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Identifying Mental Health Problems: Holistic approaches

Dr Yusuf begins by explaining why we need to identify the underlying causes of mental health problems and how we can do this.
So why do we need to understand the causes of mental health problems? And, do we have to? And if so, how do we go about doing this? Well, in order to restore health, really, there are three options in any type of condition. One, leave it to sort out itself. And the body has an amazing recuperative faculty. We are able to sort out lots of things by ourselves. And what sometimes is required therefore, is merely just a supportive approach. Support the person while they’re sorting themselves out. Great example of this. Break your leg, get a plastic cast put on it. What’s the purpose of the plaster cast? It doesn’t heal your leg. Your body heals yourself. Your body heals itself.
The plaster cast is simply there to protect it while it’s happening. The second approach is deal with the symptoms. So there is an underlying problem, there are the symptoms of the problem. Deal with the symptoms of the problem, and the underlying problem will stay there under the surface. That’s another approach that’s sometimes taken. The third approach, however, is to deal with the underlying problem itself. Now, that’s what we’re going to be talking about. This is about the underlying issue. What is the cause of the mental health problem? Now, the first approach is certainly possible in mental health for mild issues. As I’ve said, as with the body, the mind is excellent at self-repair. The second approach is usually unsatisfactory.
You may be able to deal with symptoms, but there’s really nothing to stop the problem recurring. And really it’s only there to support and help the person in the hopes that they will fix themselves, as it were. You have what is called sometimes called the natural course of an illness. So a depressive episode, if you simply leave it, in most cases will resolve itself The problem is it takes a long time and it feels awful as you’re going through it and there’s always the chance that it will recur. This therefore leaves the third option. The third option is deal with the underlying problem. There is mental health distress deal with the thing that is causing it.
The question then and the challenge is what is the underlying problem in a mental health issue? Is there a problem with the brain? Is there a problem with the mind? Is there a problem with something in your circumstance, situation or environment? Or is it something else? Is it a combination of those factors? Now, in mental health, we have no blood tests. We have no brain scans or any other form of investigation that can precisely pinpoint a biological cause. And therefore, we need an approach to get to the bottom of where has this problem come from. So in terms of where the problem has come from, we’ve got two approaches. One, you might call the medical approach.
The medical approach is about what is the organ? The tissue? Where has it gone wrong? How do we fix it? It’s a very biological approach. It’s what’s called reductionist. So it goes down to the level of the cell or the neuron, for example. Then there’s a second approach. And the second approach is really the one that is favoured by almost everybody working in mental health, simply because it has the best evidence base and it brings the best effects. And that is a holistic approach. This holistic approach considers several factors as both the cause of the mental health problem, but also the way in which you go about dealing with the mental health problem. It’s called the bio-psycho-social approach.
That is to say, there is an element of the causation of a mental health problem that is biological. It’s about the brain the neurons, the neurotransmitters. There is an element of it that is psychological. It’s about beliefs. It’s about emotions and how thoughts and memories contribute to a mental health problem. And then there is the social aspect of it. That is to say, what are the circumstances? What are the stresses and pressures that are on a person? As well as, what are positive and protective factors that may that may serve as a way out of that problem for the person? I find a great analogy to explain this to patients is the kitchen sink analogy.
That is to say, the mind is like a basin or a sink. It has a certain capacity. Some people’s capacity is very big. Some people’s capacity is very small. There is an outflow pipe and then there are taps. The more the taps are open, the faster the sink fills up. If it overflows, that’s when you get symptoms of a particular mental health problem. Now, the bio psycho-social model postulates that there are three tap. A biological tap, which is about dysfunction at the level of neurons and so forth. A psychological tap, which is about how beliefs, emotions, memories, predictions about the future, impact on your on your mental health. And then a social tap.
Now, it may be that a particular tap is open full blast, the other taps are open only a trickle. Treat that one, you’ve pretty much sorted the problem. You prevent the inflow into the basin and it can drain out in its own time. But you don’t know which of the taps is on for any one person at any given moment. And the purpose of the bio-psycho-social model is to be able to ask questions around this, to determine this, to determine how much each tap is on, and therefore what needs to be done to close that tap.
I find that’s a really useful analogy for patients and also to be honest, for professionals to think about this holistic model that we have. But I’m going to add an element into this, and this is a fourth tap. That fourth tap is the spirituality aspect. And as I say, this holistic model applies to almost everyone because we all have a biology, we all have a psychology, we all have social circumstances. But we also have a deeper element, which is our sense of ourselves in the world. Our sense of meaning and purpose.
And this is what we mean by spirituality, how the deepest core beliefs that you have about who you are and what your purpose and meaning is relate to your mental health. That fourth tap, the spirituality element, has become increasingly well recognized as a critical part of assessment of a mental health problem, but also the solution to a mental health problem. So we have this model, this bio-psycho-socio-spiritual model, which both allows you to properly assess and examine what the issues are,or the factors that are contributing to a person’s mental health difficulties, but also what the potential ways out.
And as we go through the course, particularly in the last week, in the fourth week, we’ll start to look at some of the treatment options or the management options, which will also be about this bio-psycho-socio-spiritual model. This is particularly relevant for people who identify with a spirituality or a religion, but it’s not just for them. It applies really to anyone. So keep it in mind as we go through the course because this is a theme that we will keep on coming back To, how one’s deepest sense of meaning, purpose and relationships affect your mental health positively or negatively.
So now as we keep in mind this idea of this holistic model, bio-psycho-socio-spiritual, what we’re going to do now as we go forward is take a look at how this component of spirituality affects the type of clientele that we are here to talk about in this course, which is Muslims, and particularly Muslims in the UK. So whether you are coming to this course as a service user yourself, or as a family member, or as a health care professional, we’re now going to start talking about Muslims in general, the beliefs and so forth that we hold, as well as Muslims in Britain.

In this step, Dr Yusuf explains why we need to identify the underlying causes of mental health problems and how we can do this.

All forms of spirituality, including formalised religions, are increasingly recognised as critical aspects of assessing and treating mental health problems. Spirituality can encompass one’s deepest sense of meaning, purpose, and relationships, and can have implications for mental health.

It is widely accepted that causes of mental health problems can include biological, psychological, and social factors, or indeed a mix of these. Identifying the causes of mental health problems is therefore a complex task. Holistic approaches that encompass all these factors are favoured in understanding and treating the causes of mental health problems.

Dr Yusuf introduces the bio-psycho-social (BPS) approach to understanding and ‘treating’ mental health problems. He goes on to explain that the model can be expanded to include spirituality, this is the bio-psycho-social-spiritual (BPSS) model. BPSS is a theme that will run throughout the course, presented as a holistic approach that might be particularly appropriate when supporting Muslims with mental health problems. You may find it helpful to revisit this step to remind yourself of what BPSS means as you make your way through the course.

Over to you

Imagine you had an opportunity to ask Dr Yusuf a question about his explanation of the BPSS model, what would you ask him? Maybe you can answer someone else’s question below.

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Understanding Mental Health in Muslim Communities

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