According to Avison, McLeod and Pescosolido (2007, p. 5), mental health has evolved from a model of strong custodial care which was dominated by a biomedical approach to treatment and management. Modern mental health support embraces an inclusive approach to care for people with mental problems. This inclusive method demands that nurses and social supporters examine and focus on a range of approaches and models of care to ensure that patients have the best chance of their recovery. Contemporary mental health care must acknowledge the many forces existing in society which impact and shape delivery of care.
Avison, McLeod and Pescosolido (2007, p. 5) indicate that there has been an argument whether to approach mental health from medical or physical point of view. Ghaemi and McHugh (2007, p. 2) observe that mental illness can, sometime in the future, be regarded as a medical disease upon the discovery of neuropathological correlations as illness is defined in terms of physical lesions. Because of this, Ghaemi and McHugh (2007, p. 2) argue that the notion that mental disorders are brain diseases amounts to exaggeration; thus, it cannot be regarded as illness. Similarly, Goldman and Jeffrey (2009, p. 21) found out that a biomedical approach to mental health reduces the issue of the brain requiring biological treatment. He notes that it is strange for modern medical approaches to want to limit the issue of mental health to psychiatry alone.
On the other hand, Marini and Stebnicki (2012, p.33) suggest that mental health like any other health problem should be seen as a mission to conquer and cure the disease. In this regard, he suggests that mental health professionals should be focused on the illness more than on a person. Therefore, they should be concerned with normality and pathology in patients with regard to the differences between the two. Cure in mental health should also be seen as a rational activity that is based on a scientific knowledge. Marini and Stebnicki (2012, p.33) observe that there should be an attempt to approach mental health in biomedical terms as opposed to psychiatric terms.
Similarly, a report by the United Nations Centre for Human Settlements (2008, p. 25) indicates that geographical location of people has tremendous effect on the mental stability of individuals. According to this report, mental health can be approached from the geographical point of view if the puzzle of treating mental illness is to be tackled in a holistic manner. This conclusion was drawn from studies carried out in slum areas of several countries which found out that the cases of mental illness in such deplorable conditions were higher compared to areas with favorable conditions (United Nations Centre for Human Settlements 2008, p. 25)
Furthermore, the role of social support in alleviating or treating mental illness was studied by Kiesler (2000, p. 9), and it was found out that apart from the conventional medical and psychiatric approaches, social support plays a significant role in helping people with mental illness. This paper looks at the strengths and weaknesses of biomedical approach to mental health treatment. It also explores the influence of geographical location on the well-being of people's mental health. Finally, the paper looks at the roles that social supporters play in helping people with mental distress.
Strengths and Weaknesses of a Biomedical Approach to Mental Health
Biomedical approach to mental health involves the use of medicines and scientifically proven methods to address the problem of mental illness. According to Marini and Stebnicki (2012, p.40), biomedical approach is based on the definition of mental illnesses as a pathological problems that can be diagnosed with observable symptoms like any other physical illnesses known in the medicine. Because of this view, biomedical approach to mental illnesses seeks to involve both biological conditions and medical prescription of doctors towards a mental condition. It seeks to deviate from the traditional psychiatric approaches which view mental illness as a symptom of an unstable mind (Marini and Stebnicki 2012, p.40).
According to Wilson (2011, p. 11), the essential assumption of the biomedical approach to mental health is the view that mental illness is a biological disease to be approached from a medical point of view. He argues that the implication of this is that mental illness is caused by a pathological change in the central or peripheral nervous system structure. He also indicates that mental illness can be caused by a change in the functioning of a certain body organ or malfunctioning of the biochemistry of the body. Biomedical approach helps in diagnosing mental disorders like panic. Wilson (2011, p. 11) further notes that biomedical approach helps in incorporating other factors apart from the traditionally known ones like environment as the causes of mental illnesses.
Similarly, Warren (2010, p.45) notes that biomedical approach to mental health has the advantage because it views health care in terms of medicine. This view is important as it helps arousing a quest to investigate and cure diseases not just as an end in itself, but also to establish the causative factors behind the illnesses. Additionally, biomedical approach focuses on the disease more than on the individual and, therefore, more details can be revealed to help people with similar conditions (Warren 2010, p.45). This model also focuses on the normality and pathology of the body, thus helps in deducing judgment on the differences between the two. This, in turn, helps in offering better services to people with mental illnesses. The author adds that the most important factor is that biomedical approach takes scientific techniques based on the empirical knowledge of the causative agents for mental illnesses.
