The Medical Model Is Dead Social Work Essay
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During this assignment I will examine and critically analyse both the medical and social models in relation to mental health and mental distress. I will also look into several mental health problems and see the effect it has not only on the person who has mental health issue but also towards the society in general. I will identify certain treatments which are used to work with people with mental health problems including complementary and alternative medicine (CAMs)
Initially it is important to actually understand what mental health problems are and take a brief look into the history of mental health. Mental health problems can range from someone feeling slightly down and not quite themselves to more serious issues where people struggle or can't carry on their normal life (schizophrenia, dementia). In most mental health situations people don't need any assistance and support and just carry on living day to day life and just recover naturally. Nevertheless some people do need help whether that is by medical or social professionals to help deal with their symptoms. It has been stated that around 16% of the United Kingdom are experiencing a common mental health disorder and that 1 in 4 people in their life will have a mental health issue. It is estimated that the annual cost to the economy of United Kingdom through mental distress is 77 billion. (Gould, N. , 2009)
A brief look at the history of mental health and illness shows that for many years' people who were financially secure and from a decent class of society who had a mental health issues would normally have been looked after by their family. Unfortunately if you had no status or wealth then you were put into mental asylums. From the beginning of the 19th century asylums and mad houses changed. Rather then been for just people in poverty, people started to accept a greater willingness for the need of a more medical view to madness. Asylum numbers peaked at over 150000 in 1950 but however due to changes of ideas with regards to understanding human problems and pharmaceutical medical advances at the start of the 20th century meant that asylum numbers started dropping and the mentally ill started to be seen within their communities. (Pilgrim, D. & Rogers, A. 1999)
The medical model is the dominant model within medical organisations with regards to mental health. The medical model is used by medical professionals to diagnose and treat mental ill health on the pretence that all mental health issues are generic or chemical imbalances and that those illnesses can be treated with medication or medical treatments. The medical model treats mental health illnesses similar to the way it treats physical illnesses which to a certain degree is an impossible thing to do. If someone has a bad heart or lungs for example then medication can in all probability heal there issues but if someone has a bad mind then medication can perhaps help them in the short term but will the medication actually fix or cure them long term. Whilst drugs can give the short term quick fixes there are also many anxieties about possible side effects associated with taking medication and the long term damage that drugs can have on the body obviously with other non-medical models this would not be the case. (Mental Health Care, Feb 2010)
Whilst the Medical Model is good to the degree that you can put a name to your disorder so you know what is wrong with you medically, which can also reassure family members the downside is unfortunately the stigma and prejudice associated and received towards people who have been diagnosed with a mental health issue.(Kinderman, P; Sellwood, W; Tai, S , 2008 : 96)
The Medical models stance would presume that social, cultural and environmental issues which are present in an individual's life are a result of the medical condition rather than part of it. (Bogg, D. , 2008).
The Social Model
The social model fits well with the general holistic approach of social work and that there are numerous examples of practice where the social model underpins effective practice. (Golightley, M. 2008).
The social model is service user centred and treats the person as a unique individual which realises that everyone's issues are different to the next person The social model takes in to account when dealing with people with mental health illnesses the many environmental, social and cultural factors that could lead to a person having mental health issues. Once knowing what elements brought on a service users illness it enables a worker to be able to find probable solutions to individual's mental health issues. This is called social causation. These issues range from poverty, unemployment, relationship break up, bereavement, education. By reducing service user's vulnerability issues and increasing their resilience to these issues the service user can then consequently improve their mental health issues however this is no quick fix and can take a considerable amount of time. The social model empowers the service user to tackle and take responsibility of their situation whilst the social worker is there to advocate and listen to the person and try to assist the person through their journey. There are cognitive behavioural therapies that the service user can go to. Talking therapies can have great successes as the service user has the opportunity to discuss their thoughts, feelings, anxieties, assumptions and beliefs.
When we start to critically analyse both these two theories it becomes apparent that the Medical Model has various trepidations. Whilst the Social Model is individual tailored to the service users' needs, the Medical Model sees symptoms and diagnoses them with an illness and offers a quick fix through medication. This approach does not take into account the reasons why the service user suffered and might suffer more mental health/distress issues.
One of the major issues with the medical model is the stigma associated towards people who have been diagnosed with mental health issues. The stigma received to mentally ill people from society can have a truly distressing effect on people who are receiving treatments to the degree that a mentally ill person could stop taking and attending treatments because of the stigma and label associated with that person's illness. The media also plays its part in increasing negative stigma due to all the detrimental things that are circulated either on television or in newspapers. It is a very rare commodity that the media contributes a positive image towards mental health and illness. While less than 3% of mentally ill patients could be categorised as dangerous, 77% of mentally ill people depicted on prime-time television are presented as dangerous. (Fink, J , 1992). Although this statistic is from American it clearly shows the contribution the media creates with regards to the negative stigma directed towards people suffering with mental health issues.
Another disadvantage the medical model has is that mental illnesses are not like physical illnesses. If you have an illness like cancer then medication can relive pain and suffering however if you have a mental illness medication might not actually fix your symptoms. It has not been proven enough that mental illnesses are genetic or that pharmaceutical drugs always deal and fix the problem the person might have. However pharmaceutical companies depend greatly on the medical model as it makes their companies lots of money and that's is why they invest many millions of pounds in to research and into drugs that supposable fix and heal mental health illnesses.
