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  • Writer's pictureMelanie Rivera

"Navigating Mental Distress: A Journey Through Approaches"

Updated: Sep 28, 2023


"The greatest glory in living lies not in never falling, but in rising every time we fall." – Nelson Mandela






Mental health issues, from anxiety and panic disorders to depression, phobias, and obsessive-compulsive disorders (OCDs), are a common part of the human experience.


In England alone, a staggering one in six individuals reports experiencing mental distress weekly (Mind, 2019). The path to treating mental distress is a complex, evolving landscape filled with diverse perspectives and approaches. Let's embark on a journey to understand this multifaceted realm.


The Landscape of Approaches

The mental health system is a landscape of professionals, academics, service users, and clients. It encompasses various paradigms that shape our ideas about mental health practices. Understanding these approaches demystifies the array of available help and highlights the conflicts within psychiatry.


Clues to these different models are embedded in their terminology...

  • Biomedical Approach: Often utilised by psychiatrists, this approach hinges on diagnosing and prescribing medical treatments and pharmaceutical drugs.


  • Psychological or Psychotherapeutic Approaches: Preferred by counsellors and psychotherapists, these encompass a range of talking therapies tailored to individual needs.


  • Social Approaches: Promoted by social workers and healthcare professionals, these interventions provide non-medical support to address social exclusion and promote inclusion and non-discrimination.


  • Psychosocial Approach: A contemporary stance that fuses psychology and the social model in mental health and wellbeing practices.


  • Biopsychosocial Approach: Common in mental health academic research, it considers biological, psychological, and social factors in a holistic view.


The Power Dynamics: Autonomy vs. Control

A fundamental debate in mental health revolves around the struggle between promoting autonomy and the exercise of power and control. Two opposing perspectives, often at odds, emerge the 'progressive' and 'anti-psychiatry' views. Michel Foucault (1967), a prominent critic of psychiatry, contended that psychiatry acted as a tool for controlling norms. He believed that it created an objective, detached language to describe insanity, distinct from individuals' subjective experiences. In contrast, medical researchers advocate for advancements in medicine, supporting the medical psychiatry movement.


Historical Echoes: Shaping Modern Approaches

Our understanding of mental health has evolved dramatically over time. A look back at history reveals significant shifts in approaches and ideologies.

  • The 18th century saw the rise of psychiatry, marking a turning point where mental illness became increasingly controlled, often to the detriment of patients.

  • The 'Moral Treatment' philosophy emerged in the 18th century, emphasizing respectful interaction and a safe environment as the key to curing mental distress. It echoes today in various talking therapies.

  • Charles Darwin's ideas in the 19th century tied underclass individuals to hereditary criminal tendencies, sparking a shift towards psychological and psychoanalytical approaches.

  • 'Asylums' transitioned to 'psychiatric hospitals' in the 20th century, marking a new era.

The Post-Asylum Era: A Turning Point

The post-asylum era, starting in the 1950s, witnessed mounting political pressure due to the deplorable state of asylums in the UK. New pharmaceutical drugs enabled individuals to function in society, but questions lingered about whether this transformation was primarily driven by compassion or cost control. It marked a shift from asylums to community care, but conflicts of interest surfaced (Jones, 2020, pp35-36).


The Emergence of the Survivor Movement

The 1970s saw the rise of the Mental Patients' Union, a pivotal point where individuals diagnosed with mental health issues began to advocate for themselves, highlighting the lack of a voice in their treatment. Gradually, policies changed, and community care policies in the 1990s sparked the Service-User Movement. This movement challenged oppressive psychiatric practices, emphasising the importance of individuals' experiences (Lomani, 2020, pp50-51).


The Thorny Issue of Diagnosis

Diagnosis can be a double-edged sword, particularly with the pharmaceutical industry's influence on psychiatry. It's a topic that sparks political interest and fervent debate. Allen Frances (2012) raises concerns about the overdiagnosis of mental illness, with diagnostic labels leading to medication, potentially tipping the power balance towards commercial interests. Labelling individuals can also lead to stigmatisation (Jones, 2020, pp35-36).


A Modern Tapestry of Approaches

Today, we're blessed with a more diverse range of approaches to treating mental distress than ever before. Collaboration and integrative approaches are gaining traction. The NHS Long Term Plan (2019) supports this shift. The Improving Access to Psychological Therapies (IAPT) program offers a range of evidence-based treatments, such as Cognitive Behavioral Therapy (CBT). Other psychological approaches, like humanistic models, are accessible through private therapy and community counselling agencies.


Conclusion: Choices for Mental Health

History warns us of the potential harm within psychiatry. With diverse treatment options available today, the power to choose our path lies with us. Some may find solace in medical approaches, while others may seek autonomy in person-centred, psychological, or social interventions. The survivor movement has empowered individuals to voice their experiences, reshaping the landscape of mental health care.


In this tapestry of approaches, there is no one-size-fits-all solution. We must choose wisely, knowing that the power of recovery lies within us and that every step, no matter how small, brings us closer to rising after each fall.



References


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Gov.uk (1959) [website] Legislation Mental Health Act, 1959. Available:


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Jones D (2020) ‘Introduction’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications pp.5-7.


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Jones D (2020) ‘Introduction’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications pp.6-7.


Jones D (2020) ‘Introduction’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications pp30-31.


Jones D (2020) ‘The birth of psychiatry’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications pp.33-32.


Jones D (2020) ‘The birth of psychiatry’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications p.35-36.


Lomani, J. (2020) ‘The service-user movement’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications pp.50-51.


Lomani, J. (2020) ‘The service-user movement’ in Moller, N., Vossler, A., Jones, D.W. and Kaposi, D. (eds) Understanding Mental Health and Counselling, London: The Open University/ Sage Publications pp.60-65.


NHS UK. (2019). About the NHS Long Term Plan. Available: https://www.longtermplan.nhs.uk/about/. Last accessed (19 November 2019).


NHS, England. (2019). Improving Access to Psychological Therapies programme. Available: https://www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf. Last accessed (November 2020).


The Critical Psychiatry Network (1999). Available [online],https://publications.parliament.uk/pa/cm200405/cmselect/cmhealth/42/42we13.htm. Accessed (April 2020).


The Open University (2020), D241 Exploring Mental Health and Counselling. Block 1: Understanding mental health: the emergence of the talking cure. Milton Keynes the Open University.






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