Weaknesses of Biomedical Approach
Tew (2005, p. 5) argues that biomedical approach overlooks the vital influence of societies on individuals. The approach does not acknowledge that people’s behavior can be changed by the society they live in; and therefore ignores any attempt to relate mental wellness with the environment. In spite of the numerous evidences that factors such as experience and environmental conditions have great influence on the mental health of people, it is still undervalued in the approach. In this regard, Sturmey (2009, p. 9) observes that biomedical approach attempts to treat the illness of the mind, which is assumed to be pathological, and completely ignores the causative factors. However, these factors when dealt with could help to reduce cases of mental distress.
Similarly, biomedical approach does not consider the experiences of the patient as some of the factors, which could cause mental distress. Instead Sapouna and Herrmann (2006, p. 12) observe that in biomedical approach, mental illness and distress are perceived from the point of experiences, which are disgracing or embarrassing not only to the patient but also to his/her community . Biomedical approach tends to view mental distress as a sign of personal weakness. Additionally, Sapouna and Herrmann (2006, p. 12) note that biomedical approach views mental illness as something that people can never fully recover from. This leaves the patient tainted, particularly in a case when one is diagnosed with a mental illness like schizophrenia (Sturmey 2009, p. 20).
Arguments for and Against Change in Mental Health Services
Marini and Stebnicki (2012, p.40) argue that mental health services like any other service require continuous change to be able to deal with the increasing requirements. The increasing number of people who are in need of mental services should be properly met by the change of facility. Ramsay (2002, p. 14) observed that research has shown that one out of four people require mental services in their life. Similarly, Ramsay (2002, p. 14) argues that these services need to be based on the need of establishing a meaningful and satisfying life, which is acceptable by people experiencing mental distress regardless of whether they recover from this problem or not.
Kronenfeld (2010, p. 11) observes that there is the need for change in the way mental health services are provided to emphasize a shift from the usual prescription of symptoms and pathology to strengths and wellness. Furthermore, mental health services should be focused on hope that each person in the facility can be controlled and this should be enhanced through publications of various case studies of people who have been able to recover from mental distress.
Sturmey (2009, p.22) observes that mental health services encourage self-management and facilitation of people who are having mental distress. In this way the idea that self-management processes is emphasized and may be prescribed in the same manner to everyone, but each individual experiences of the prescribed method are different. Sturmey (2009, p.22) also notes that this is in recognition of the fact that one description of self-management cannot be used by all people, even if those people have similar mental conditions. Similarly, mental health services need to evaluate the existing relationship between the clinicians and their patients. This will go a long way in changing how patients relate to clinicians, and thus help in discovering issues that could boost the service in mental health facilities. For instance, Ramsay (2002, p. 6) points out that clinicians should be there to be tapped not to be on top.
Sturmey (2009, p.22) indicates that there is the need to appreciate the role of social support in the mental health services. This will help psychiatrists and doctors to appreciate that people cannot recover from their mental distress when they are isolated, thus they need social supporters as vital ingredients in alleviating mental distress. Similarly, Ramsay (2002, p. 6) suggests that there is the need for change in facilities to incorporate social support to take on satisfying and important social roles not only in isolated services, but within local communities as well. Sapouna and Herrmann (2006, p. 12) write that since mental health is about disclosing of causes, there is the need to instill a sense of individuality in those with mental distress services so as to separate mental illness or distress from disability.
On the other hand, Kronenfeld (2010, p. 9) notes the argument by psychiatrists that mental health services currently are sufficient to meet the needs of modern society. The psychiatrists argue that biomedical approach has not been able to solve the puzzle of conventional diseases and therefore they will not bring in the change in the area of mental well-being like they purport (Ramsay 2002, p. 10).
Role of Social Support in Mental Health
Kaye (2008, p. 7) had found out during his study that the social support in mental health emphasizes the role of networks and groups in individual’s mental health. He notes that social isolation is a common problem that people experiencing mental distress undergo. Social support goes a long way in alleviating this isolation through formation of social networks between user groups or people with mental problems.
According to Jenkins (2002, p.12), there has been little attention given to the role of social supporters in alleviating mental distress. Indeed, Kaye (2008, p. 7) notes that so far there is little literature on the significant role that social support plays in the expression and decrease of mental distress. Jenkins (2002, p.12) acknowledges that illness and mental health are shaped by the perception of culture and the evaluation of the distressing factors. In this case, Kronenfeld (2010, p. 9) observes that accepting the social support within a certain culture requires understanding the culture, in which a service is offered. Additionally, the well-being of an individual can be viewed in terms of his/her culture. According to Marini and Stebnicki (2012, p.40), culture is both subjective and objective and incorporates racial and ethnic rituals, symbols, language, and general rules of behavior. It is therefore the culture of a group that determines the kind of social support to be given to people with mental distress.