Figures show that pharmaceutical research and development in the UK has risen to £3,172 million amounting to nearly £9 million every day. (The Association of the British Pharmaceutical Industry, 2010)
Also in this modern era it is also important not to eliminate the use of complementary and alternative medicine (CAMs) over the use of the medical and social models due to the fact of the amount of people who have had success using these forms of treatment. There are many different and varied treatments available ranging from
An April 2001 survey by the Office for National Statistics (ONS) found that one person in ten in the United Kingdom had used a complementary therapy in the previous 12 months (NHS Careers ,2010). Once a person has had success with complementary and alternative medicine then usually if that person became ill again they would refer to complementary and alternative medicine as a first point of contact in the future.
Depression is a good example of mental illness that the medical and social models approach from completely different angles. There are numerous different types of depression ranging from seasonal affective disorder (SAD), postnatal depression and bipolar disorder (manic depression). It is stated that around 1 in 6 people in life will suffer from one of the types of depression. In its lowest form depression can be someone just feeling down but in its worst form depression can be life threating leading to a person feeling suicidal or just wanting to give up on life. (Mind , 2010)
The medical model would involve the person going to their general practitioner who would then prescribe anti depression medication to overcome the depression. In worse case scenarios of depression the medical model would if necessary admit a person to hospital where they can have a calm safe environment where they can be observed, monitored and medicated. It was quite normal practice in the past within hospitals to use Electroconvulsive therapy (ECT) on people who had severe depression which did have positive results. More recently a treatment called Transcranial Magnetic Stimulation (TMS) is used for depression which stimulates the certain areas of the brain where depression is located.
However the medical model never actually looked at what it was that was actually causing the depression which would probably mean that the depression would return. However with the social models holistic approach a deeper emphasis would be applied into the origins of the depression and in turn try to find solutions in how to fix or reduce the causes. There could be many issues that actually brought about the depression ranging from drug and alcohol misuse, unemployment, abuse, loss, poverty, crime and social exclusion to name a few. The social model would attempt to improve the area of the person's life which was creating the depression. With regards to complementary and alternative medicine (CAMs) there are any different types of treatment which are available to help deal with the depression. These treatments would range from yoga, acupuncture, talking therapies, taking of herbs and vitamins and homeopathy.
Dementia is mental illness that affects brain which causes a person to have memory loss which in turn effects a person's personality and behaviour although it is not known what actually causes dementia it is thought that it is brought on due to chemical changes within the brain. They are different types of dementia ranging from Alzheimer's disease, vascular dementia, mixed dementia (mixture of Alzheimer's and vascular) and Dementia with Lewy bodies (DLB). The medical model plays an influential part when dealing with dementia. Initially a person would approach their general practitioner who would diagnose the person with dementia and refer to a more specialised medical practitioner. The GP would prescribe the relevant drug which would be able to slow down the progression of symptoms in some people. However there is no permanent cure or fix for dementia. That is why there is an importance for the social model to be there for the person as well. With dementia the social models personal centred care is important because no two service users' needs will be the same. The care is very much personalised to the needs of that particular person. The social models treat the service user as an individual. It is important to ensure that a person with dementia is happy in the environment that they live in. A person with dementia wants to have familiarity around them whether that is clothes, food or family and the social model would look at these sorts of factors and ensure that all family members have the support they need to assist the person with the dementia. (Brooker, D. 2006). One of the best forms of treatment with regards the social model and assisting people with dementia is cognitive behavioural therapy. Talking therapies have been shown to really help people with dementia due to the fact that it stimulates the mind. It is also good for people with dementia to reminisce about the past whether that is there childhood, relationships or middle age. Using prompts like old letters and photos can help. (Marshall, M. 2004). With regards to complementary and alternative medicine (CAMs) the only CAM to show any evidence of helping a service user with dementia is aromatherapy as this has shown to help service user feel less aggravated.
In summary the perfect scenario would be to combine both Medical and Social Models with regards to Mental Health and Mental distress. However the biggest dilemma is getting the professional people who work in their chosen fields whether that is medical practitioners or social work practitioners to actually be prepared to work to a combined model. There is a need for the Medical Model to treat the illness with medication however there is also the need for the Social Model to look into the reasons around why the service user became mentally ill and to prevent relapses. From the social workers perspective it is important to look at things holistically and to take into account the external factors in someone's life that may be causing them mentally ill health. Whilst for the medical practitioner's perspective there main ethos is to preserve and maintain life and discharge people back to their homes. I think that the perfect situation would be to have strong multi agency relationships between medical and social work professionals. Where planning and discussion with regards to the patient/client is paramount as so both the medical and social models are working together in harmony. The consequential effect would be that the client would receive the best from all professional workers involved and ensure that the client would stand a better chance of getting the best treatment available both within the medical setting and within the community that they live. I also think that it is important that professionals whether from medical or social backgrounds are actually prepared to embrace models from different professional occupations. However this is one of the major apprehensions and conflicts due to the different training and working environments that the professional workers come from.
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