As rates and awareness of mental-emotional problems and suicides have climbed in the United States and the western world generally, use of the term “mental health” often triggers a debate that reflects sharp philosophical differences.
On one hand, the overwhelmingly dominant perspective, especially in the United States, is a medical one centering largely on brain health - with illness stemming from some kind of identifiable and correctable chemical deficiency in the body. From this perspective, it is appropriate to attempt to remedy mental or emotional challenges primarily (and initially) by correcting underlying biological deficiencies. To those holding this view, the effort to do so via pharmaceutical agents has largely been an undoubted success - even what some describe as “miraculous.”
To others, such portrayals of dramatic success achieved by psychiatric treatment overstate success and say more about the dominant power of “Big Pharma” marketing than they do about the lived reality of those facing mental/emotional challenges. Those holding this view see drug therapy as having almost exclusively short-term effects (and only for some people), with long-term outcomes poor and sometimes disastrous. Some call this view a “recovery approach” and contrast it with a “treatment approach” that focuses narrowly on symptoms and treatments rather than the whole patient and his or her journey to recovery. Critics argue that the treatment approach has made things significantly worse - especially when compared with the potential of environmental and lifestyle adjustments.
These polarities are reinforced by insurance coverage policies that favor the treatment approach, by the lure of (and reward for) quick and easy answers in our culture, and the stigma about mental illness that keeps those with personal experience from speaking about it.
Between the poles there are approaches that see value in and utilize both perspectives. Some people feel caught in the middle in acknowledging mental health challenges and valuing all approaches that can help them get better - rather than “picking sides.”
QUESTIONS TO PLAY WITH:
If you were facing a mental health crisis, would you rather see a medical professional who favored the treatment approach or the recovery approach? Or would you rather have a balanced team?
Does the idea of empowering mentally ill people to fully engage in their own recovery, rather than submitting to treatment, appeal to you? Why or why not?
Can you think of situations in which each approach described here makes more sense to you? If you were in charge of making medical decisions for someone you care about, how would you choose?
- Living Room Conversation Guide: Mental Health
- Living Room Conversation Guide: Mental Health, Addiction & Incarceration
- Community Conversations About Mental Health (2013) Substance Abuse and Mental Health Services Administration (SAMHSA), Deliberative Democracy Consortium and Everyday Democracy
- Mental Illness in America: How Do We Address a Growing Problem? (NIFI Issue Guide) (2014) 13-page issue guide from National Issues Forums
- Addressing Mental Health Care: A Handbook for Discussion & Deliberation was created in 2007 by Kansas State University’s Institute for Civic Discourse and Democracy (ICDD) in association with the National Association of Mental Illness (Kansas).
Bob Whitaker’s Blog
Jacob Hess, Mary Jacksteit, Cynthia Kurtz
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