Mental health practice: Bonnyrigg
Mental health practice: Bonnyrigg

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Mental health practice: Bonnyrigg

1.3 Models of understanding in mental health

Because mental health is such a complex area, it is important that the models of understanding which are applied to it are broader than the ‘biomedical’ one alone, which focuses simply on professional activity and on diagnoses and treatment. The box below provides a quick summary of the biomedical model.

The biomedical model

Health care is seen as medical care, and medical care is seen as:

  • a quest to conquer and cure disease;

  • focused on disease more than on the whole person;

  • concerned with what is normal and what is pathological and making judgements about the boundary between them;

  • a rational activity based on scientific knowledge that is secured through lengthy formal training.

The biomedical model has been the dominant model in mental health services because the dominant profession in these services has been psychiatry. Psychiatrists are medically trained and therefore tend to see the main purpose behind their work as the diagnosis and treatment of illness or disorder. However, the work of more and more mental health professionals, including psychiatrists, is influenced by much broader models of understanding mental health, particularly social models such as the one described in the box below.

The modern social model in mental health has the following key characteristics:

It is based on an understanding of the complexity of human health and well-being.

It emphasises the interaction of social factors with those of biology and microbiology in the construction of health and disease.

It addresses the inner and the outer worlds of individuals, groups and communities.

It embraces the experiences and supports the social networks of people who are vulnerable and frail.

It understands and works collaboratively within the institutions of civil society to promote the interests of individuals and communities and critique and challenge when these are detrimental to these interests.

It emphasises shared knowledge and shared territory with a range of disciplines and with service users and the general public.

It emphasises empowerment and capacity building at individual and community level and therefore tolerates and celebrates difference.

It places equal value on the expertise of service users, carers and the general public but will challenge attitudes and practices that are oppressive, judgemental and destructive.

It operationalises a critical understanding of the nature of power and hierarchy in the creation of health inequalities and social exclusion.

It is committed to the development of theory and practice and to the critical evaluation of process and outcome.

Duggan, Cooper and Foster, 2002

The social model of mental health places much greater emphasis on the role of networks and communities in maintaining the mental health of individuals. Social isolation is a common problem for people experiencing mental distress and some kinds of mental health services can make a vital contribution towards alleviating this isolation, thereby forming an essential part of the social networks of their service users. To highlight the importance of these issues, this course next introduces the work of a community resource centre in Scotland which makes a significant contribution to the welfare of local people.

Activity 3: Evaluating reflective writing

1 hour 0 minutes

For this activity you need to evaluate a piece of reflective writing rather than complete any yourself. The five questions below should be used to complete this evaluation.

  1. Have relevant areas of knowledge, skills, values or processes been selected and discussed?

  2. Does the answer show an understanding of the issues and arguments discussed in the course materials?

  3. Does the answer indicate an ability to reflect upon practice learning through the integration of learning from a range of sources?

  4. Is the writing clearly expressed?

  5. Is the organisation of the answer clear and logical, with a clearly expressed, well-evidenced discussion?

Now, use these criteria assess the following piece of writing. For the purpose of this exercise you should correct any mistakes that you find and note any parts which you think are effective. If there are sections which you feel could be written better, then you may wish to suggest a rewording.

Discussion

I have written my comments in parentheses in the box below.

Looking back at my five questions:

  1. Have relevant areas of knowledge, skills, values or processes been selected and discussed?

    There is some good evidence of knowledge, but skills, values and processes need to be more explicit.

  2. Does the answer show an understanding of the issues and arguments discussed in the course materials?

    Yes – there are some good links.

  3. Does the answer indicate an ability to reflect upon practice learning through the integration of learning from a range of sources?

    There is some good reflection and evaluation, but some issues need further discussion.

  4. Is the writing clearly expressed?

    Yes.

  5. Is the organisation of the answer clear and logical, with a clearly expressed, well-evidenced discussion?

    Some improvements in evidence would be helpful, and a more explicit structure. An introductory paragraph outlining the areas of practice to be evaluated would be useful.

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