental models. Later, this paper reviews how the medical model disempowers and stigmatizes patients, and the various biological biases that it upholds.
Medical Models and Patient Disempowerment
The debate on medical models and their applicability has been raging over the years, with different individuals taking on the contrasting sides and raising various arguments in effect. Nevertheless, it has been clear that in as much as medical models are predominantly applied by psychiatrists in the health care environment to diagnose and treat mental illnesses, less evidence has been established to link medical solutions to mental illnesses. To tart with, it is important to understand the basis on which proponents of medical models lay their arguments. Proponents of medical models argue that mental illnesses are physical in the sense that they have underlying physical deviations of the body from the norm that contribute to their occurrence (Deacon, 2013). As such, just like any other physical conditions that a body can experience, medical solutions become viable in treating such conditions. In this case, it is believed that alterations in the functionality of neurotransmitters or the brain, among other regions of the central nervous system, lead to the manifestations of the various symptoms observed in persons with mental disorders (Wand, 2013; Casstevens, 2010). Such a take is highly criticized considering the fact that unlike other medical or physical conditions such as typhoid or kidney failure, among others, that can be identified through biological tests, mental disorders such as schizophrenia or depression cannot be diagnosed using any tests (Pirutinsky, Rosen, Shapiro, & Rosmarin, 2010). This is because such conditions do not occur in the physique, but in the mind, whence their behavioral symptoms. Proponents of mental disorders thus mislead the practice of treating mental illnesses by targeting at the wrong etiology of mental illnesses, an aspect that has unmeasurable implications to the lives of the individuals diagnosed with mental illnesses.
To facilitate their diagnosis of mental disorders, instead of psychiatrists coming up with befitting biological tests that would allow for the identification of the physiological change that cause the occurrence of such disorders, they base their judgement on established criteria systems that have categorized mental disorders using sets of symptoms that are considered reflective of each condition (Johnstone, 2008). As such, a condition such as the Bipolar disorder is characterized with mania, feelings of worthlessness, diminished concentration, and thoughts of death, among other symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD) are some of the criteria systems that have been established to facilitate the diagnosis of mental disorders and to define the methods of treatment (Warelow & Holmes, 2011; Miller & Prosek, 2013). This paper argues that such systems are less practicable as mental disorders are behavioral and behavior is influenced by certain conditions, and hence the defined traits in the classification systems may not be obvious unless such conditions are in place. The criteria were established to work in the same way as criteria for diagnosing medical conditions such as typhoid work. In the case of such conditions as typhoid, the symptoms can be physiologically identified, an aspect that justifies the diagnostic approaches.
Nevertheless, in the cases of mental illnesses, the symptoms are behaviorally defined, hence they remained dependent of the underlying conditions that influence such behavior. This is clearly brought out in the video, “How Mad Are You”, uploaded by Verda Divina. The video involved a study in which ten characters were picked, five of whom had been diagnosed with mental illnesses, and taken to a castle, in which they were subjected to different tests while being watched by a panel of experts in psychiatry, who were required to identify the individuals with mental illnesses and the disorders they were diagnosed with (Liddell, 2008). Out of the five individuals with mental disorders, the panel of experts were only able to identify two cases. One of the participants in the study, Stuart, a male diagnosed with bipolar disorder, is an example in the disparities surrounding the medical model of mental disorders. As much as the panel of experts included individuals with great knowledge and many years of experience in psychiatry, they were unable to single out Stuart an individual with bipolar disorder. This is because the conditions under which Stuart may exhibit bipolar related symptoms such as mania and feelings of worthlessness were not present during the week that he was in the camp with other individuals (Liddell, 2008).
Proponents of medical models pathologize behavior (Harkness, Reynolds, & Lilienfeld, 2014). Behaviors characteristic of mental illnesses are distinctive and explainable using psychosocial approaches only. However, proponents of medical models argue that such behaviors are symptoms of underlying physical conditions (Wyatt, 2009). As such, it is argued that it is due to changes that take place in the normal functionality of the brain or other areas of the central nervous system that individuals develop mental disorder related behaviors. This perception is highly refutable considering the suppression of the abnormal behaviors of individuals with mental disorders in certain circumstances. Case in point, Stuart did not exhibit behaviors related to bipolar disorder throughout the test as a result of the conditions that could have induced manifestation of such behaviors (Liddell, 2008). Instead, he is seen as jovial and highly interactive withy others on his team and across the group, an aspect that made it difficult for the panel of experts to single him out as an individual with at least a mental disorder.
