W2: Changing Explanatory Models for Mental Health Perception

A person’s understanding of what a mental illness is greatly influences the treatment options offered to them as well as the social, political, and health outcomes that follow being diagnosed with a mental illness.  A person with a better understanding of what a mental illness is and who can clearly voice their explanatory model, which explains how they are feeling and how this health issue is affecting them (Kleinman, 1988), is more likely to get accurate and affective treatment than somebody who cannot successfully communicate their explanatory model.

These explanatory models can also share how the health episode is perceived not only by the patient, but also by their family (Kleinman, 1988).  The families, patient(s), and doctor being on the same page as to how the illness is perceived will allow for less social unrest due to misunderstandings of what is going one, and will also allow for a better and more positive health outcome for the one experiencing the illness.  As stated in “Explanatory Models for Psychiatric Illness”: “Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of the individual, and involving processes best understood from biological, psychological, and sociocultural perspectives, traditional models of science that strive for single broadly applicable explanatory laws are ill-suited for our field” (Kendler, 2008).

Furthermore, the explanatory models held by doctors can also affect the outcomes and options that are provided to the person experiencing the health issue.  As Dr. Metzl mentioned, in the 60s and 70s the Ionia Hospital changed from being mostly populated by woman who were diagnosed with Schizophrenia to mostly black males from Detroit who were diagnosed with Schizophrenia once they reached the hospital (Book TV: Jonathan Metzl, 2010).  This is where the political effect of explanatory models comes in.  Diagnosing these black men with Schizophrenia was, according to Dr. Metzl, an attempt to erode the Civil Rights movement (Book TV: Jonathan Metzl, 2010).

Another view of explanatory models comes from McGruder, who discusses the need to understand how a mental illness is perceived by the cultural group, religious system, and family of someone who has a mental illness, and how the cultural and religious views will affect the treatment and perception of this individual (Jenkins, 2003).  For example, having criticism or rage directed at a person suffering from mental illness will cause relapses and could hinder the possibility of having positive health outcomes (Jenkins, 2003).  Understanding how a culture perceives a mental illness will also allow the social and political effects to be better understood and taken into consideration when treating an individual with a mental illness so the best outcome can be reached (Jenkins, 2003).

 

Kenneth S. Kendler, “Explanatory Models for Psychiatric Illness,” The American Journal of Psychiatry 165 (2008): 695-702, accessed July 15, 2016, doi: 10.1176/appi.ajp.2008.07071061.

One thought on “W2: Changing Explanatory Models for Mental Health Perception

  1. Hello Lucy,

    I really enjoyed the point you brought up on doctors being understanding of the social stigma that can surround different mental illnesses. Most medical staff who operate outside of the related specialties of mental health aren’t as understanding of these illnesses. Every doctor can understand a broken arm, but not everyone can understand the complexities that can be involved in things like schizophrenia. I also appreciated that you focuses on the fact that casual factors have a multi-level impact on mental illnesses, and that focusing exclusively on the biological prospective will leave a gap in the understanding of the diseases.

    I also liked the mention of the impact that explanatory models can have on the outcome of a patient’s health, especially with mental illness. This impact can be seen as well based on the patient’s family’s explanatory model of the illness. Some of the same things that can help one person can hinder another’s treatment and recover. I’ve seen many friend’s struggles with things like depression and anxiety improve once they were able to get away from a place where their illness was used as a way to criticize them. It is amazing what can happen when people are given a chance to recover without also having to deal with the secondary effects of being put down for something they lack control of.
    Good post, and I’m glad you touch on of the important parts from this week!

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