Conceptualisations of mental disorder Flashcards
Where does the word ‘madness’ come from?
How is it used? Any alternatives?
> Dating to Freud
Used by historians provocatively
Alternative: ‘Survivors’ movement - “we’re not mad, we’re angry”
How are the words we use ‘value-laden’ (heavily loaded)?
> Mental disorder -> legal and administrative construct
Mental illness -> medical construct
Mental health problem/distress -> acceptable alternatives or euphemisms
Mental health -> WHO, popular conceptions
How is a mental disorder considered a legal and administrative construct?
1983 Mental Health Act:
> Mental disorder = ‘any disorder or disability of the mind’
Mental Health Act - Code of Practice:
> clinically recognised conditions:
- affective disorders: depression, bipolar disorder
- schizophrenia, delusional disorders
- neurotic disorders
- organic mental disorders (e.g. dementia, delirium)
- personality and behavioural changes caused by brain injury
personality disorders
- autism spectrum disorder
- …
-> Defines a mental disorder depending on alcohol and drugs, which negate the presence of a mental disorder
Crown Prosecution Service:
- ‘Mentally disordered offender’
- covers a range of offenses
- relevant to the decision of protection, divert (turn aside), fitness to plead, sentencing, disposal
How are mental disorders identified in England and Wales today? What perspective can be taken here?
Someone can be detained in hospital and treated against their will
IF 3 professionals agree on the presence of a mental disorder (+ other criteria)
-> social perspective
How is a mental disorder an ‘administrative construct’?
- Identifying mental disorder
- Counting mental disorder
- Calculating the burden of mental disorder
- Accessing specific services and benefits -> you need to have a label of a mental disorder (e.g. autistic spectrum)
- Diagnostic function: do I have a mental disorder?
=> DSM-5
Who criticises the DSM-5 and why?
Criticised by:
- Those who reject the ‘mental illness’ language implicit in the DSM-5 outright
- Those who feel that the DSM-5 approach is an intellectual blind alley
Can you give 3 examples to illustrate the ‘image’ of disorders?
- an uncontroversial disorder: depression
- a ‘fashionable’ disorder: bipolar disorder
- a contested disorder: schizophrenia
How are mental disorders misused? What are the consequences of this misuse?
- As adjectives: “you look so anorexic”, “my OCD is coming again”
- Bad labels and headlines: “psycho”, “schizo”, “paedo”
=> Inaccurate, demeaning, stigmatizing
What is a mental health problem?
What information this terminology conveys?
Ranged from worries we all experience in everyday life, to serious long term conditions.
- > careful about use of language
- > there’s a spectrum of difficulties
- > avoids ‘illness’ language
How does the WHO (2016) defines mental health?
“a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her own community”
What are key facts the WHO provides about mental health?
- around 20% of the world’s children and adolescents have mental disorders or problems
- Mental disorders are important risk factors for other diseases, as well as unintentional and intentional injury
- War and disasters have a large impact on mental health and psychical wellbeing
- About 800,000 people commit suicide every year
- Mental and substance use disorders are the leading cause of disability worldwide
- Globally, there’s a huge inequity in the distribution of skilled Human Resources for mental health
- Financial resources to increase services are relatively modest
- Human rights violations of people with mental and psychosocial disability are routinely reported in most countries
- Stigma and discrimination abasing patients and families prevent people from seeking mental health care
What is the gap between WHO’s definition (2016) of mental health and their policy?
Inclusive definition but the WHO policy focuses on increasing services for people with severe mental health problems (specifically)
What are the 5 steps the UK NHS proposes to mental wellbeing?
- Connect: with the people around you, develop relationships
- Be active: find an activity you’ll enjoy and make it part of your life
- Keep learning: new skills -> sense of achievement, confidence
- Give to others: small acts count (a smile, a “thank you”), volunteering
- Be mindful: more aware of the present moment (thoughts, feelings, your body, the world around you)
- > mindfullness
What are the 3 explanations given to madness in the Ancient World?
Where lies the interest towards madness today?
- a disorder of the brain
- a reaction to circumstances / mortal weakness or failing
- spiritual or demonic possession
Today, we take interest in the spiritual domain.
What is the evolution of psychological constructs?
- Associationism : John Locke (1659)
- “… they err as men do that argue right from wrong principles” - Psychodynamics
- Cognitive-Behavioural approaches: Daniel Freeman (2016)
- “at the heart of persecutory delusions are unfounded threat beliefs”