Considering the disparities in the medical model, it is clear that it disempowers and stigmatizes individuals labeled with mental illnesses (Murphy & Lupfer, 2014). By proposing that mental disorders can be explained in medial terms, the proponents of mental disorders argue that such individuals are diseased. This implies that they are having a disease and hence the suggestion for medical solutions. This paper argues that by labeling individuals as being diseased and requiring medical attention, medical models take the power of recovery away from the patients (Pirutinsky, Rosen, Shapiro, & Rosmarin, 2010). Behavioral conditions require the primary involvement of the patients in adjusting their behaviors and being engaged in therapeutic sessions that will allow them to overcome the underlying factors that contribute to their current behaviors. Labeling patients as being abnormal and diseased leads to self-stigmatization where individuals develop feelings of hopelessness (David & Sartorius, 2013). In addition, such persons may face stigmatization from the society, an aspect that leads to social isolation, which further aggravates their conditions and behaviors (Nesse & Stein, 2012). In the video by Divina, Yasmin, another of the participants in the test identified a moment during his childhood, when she started exercising depression when she found no reason to wake up as she felt isolated by the people around her. She further explained that when the judges told her that they believed that she was among the persons that did not have mental illnesses during their first meeting, she felt vindicated (Liddell, 2008). This means that she initially felt as if she was being blamed and that she was now justified.
Biological models are biased in their approach to mental disorders such that they base their description of mental disorders on notions that contradict scientific approaches. Case in point, in as much as the proponents of medical models argue that mental disorders are manifestations of hidden physical conditions, no scientific methods have been developed to allow for the diagnosis of the physical conditions that lead to mental disorders (Gambrill, 2014; Scott, 2010). The practicability of the theorized conditions thus remains at bay and unproven. In addition, in as much as psychiatrists acknowledge then behavioral manifestation of mental disorders, they tend to emphasize their treatment using medical approaches, as opposed to behavioral or psychosocial approaches (Lewis, Laçasse, & Spaulding-Givens, 2010). This downplays the scientific rationale for treating of behavioral conditions.
Conclusion
It is evident that the
medical model of mental illness disempowers and stigmatizes patients because
behaviors are pathologized. Proponents of medical models fail to acknowledge that
mental illnesses are behavioral and of no physical roots and hence should be
handled using psychosocial solutions. The medical models base their judgement
of individuals as having mental disorders on developed criteria, without
establishment of scientific tests that can allow for diagnosis of the
conditions like other “similar” medical conditions. Such approaches are detrimental
to the quality of life of the affected patients as they medicalize their
conditions and hence take the power to adjust behavior from the patients even
as they insist that their problems are medical. As such, proper measures should
be put in place to ensure that behavioral models are implemented in
facilitating healing among individuals with mental illnesses.
References
Casstevens, W. J. (2010). Social Work Education on Mental Health: Postmodern Discourse and the Medical Model. Journal of Teaching in Social Work, 30(4), 385-398.
David, A. S., & Sartorius, N. (2013). Has psychiatric diagnosis labelled rather than enabled patients? BMJ: British Medical Journal, 347(7920), 20-21.
Deacon, B. J. (2013). The biomedical model of mental disorder: a critical analysis of its validity, utility and effects on psychotherapy research. Clinical Psychology Review, 33(7), 846–861.
Divina, V. (2016, February 26). BBC Horizon How Mad Are You. Retrieved from YouTube: https://www.youtube.com/watch?v=2G4SqtCq8kA
Gambrill, E. (2014). The diagnostic and statistical annual of mental disorders as a major form of dehumanisation in the modern world. Research on Social Work Practice, 24(1), 13-36.
Harkness, A. R., Reynolds, S. M., & Lilienfeld, S. O. (2014). Review of Systems for Psychology and Psychiatry: Adaptive Systems, Personality Psychopathology Five (PSY-5), and the DSM-5. Journal of Personality Assessment, 96(2), 121-129.
Johnstone, L. (2008). Psychiatric Diagnosis. In R. Tummey, & T. Turner (Eds.), Critical Issues in Mental Health (pp. 5-22). Hampshire: Palgrave Macmillan.
