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The World Health Organization (2019) defines mental health as a state of well-being in which the individual realizes his or her abilities, can cope with the normal stress of life, can work productively and fruitfully, and can make a contribution to his or her society . For a behavior to be considered abnormal, it must be deviant from normal behavior, it must cause distress, it must be dangerous, and well as cause dysfunction in a persons daily routine (Davis, 2009). When a behavior consists of the four Ds, that behavior is considered abnormal. A recent study found that two hundred and twenty-five billion US dollars were spent on mental health patients (2019). As such it is evidently clear that mental illnesses are taking place rapidly and are a problem of major concern in the modern world. The following paper will explain and critically evaluate two of the most common definitions of mental health, namely the biomedical model and the biopsychosocial model.
The Biomedical Model
The view presented by the biomedical model is that mental illnesses are due to biological factors. The biomedical model takes into consideration the doctor’s diagnosis and treats mental illnesses as physical ailments (Farre & Raley, 2017). As such the prime focus of the biomedical model is biology as the model believes biological factors such as genetics are the main factors that lead to mental illness. Therefore, mental illnesses should be treated as physiological problems. The perspective put forward by the biomedical model was further strengthened upon the discovery that general paresis was a result of a microorganism and could be cured by penicillin (Deacon, 2013).
There has been research conducted that supports the view put forward by the biomedical model. According to an article (Harvard Health Publishing, 2009), an explanation for people suffering from mental disorders is the fact that there is problematic neurotransmission. For instance, in the case of depression, the biomedical explanation for depression is the fact that depression is a result of low serotonin production. Scientists also believe that certain problems such as schizophrenia may be a result of the disruption of the neurotransmission of chemicals such as dopamine and glutamate (Harvard Health Publishing, 2009). There is evidence proving that problems such as ADHD may be genetic as well (Franke et al., 2012). As such the biomedical model explains mental health from one point of view and that is biology.
The fact that mental illnesses are defined and explained in terms of biology presents several strengths. One of the strengths is that the biomedical explanation of mental health leads to empathy. The reason behind this is that mental diseases are explained in terms of genetics and biology, so a person cannot be held accountable for the problems that one is facing as they are purely because of biological reasons. Studies conducted have found that in court the judge would give mental patients a shorter prison sentence (Lebowits, & Woo-Kyoung, 2014). This could be a result of the reductionist view put forward by the biomedical model. As the only explanation for deviant, distressing, and dangerous behavior put forward by the model is genetics. As such the presentation of this model leads to an increase in empathy as it presents a reductionist point of view for which the person cannot be held accountable.
Another strength of the biomedical model is that it is revolutionizing psychiatry. According to an article (Deacon & McKay, 2015), the medical explanation has led to the formation of treatment methods such as neuroimaging. Neuroimaging is the process of obtaining pictures to identify the functions and processes of the brain. The medical approach as a result of taking into consideration biology has resulted in the formation of methods of treatments such as providing anti-depressants and anti-psychotic drugs. The biomedical model states that mental health problems such as depression may be a result of chemical imbalances in the brain. These anti-depressants are given to increase production and regulate the production of certain chemicals which lead to problems regarding mental health (Deacon &McKay, 2015).
Although the biomedical model presents several strengths in terms of defining mental health, the very strengths of the model may also be its weaknesses. One of the weaknesses presented by the biomedical model is the fact that it has low validity. It is low on validity as research has found that anti-depressants may not help address mental health problems (Lacasse & Leo, 2015). Thus, the lack of scientific evidence in this aspect leads to the model lacking validity. In addition to that, research has also identified that the use of anti-depressants has had negative effects. The common types of anti-depressants used are tricyclic anti-depressants, selective serotonin reuptake inhibitors, and selective serotonin non-adrenaline reuptake inhibitors (Nordqvist, 2018). As the biomedical model proposes that mental illnesses are a result of the low production of chemicals, the anti-depressants cease to increase the production of these chemicals. The problem with this is the fact that anti-depressants lead to problems such as diarrhea, nausea, and urinary problems. Certain anti-depressants also lead to problems relating to sleep as well (Nordqvist, 2018). Although anti-depressants claim to be effective, mental diseases have not been reduced but only increased at present (Whitaker, 2015). As such it is clear that anti-depressants are often injuries to health, thereby identifying that as a weakness presented by the biomedical model, as it is the biomedical model that led to the creation of such methods of treatment.
The biomedical model as stated presents a reductionist view. This is a flaw in the model as the functions of the brain are often complex and cannot be reduced to simple genetics and molecules. This flaw was addressed by Engel who presented the biopsychosocial model and created a new definition of mental health, acknowledging genetics and other factors that influence mental health. As such Engel stated that the model was not sufficient as it only addressed one potential reason for problems regarding mental health. The weaknesses presented by the biomedical model were addressed by Engel (1990), thereby giving birth to the biopsychosocial model.
