Treatment of Mental Illness - Essay Example

? Critically assess the medical model as applied to the diagnosis and treatment of mental illness. Critically assess the medical model as applied to the diagnosis and treatment of mental illness. Psychiatry is the branch of medicine that focuses on diagnosis and treatment of mental illnesses. It is a medical approach that assumes that every case of mental illness has a biological basis – either due to a chemical imbalance in the brain, physical defect in the brain or genetical abnormality. It entails research and creates generalizations on the basis of causation and treatment. It contrasts the holistic model, bio-psychosocial model and recovery models of treating mental illness. Proponents of these alternative models claim that the medical model is flooded with fundamental problems of diagnosis which in turn lead to inadequate and often apparently punitive treatment. Critics of the medical model (MM) argue that it does not take into account psychological problems pertaining to an illness. The drugs prescribed by psychiatrists only give a temporary relief instead of curing the illness. The legitimacy of this model lies on its validity of how it classifies mental disorders which are outlined in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA 1994). An individual’s mental illness is a result of personal characteristics and circumstances, and this classification pays little attention to these influences. The medical model cannot determine individual responses to certain adverse circumstances. Therefore, its classification of behavior in a way that identifies the existence or non existence of mental illness is questionable. Conceptualizations of mental disorders cast considerable doubts on how they are classified by the medical model. For example, symptoms associated with schizophrenia exhibit no empirical evidence. It is a bunch of random analysis of physical behavior that cannot be scientifically proven. The criterion fails to meet the requirements of reliability. The data provided do not accurately establish connections as far as the classification of mental illnesses is concerned. To a great extent, the classification seems to be based on chance. It offers invalid and unreliable measurements that amount to some of the most serious criticisms against the medical model. The importance of the medical model’s treatment cannot be sidelined. However, other approaches should be incorporated to ensure treatment offered is more effective. People’s perception of illness varies across cultures. These perceptions are context specific, dynamic and susceptible to change. Sociologists argue that medical illness is a societal conception and its study is connected to the relationship between medical belief systems, exercise of power and social control. Sociologists argue for the application of social context in examining the behavior of patients whose behavior is questionable to psychiatrists. Parsons (1951) analyzed management of illness, arguing that being sick means choosing to withdraw from normal behaviors expected by society, and therefore being sick is a form of deviance. In his view, for the social system to function effectively, the sick must be managed and controlled. Parsons recognizes the role of doctors in regulating and controlling those who have decided to be sick, and enabling them return to their normal tasks and responsibilities. Contexts, including social, political and cultural realities should be central in understanding mental illness (Bracken and Thomas, 2001, p. 726-727). Contextual relativism acknowledges the importance of empirical knowledge in understanding social factors that lead to mental illness. They enable psychiatrists understand individual experiences and connect those experiences to diagnosis and treatment. Bracken and Thomas argue that applying contexts enables psychiatrists to attach more meaning to psychosis rather than being simply psychopathological. The most radical critics of the medical model argue that psychotropic medications are effective only because of their inability to interfere with normal brain functioning. The medical model focuses on controlling symptoms, not treating the disorder itself or enabling the mentally ill to better address the environmental factors that may be the basis for their condition. The medical model achieves symptom control by rendering portions of the brain or killing brain cells (Whitaker, 2002). Among the critics, Laing observed that the diagnosis of a mental illness focuses on patient behavior and not on physical pathology. Laing (1971) points out that diagnosis by the medical approach contravenes the standards of medical procedures that require ancillary tests, besides physical examination. In cases where these tests are done, they are taken only after the diagnosis is made. Mental illness is diagnosed by examining the patient’s behavior such as hyper mania, paranoia, delusions and hallucinations instead of examining the patient’s body tissues. Liang further questions the manner in which the language and practice of biomedical psychiatry deals with its patients. He points out that social scientist have learnt a fundamental lesson that understanding social events require that they be viewed in a context that extends both spatially and in time. Diagnosis and treatment of mental illness must encompass social networks which must be viewed in relation to larger contexts of organizations and institutions. Szasz (1973) questioned the validity of labeling certain individuals as mentally ill, when, in fact, they were merely suffering from problems in living. He further argued that mental illness is a myth, not a genuine disease at all. He suggested that the underlying purpose of diagnosing certain people as mentally ill is to provide the society with a convenient way of getting rid undesirable deviants. Similarly, Kovel (1980, 73) points out that psychiatrists focus on the psychological aspects of the patient is a convenient way of “mystifying social reality”. He further argues that psychiatrists exert social control over a treatment plan, disregarding the damaging role of poverty, poor housing, lack of opportunity, unemployment and other social ills. In other instances, illness is often linked with failure to properly deal with interpersonal relations, so that social or moral vis-a-vis biological repair is needed. Alternative approaches to ill health take a holistic approach in diagnosis and treatment. Zur and Nordmarken (2010) argue that the current criterion of DSM focuses on medical management of behavioral intrapsychic focus and the power of political and economic agendas. They argue that many clinicians are unaware that the DSM is more political than scientific with little agreement among professionals on vaguely defined concepts, and it includes only scant empirical data. According to Zur and Nordmarken, decisions regarding inclusion or exclusion of disorders are made by majority vote vis-a-vis valid scientific data. According to them, constructors of this model positively use it to build evidence based treatment plans to facilitate continuity of medical care and enhance collaboration between professions of varying treatment modalities. References Bracken P. and Thomas P. (2001). Post psychiatry: A new direction for mental health BMJ 322: 724-7 www.critpsynet.freeuk.com/CPNpublishers. Retrieved March 4, 2012 Kovel J. (1980). The Biomedicalization of Psychiatry: A Critical Overview. www.lsic.ucla.edu/../GenderBiasDSM.pdf. Retrieved March 4, 2012. Liang R. (1971. The Politics of the Family and Other Essays. Tavistock Publications. Parsons, T (1951). The Social System – Social Theory. Glencoe: Free Press Szasz T. (1973). Science and Scientism”, The Second Sin. Boston: Anchor Press. Whitaker R. (2002). Mad in America: Bad Science, Bad Medicine, And the Enduring Mistreatment of the Mentally Ill. New York: Perseus Publishing. Zur, O. and Nordmarken, N. (2010). DSM: Diagnosing for Money and Power" Summary of the Critique of the DSM.  http://www.zurinstitute.com/dsmcritique.html. Retrieved May 4, 2012. Read More