Lewis, S. J., Laçasse, J. R., & Spaulding-Givens, J. (2010). Mental Illness Beliefs Inventory: A Preliminary Validation of a Measure of the Level of Belief in the Medical Model of Mental Illness. Ethical Human Psychology & Psychiatry, 12(1), 30-43.
Miller, R., & Prosek, E. A. (2013). Trends and Implications of Proposed Changes to the “DSM-5” for Vulnerable Populations. Journal of Counseling & Development, 91(3), 359-366.
Murphy, E., & Lupfer, G. (2014). Basic principles of operant conditioning. In F. McSweeney, & E. Murphy (Eds.), The Wiley Blackwell handbook of operant conditioning (pp. 167-194). West Sussex, UK: John Wiley & Sons.
Nesse, R. M., & Stein, D. J. (2012). Towards a genuinely medical model for psychiatric nosology. BMC Medicine, 10(1), 5.
Pirutinsky, S., Rosen, D., Shapiro, S. R., & Rosmarin, D. (2010). Do medical models of mental illness relate to increased or decreased stigmatization of mental illness among Orthodox Jews? Journal of Nervous & Mental Disease, 198(7), 508-512.
Scott, H. (2010). The medical model: the right approach to service provision? Mental Health Practice, 13(5), 27-30.
Wand, T. (2013). Positioning mental health nursing practice within a positive health paradigm. International Journal of Mental Health Nursing, 2, 116-124.
Warelow, P., & Holmes, C. (2011). Deconstructing the DSM-IV-TR a critical perspective . International Journal of Mental Health Nursing, 20(6), 383–391.
Wyatt, W. J. (2009). Behavior analysis in the era of medicalization: Current state of the science and recommendations for practitioners. Behavior Analysis in Practice, 2(2), 49-57.
Solution 2 of 3
Medical model of Mental Illness Disempowers and Stigmatizes Patients Because Behaviors are Pathologies
A medical model is an approach to mental health issues that incorporates aspects of biology and science without either of the two being synonymous. This model views mental illness like any other form of physical ailment such as breaking an arm in that they are a cause of the injury in this case the injury being mentally inflicted. The proponents believe there is a physical cause of mental illness just like any other disease or illness that a patient may be physically suffering from. Therefore, supporters consider symptoms to be the outward manifestation of the inner physical disorder, and they believe that if these signs are grouped together and are classified into what is known to be a syndrome then the real cause of the disease can be discovered and the proper treatment can be administered (McLeod, 2016).
The model encourages practitioners in the field of mental health to be aware of their perspectives and personal interests that may influence how they treat their patients and to compare their views with other practitioners in the field consistently. It pushes them to aspire towards maintaining the objectivity that can be tested against what others believe since expertise only becomes efficient in the area if it accompanied with objective perspectives and observations.
The context of the relationship between the doctor, patient and culture are also considered to be a matter of importance. The patient is regarded as a passive recipient while the physician becomes the active agent. In simple terms, the patient had a problem that was fixed by the doctor, and this interaction is made possible through the payment of a fee for the services. Since one party has the expertise and the other holds the means of facilitating the service it is expected that one party will seek out the other and try to receive a rapid and efficient response.
In the medical model, the biological view of psychopathology holds that disorders have a physical or organic cause. Thus, they lay their focus on genetics, neuropsychology, neurotransmitters, and neuroanatomy. The proponents argue that mental illness is related to the functioning of the brain and the physical structure. Behaviors that are displayed such as hallucinations, phobias, and suicidal ideas are signs of mental illness (“Mental Health & Stigma”, 2016). The different diseases can be noted as clusters of symptoms that are caused by a particular disease and can be grouped together. Symptoms, in turn, lead the psychiatrist or relevant medical practitioner to make the right diagnosis based on their manual of reference. Based on the patient’s behavior the doctor makes a judgment during a clinical interview by making observations and what the relatives of the patients say about the client.
The diagnostic criteria that are used should be both valid and reliable to prevent cases of misdiagnosis. Kraeplin published one of the first diagnosis criteria in 1883. He claimed that a particular group of symptoms and signs that occur together when a patient is suffering from an individual mental illness(Pickren& Zimbardo, n.d.). These symptoms have to occur frequently and sufficiently for them to be referred to as a disease. Thus, according to his theory, every mental illness has a distinct origin, course, symptoms, and outcomes that are unique from another and that occur together. His work is the basis of the modern classification systems that are used today such as the diagnostic and statistical Manuela of mental disorders and the international classification of diseases.