Moreover, Kronenfeld (2010, p. 9) notes that social supporters have the role of informing their clients about the existing legislation on the treatment of mental distress as a first step. The social supporter always provides useful information like the circumstances under which the service users have to reject treatment and the role of appointed doctors. Similarly, Marini and Stebnicki (2012, p.40) suggest that in case a specific treatment is prescribed, the social supporters should ensure that the client gets sufficient information for them to be able to understand the treatment in greater details. The information may include the nature of treatment, the likely side effects and the major possible adverse outcomes, the degree of the likelihood of its success, as well as the information on any alternatives for the treatment.
Additionally, social supporters should ensure that their service users in need of emergency treatment receive it without delay, especially as a form of responding to an immediate crisis. Jenkins (2002, p.18) notes that in such situation, social workers are not obliged by law to ascertain whether the client is in a position to consent to the treatment to be administered. In pursue of good practice, Jenkins (2002, p.12) notes that social support should ensure that documents relating to service users are recorded and kept confidentially in a medical file.
Social supporters are also known to significantly reduce the likelihood that a patient with mental distress will start receiving mental health treatment. Sturmey (2009, p.22) argued that except for patients with severe mental distress, social support can substitute the professional biomedical or psychiatric treatment for mental distress besides reducing their need for formal assistance. Warren (2010, p.50) indicates that if proper social support works alongside medical treatment, there is high likelihood that people with mental distress will be able to cope up with their conditions. Social support plays a crucial role in providing personal support in homes. Similarly, Goldman and Jeffrey (2009, p. 3) agree that social support helps in accessing a wide range of social, cultural and training exercises. Through these families, patients who suffer from mental distress are assisted with backup helps. This can help one to establish himself as an independent member of the community after being hospitalized for a long time (Goldman & Jeffrey 2009, p. 3).
The Impact of Geographical Location on Mental Health
According to Ghaemi and McHugh (2007, p. 9), the geographical location influences many aspects of mental illness. This effect may vary from how patients communicate and show their symptoms, the way in which they cope up with their conditions, the kind of family and community support they receive, and their willingness to seek social support and treatment. Similarly, Sturmey (2009, p.22) notes that the location of the clinicians will influence the way he/she diagnoses mental illness and service delivery to the patients. In this regard, Ghaemi and McHugh (2007, p. 9) note that cultural and social influences are not the only factors that determine the state and pattern of mental illness, but that location also plays a crucial role in the way mental distress is tackled.
Additionally, geographical location contributes to the occurrence of mental illness and this varies depending on the kind of mental distress. According to Ghaemi and McHugh (2007, p. 10) mental illness is a product of a multifaceted interaction among biological, psychological, geographical, social, and cultural factors. The influence of any of these factors can impact the mental illness of an individual. For instance, United Nations Centre for Human Settlements (2008, p. 25) report indicates that people who leave in slum areas in towns face a social and economic environment of inequality that includes greater exposure to violence and poverty. The report further states that people living in poverty-prone areas have the most impact on the rates of mental illness. Consequently, people in the lowest strata of income, education, and occupation, collectively known as socioeconomic status, are three times more exposed to mental distress than those with higher socioeconomic status.
Geographical location also influences the way people are treated racially. Ramsay (2002, p. 13) observes that racial discrimination affects both general and mental health. This is because racially discriminated people are at risk of mental disorders like depression and anxiety. It has been found out that people who live in areas where they are exposed to any form of discrimination records higher cases of mental distress compared to the one, who are located in areas with no discrimination. Ramsay (2002, p. 13) argues that this may be due to the fact that people in such areas tend to lose trust in the mental health services which are provided as they point out the evidence of clinicians being biased and stereotyping. Similarly, people who live in the regions, where their culture is viewed differently from that of their hosts may be affected more seriously as mental services will be changed to meet the cultural practices of such group. Furthermore, Ghaemi and McHugh (2007, p. 10) note that clinical environment, which does not respect or is incompatible with cultural practices of the minority, will deter them from using services and receiving appropriate mental care.
From the above discussion it is evident that biomedical approach to mental health treatment plays a crucial role in alleviating the problem of mental illnesses in the society. It is also found that although the approach is lauded as a better methodology to the problem, there is the need to have concerted effort by different players to ensure that patients with mental illnesses receive the highest quality of attention from the society through social support. The discussion has also assessed the need to evaluate the geographical impacts on mental health for people living in areas with deplorable conditions like slums and other poor areas with no amenities like housing and water. Additionally, the discussion has demonstrated that social support plays various roles in helping people with mental distress. It must therefore be noted that social support is crucial in building a society with better mentally health.