The Biopsychosocial Model
The biopsychosocial model was put forward by Engel in the year 1980. The biopsychosocial model states that mental illnesses are a result of biological, psychological, and social reasons. The model states that for a mental illness to develop all three of these perspectives must be taken into consideration. Mental illnesses are a combination of the three perspectives as opposed to one reason as put forward in the biomedical model. For instance, if depression were to be explained in the biopsychosocial model, the biological aspect would be that: depression is a result of genetics. The biological model also states that depression is a result of dysfunctional tissues and cells. A study was conducted by Mullins and Lewis (2017) in China to explore the reasons for depression. The research found evidence for biology being a possible explanation for depression. At least 5.5% of the population suffered from depression in 2010 (Albert, 2015). It has also been identified that the ratio of women who have depression is higher as opposed to men. The reason behind this is often questioned. A study conducted on monozygotic twins identified that women proved to be more sensitive to interpersonal relationships. In terms of biology, this is explained as a result of chemical imbalances which occur mainly during puberty and before menstruation. Therefore, studies state that depression may be the underlying result of the hormone estrogen (Albert, 2015). The psychological explanation for depression is because of problems in the hippocampus and other related areas in the brain (Yang et al., 2015). Scientists have found that neuronal damage is often an explanation for mental illnesses. As such, various structural and functional damages caused to the brain often lead to mental illnesses such as depression (Yang et al., 2015). And in terms of the social aspect, depression takes place because of various societal pressures. A study was conducted in China after the eruption of the Wenchuan earthquake. The study conducted identified 15.8%, 40.5%, and 24.5% of those who suffered as a result of the eruption of the earthquake were diagnosed with post-traumatic stress disorder, anxiety, and depression. Thus, it is clear that depression and other mental illnesses could be a result of various social problems that take place.
The biopsychosocial model presents several strengths. One of the key strengths of the biopsychosocial model is the holistic model it portrays. Instead of taking one factor to be the cause of mental illnesses, the biopsychosocial model takes into consideration the biological, psychological, and social factors into account. Thereby, giving a holistic perspective to mental illnesses. Individuals in the biopsychosocial approach, in contrast to the medical model, are considered active participants in the process of recovering from their mental health challenges, as opposed to being perceived as passive beings with problems. The biopsychosocial model is also recommended in several medical textbooks.
The biopsychosocial model helped remove the notion integrated into Western culture where the mind and body are considered as two separate entities (Cowen & Browning, 2015). However, utilizing the biopsychosocial model has removed that notion and sought to consider the mind and body as one. The biomedical model constantly focuses on biological explanations for diseases such as the dopamine hypothesis for schizophrenia and the serotonin hypothesis for depression. The serotonin hypothesis about depression states that the diminished activity of serotonin pathways leads to depression. Serotonin is present in blood platelets, which constricts the blood vessels and acts as a neurotransmitter (Cowen & Browning, 2015). As such, the biomedical model was constantly focusing on and addressing mental illnesses as physical ailments thereby, not taking into consideration the brain and the problems about ones brain. Whereas the biopsychosocial model addresses mental illnesses as problems taking place as a result of problems taking place both physically and mentally.
Although the biopsychosocial model presents several strengths, it is not without its weaknesses. One of the limitations of the model is that it lacks scientific evidence supporting its claims. In 1998, McClaren conducted research on the biopsychosocial model and stated that the model lacks substantive evidence on how the three aspects contribute to the development of mental illnesses. The biopsychosocial model although claims for the three perspectives to be inter-twined often fails to take equal consideration of all three perspectives. It is often identified that most studies do not pay equal attention to all three aspects when defining mental illnesses. It was found that 94% of journals when defining mental illnesses in the biopsychosocial model failed to take into consideration the social aspect of the model (Benning, 2015). This flaw is a result of another flaw, which is the fact that the model does not give guidelines as to how and when the three perspectives need to be used and when to prioritize and not the three perspectives. As such, that is identified as one limitation of the biopsychosocial model.
Another problem identified in the biopsychosocial model is the fact that, although the three aspects are considered to be working together epistemologically, this perspective that is put forward by Engel is naive. The biopsychosocial model is not a theory, but merely a point of view in which a certain problem is perceived as such, it does not necessarily provide an accurate explanation and an answer for most of the mental illnesses. As such, the biopsychosocial model presents several weaknesses as well.
Conclusion
The biomedical model defined mental illnesses in terms of physiological ailments. The medical presented several strengths and weaknesses. The strength displayed by the model was the fact that it revolutionized psychiatry by bringing forth treatments for mental illnesses. It also increased the empathy towards mental health patients, as it was perceived as problems resulting from biology for which a person could not be held accountable. The limitations of the model are the fact that it presents a reductionist point of view and therefore does not take into consideration other possible explanations for the development of mental health illnesses. The model is also low on validity, as research has found that antidepressants can prove to be ineffective. The biopsychosocial model, on the other hand, defined mental illnesses from the three perspectives of biology, psychology, and society. The strengths of the model were the fact that it provided a holistic point of view and that it helped remove the notion that the mind and body should be considered as two different entities. However, this model presented several flaws. The first flaw was that the model lacked scientific evidence. The second flaw displayed by this model was that the perspective put forward by the model was epistemologically naive. Thus, the conclusion arrived at is that both models present new and different perspectives when defining mental health. Each perspective presents several strengths and weaknesses and has contributed to the field of psychology.
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