According to these manuals, a particular sand systematic method is used in the diagnosis and treatment of a patient. First, a clinical interview needs to be carried out whereby the doctor collects information from the client and the relative. Then the doctor carefully observes the behavior of the patient that is the mood, the state of emotions, the body language, and etcetera. Then the doctor reviews the client’s medical history from the previous medical records and notes down relevant information that will be helpful in the diagnosis of the current case. Lastly, psychometric tests are used to collect more information in a scientific and reliable manner that will be instrumental in the final diagnosis of the client. Based on the determinations that the doctor will make treatment will be prescribed after that such as psychosurgery, electroconvulsive therapy and use of drugs (Diagnostic and statistical manual of mental disorders, 2013).
Recent studies have shown that diagnosis is not a reliable tool in showing what the client is suffering from(“Models of Mental Health”, 2016). An experiment was conducted to confirm whether psychiatrists would be able to tell reliably apart people who were not mentally ill from those who were. The study consisted of two conditions whereby individuals who were not mentally ill were sent to a hospital for diagnosis. The psychiatrists in this instance diagnosed forty-one out of one hundred and ninety-three patients as suffering from mental illness. In the other approach, eight people were instructed to report to the hospital while claiming they were experiencing hallucinations then soon as they would be admitted they behave normally. The psychiatrists diagnosed these set of patients as suffering from dormant schizophrenia. This study brings to question the reliability and validity of the method of diagnosis that mental practitioners use. The conclusion was that no psychiatrist could distinguish between a sane and an insane person.
There are some mental illnesses as classified in the Diagnostic and statistical manual of mental disorders the most common being schizophrenia, depression, and obsessive-compulsive disorder. There are drugs such as mono-amine oxidase inhibitors and selective serotonin reuptake inhibitors that are used to treat depression and obsessive-compulsive disorder while for schizophrenia drugs such as chlorpromazine, pimozide and risperidone are typically used (“Mental health”, 2014). Antipsychotics have been classified as drugs which are effective for treatment as they rapidly reduce one’s symptoms enabling people to live normally. However, relapse is likely when the intake of medicines is discontinued, and not everyone benefits from drug treatments.
Drugs are efficient during the time when the illness breaks out, but they do not address the cause of the problem, they only deal with the symptoms. They also have side effects such as weight gain and muscle tremors while others create dependency. Therefore, a multi-dimensional approach is required to be used for there to be a complete recovery from the disease, drugs and therapy should be used hand in hand. Electroconvulsive therapy is also another mode of treatment used when all else fails. The procedure entails the patient receiving anesthetic and muscle relaxant before the shock and oxygen are administered to the brain for half a second. A resultant seizure lasts for a minute. This form of therapy when used is applied three times a week for a total of five weeks. The very final result when electroconvulsive therapy and drugs have failed is psychosurgery. It involved removing brain nerve fibers or burning parts of nerves that are believed to cause the disorder when the patient is not conscious.
The medical model of mental illness carries with it some form of stigma due to the labeling of someone who is mentally ill. The labeling can lead to discrimination, yet most of the mental disorders are problems associated with one’s lifestyle. It has also been related to being the most influential when it comes to determining how people who are mentally ill are treated yet the model provides only partial information concerning the disease. Views such as people with mental illness are prone to violence or are aggressive in nature and that their behavior is unpredictable are a byproduct of the model. The medical model implies that mental health issues are similar to physical illness and may result from a natural or medical dysfunction. This gives the impression that mentally ill people are in some way different from the normally functioning individuals. Secondly, as noted above the model implies a label that is applied to a patient in diagnosis. This label could be associated with many undesirable attributes such as insaneness that would lead to them being treated differently and with caution that creates fear for those who are mentally ill causing people to segregate themselves(Bhadra, 2012).
References
Bhadra, M. (2012). Mental Health & Mental Illness: Our Responsibility. Health Renaissance, 10(1). http://dx.doi.org/10.3126/hren.v10i1.6014
Diagnostic and statistical manual of mental disorders. (2013). Washington, D.C.
