Modelling psychiatric disability

J Eval Clin Pract. 2015 Jun;21(3):490-5. doi: 10.1111/jep.12316. Epub 2015 Mar 10.

Abstract

Rationale, aims and objectives: There has been inadequate philosophical attention to the claims of psychiatric user/survivor activist groups, although these groups represent a significant social justice movement. Many of the core concerns and claims emerging from this activism can be found in disability activism. A first step that must be taken is to question how mental illnesses are modelled. Biomedical modelling is heavily criticized by psychiatric users/survivors for being reductionistic and for perpetuating damaging presumptions about decline and pathology. Social constructionist modelling, on the other hand, tends to be overly dismissive of biological factors that are often at play with these sorts of impairments. A middle-ground approach, interactionist modelling, promises to be responsive to demands for recognition from psychiatric users/survivors.

Method: I will first outline the core commitments of psychiatric users/survivors. Next, I will evaluate different models for mental illness by bringing together insights from user/survivor and disability activism.

Conclusions: I conclude that interactionist modelling holds the best hope for supporting shared decision making. This type of model braids together the expertise of patients and medical professionals.

Keywords: activism; biopsychosocial; disability; modelling; psychiatric user/survivor movement; self-definition.

MeSH terms

  • Decision Making*
  • Humans
  • Mentally Ill Persons*
  • Models, Psychological*
  • Persons with Mental Disabilities*