Skip to 0 minutes and 1 secondSo we've covered quite a lot of ground over the past five weeks. We've looked at biological factors, at nature, on how our biology and the functioning of our brains can affect our mental health. And we've looked at life events and how the things that happen to us can impact our mental health. And of course, we've also looked at what's important from my perspective, which is the psychology of the situation, how people's understanding of their world and their sense-making of the things that happen to them can shape their mental health. And of course, for me this has some profound implications. First of all, it speaks to the nature of what causes things.
Skip to 0 minutes and 45 secondsAnd for me, as a psychologist, I think that how we make sense of the world is almost a third type of variable after nature and nurture. And my logic goes something like this. That in philosophy and in everyday life, something is said to cause something else if that something else occurs when that cause is present and doesn't occur when the cause isn't present. So then feeling hopeless and depressed, maybe even suicidal, those sorts of thoughts and feelings occur when there's a particular psychological framework of understanding of the world. And they don't occur if the person has a different viewpoint on life.
Skip to 1 minute and 28 secondsSo it seems to me as if the way we make sense of the world has a causal value, is a cause of mental health problems. If we think about things in that way, as I've said earlier on in this course, there are some profound implications. I asked you in the second week to look at the manifesto for mental health services that had been written by Professor Nick Craddock and colleagues, outlining how services could be organised very much from a biological perspective. But then in the third week, I asked you to look at almost a rival manifesto by Pat Bracken and his colleagues arguing that psychiatry and mental health services could be organised from a social perspective.
Skip to 2 minutes and 18 secondsI suppose for the sake of completeness, I should outline some of how I think things could be organised from this third perspective, from a psychological perspective. Ultimately I think it's up to you to decide. I don't think there's a right and wrong answer. And I would encourage you to read all sides of the debate. So on the website, you'll find, as I've said before, the manifestos by Nick Craddock and Pat Bracken. But I've also put some other reading. You can find links to my blog. You can also find links to a book chapter where I've recently outlined these kinds of ideas and set out what's effectively my manifesto for mental health services.
Skip to 2 minutes and 56 secondsAnd I think you should also read work by psychiatrists who have critical perspectives on the way that mental health services should be delivered. And you can find links to all of these ways of thinking about the world on the course website.
Doing things differently (perhaps...)
As a Professor of Clinical Psychology, the ideas that I research and write about have real significance. I work (part time, unpaid) in the UK’s NHS as a clinical psychologist. That means that I am passionately interested in how we can translate research ideas into help for individuals (which was really the basis of last week’s material) and how we might design mental health services differently… and better.
This week, I suggest that you read some of the things I have been writing about in a ‘manifesto’ for mental health. This is very similar (in some senses) to the ideas put forward in Week 2 by Nick Craddock and colleagues and in Week 3 by Pat Bracken and colleagues… but I come to rather different conclusions.
In brief, I criticise the poor reliability, validity, utility and humanity of conventional psychiatric diagnosis, and suggest that reviews of the ineffectiveness and adverse effects of many psychiatric drugs as well as of the effectiveness of evidence-based psychological therapies have led many to call for alternatives to traditional models of care. I conclude that psychological science also offers robust scientific models of mental health problems and wellbeing. These integrate biological findings with the substantial evidence of the social determinants of health and wellbeing, mediated by psychological processes.
These significant scientific and professional developments allow us to foresee a future beyond the ‘disease model’ of mental health and wellbeing. I recommend that we move away from the ‘disease model’, which assumes that emotional distress is merely a symptom of biological illness, and instead embrace a psychological and social approach to mental health and wellbeing that recognises our essential and shared humanity.
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