McLeod, S. (2016).Medical Model – Treating Mental Disorders | Simply Psychology.Simplypsychology.org. Retrieved 5 April 2016, from http://www.simplypsychology.org/medical-model.html
Mental health. (2014). The Pharmaceutical Journal. http://dx.doi.org/10.1211/pj.2014.11138875
Mental Health & Stigma.(2016). Psychology Today. Retrieved 5 April 2016, from https://www.psychologytoday.com/blog/why-we-worry/201308/mental-health-stigma
Models of Mental Health.(2016). Serendip.brynmawr.edu. Retrieved 5 April 2016, from http://serendip.brynmawr.edu/sci_cult/mentalhealth/models/mentalhealthmodels2.html
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Solution 3 of 3
Medical model of Mental Illness Disempowers and Stigmatizes Patients Because Behaviors are Pathologies
Introduction
The question of applicability of medical models has faced increased debate over the past decades, with psychiatrists and psychologists coming head to head on whether mental disorders are behavioral or medical. It is without a doubt that medical models have dug their roots deep into health care practice, forming the most common approaches towards mental disorders across the globe, with different individuals being forced to submit to pharmacological solutions for having distinctive behaviors that are deemed sub-optimal. As much as proponents of medical models have come up with various ways of justifying the medical approaches towards treatment of mental disorders, it is clear that individuals diagnosed with medical models tend to be responsive of certain conditions or environments that either lead to exacerbation or suppression of their distinctive behaviors. As such, this paper establishes that the medical model of mental illness disempowers and stigmatizes patients because behaviors are pathologized.
Applicability of the Medical Model
The integral part of the medical model debate is the issue of whether mental illnesses are medical or behavioral. According to the proponents of the medical model, mental disorders are medical conditions as they are manifestations of underlying physical illnesses (Deacon, 2013). As such, they insist that there are neurological or anatomical explanations of conditions such as schizophrenia and others, which can be identified through medical methods and treated using pharmacological solutions. In this case, the behavioral symptoms exhibited by individual’s suffering from mental disorders are viewed as indications of underlying physiological conditions (Barber, 2012). As such, various symptoms have been categorized into identifiers of each mental illness, just like other medical conditions such as ‘malaria’ are identified by certain characteristics (Gambrill, 2014). This paper highly refutes this take considering the fact that mental illnesses are exhibited through exclusively behavioral and not physiological manifestations. There is no link between mental disorders and physiological changes, except in cases where the behavioral changes exhibited by the patients lead to physical reactions. Mental disorders are exclusively behavioral, such that they surface after individuals are exposed to certain conditions that may lead to their change of behavior. Strine et al. (2008) identified bereavement as a major cause of depression among individuals who have lost a loved one. In such a case, it is clear that the condition of losing someone that is close leads individuals into a state of excessive sadness that they withdraw from their initial social state.
The behavioral aspect of mental disorders is evident in the video “How Mad Are You” by BBC, in which one of the participants in the tests, Yasmin, had been diagnosed with the ‘major depression disorder’, yet the panel members were unable to pick up the so defined depression traits as her current environment has allowed her to actively interact with other people without showing signs of depression (Divina, 2016). Yasmin proved to be increasingly active and interactive, which is medically uncharacteristic of persons with depression. This is a clear indication that the medicalization of mental disorders fails to establish the roots of such problems and makes an avoidable mistake by relating such disorders to physical conditions rather than psychosocial conditions (Wand, 2013). The insistence of physicality of mental disorders by proponents of the medical model is impractical as it would lead to Yasmin’s exhibition of symptoms of her depression regardless of external environmental influences.
This paper establishes that contrary to the take by proponents of the medical models, this model stigmatizes and disempowers patients. Just like it is the case with other physiological conditions that lead to abnormal functionality of the body, proponents of medical models establish that individuals with mental disorders have definitive physical conditions that affect their normal functionality (Wyatt, 2009). Proponents of mental disorders claim that patients with mental disorders have no control over their conditions as such conditions are medical and can only facilitate their healing through complying with the prescribed treatment regime (Pirutinsky, Rosen, Shapiro, & Rosmarin, 2010). This paper refutes this notion by insisting that mental disorders are behavioral and hence can only be treated through behavioral manipulations. Such manipulations arte entirely unachievable without involvement of the patients as the patients are the central determinants of behavior change. As such, mental models do more harm to the mental illness patients than good. This paper also emphasizes that apart from disempowering the involved patients, medical models lead to the stigmatization of patients by labelling them as abnormal, in the same way individuals with chronic diseases such as cancer and HIV face stigmatization from a portion of the society as they are perceived as having deviated from normality (Tucker, et al., 2013).
Supporters of mental disorders pathologize behavior by insisting that mental disorders should be diagnosed and treated using medical approaches (Pirutinsky, Rosen, Shapiro, & Rosmarin, 2010). Most, if not all, experts in mental studies and practice agree that mental disorders originate from the mind. The mind and the brain are two distinctive parts of the body as the latter is tangible while the former is not (Johnstone, 2008). Behavioral practices exhibited by individuals diagnosed with mental disorders originate from the mind, an aspect that makes medical interventions inapplicable. Case in point, in Yasmin’s case, if she was exposed again to one of the conditions that led to her depression, she is likely to ignite her feelings of depression. On the other hand, when she was exposed to contrary conditions in a group setting where she was acknowledged as important, she felt as part of the group and suppressed any depression related behaviors (Divina, 2016). If her condition was physical, she would show symptoms of depression regardless of the surrounding conditions.
This paper also establishes that the use of psychopathology diagnostic classification systems to define and categorize mental disorders overlooks the very fabric of understanding the occurrence of mental disorders. Supporters of the medical model have come up with various specifiers that are applied in the DSM and ICD-10 classification criteria to categorize behavior (Cooper & Hassiotis, 2009). The criteria used in such cases are not operationalized, an aspect that results in different usage of the findings by different health care professionals or researchers. The classification criteria included in these systems also provide definite symptoms of mental disorders, with the intent of differentiating one mental disorder from the other (Pilecki, Clegg, & McKay, 2011). Proponents of medical models fail to acknowledge that mental disorders are behavioral and thus prone to change as a result of changes in conditions or circumstances (Warelow & Holmes, 2011). On the other hand, this paper establishes that mental disorders are behavioral and that they require changes in behavioral influencers to effect change in the individual’s state. Case in point, in the case of Yasmin, if she is continuously exposed to group settings whereby she is shown affection and develops a sense of belonging, she is less likely to relapse into depression (Divina, 2016).
In addition, this paper observes that the biological model is biased in various perspectives with the proponents of such a model taking a subjective approach towards the issue of mental disorders. They strictly believe that mental disorders are clinical conditions defined by physiological symptoms that can be explained using medical phenomenon (Murphy & Lupfer, 2014). They choose to turn a blind eye to the behavioral response of individuals with mental disorders to circumstantial factors. Case in point, individuals with social anxiety disorder mostly express increased anxiety and shyness while in crowds. This means that they are influenced by the crowd setting into development of anxiety. Such individuals may not exhibit their anxiety in cases where there are no crowds or even in some cases with crowds. One would argue that the presence of crowds does not have any physical influence on the individuals. As such, it cannot be explained in medical terms, but in psychosocial terms as it involves the emotional influence of such crowds on the individuals.
Conclusion
Medical models have contributed in various ways
towards the development of the field of mental disorders. Technological advancements
used in determining the symptoms behind different mental disorders have proven
to be important contributors to minimization of the symptoms related to the
various mental disorders. However, those in support of the mental models as
primary determinants of the categorization and treatment of mental illnesses
choose to ignore the causative factors of such disorders and the nature of
their symptoms. It is important to note that mental disorders are generated in
the mind with regards to its previous interaction with various stimuli and the
pre-established perception towards such stimuli. As such, it is only by determining
the various psychosocial factors that influence the behavior of individuals
that one can be able to effectively identify mental disorders and facilitate
the treatment process. it is important to note that health care professionals
can only play a passive role in the treatment process of the mental disorders,
and that it is the patient who is actively involved in their healing process even
as they identify the various obstacles established in their minds and uprooting
them. In this view, it is within question that the medical model ought to be thought
through again and its applicability and reliability reviewed in order to determine
how it affects the management of mental disorders as it is the widely employed
mechanism. As such, this paper establishes that the medical model of mental
illness disempowers and stigmatizes patients because behaviors are pathologized.
References
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Divina, V. (2016, February 26). BBC Horizon How Mad Are You. Retrieved from YouTube: https://www.youtube.com/watch?v=2G4SqtCq8kA
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