The Problem with the Medical Model
My new Zoom client was late.
After resolving a few technological issues, she came online. We chatted for a minute then she enabled the video so I could see her.
Sitting on a red couch in an apartment that resembled a hotel room was a beautiful young African woman.
Away from home on her own, working long hours in a mono-cultural European city where she was at odds with the dominant culture, this smart and ambitious young woman was understandably lonely and distressed.
She needed a friend, not a therapist.
We don’t live in a vacuum.
Our mental health is not siloed either.
We are all subject to the stresses and strains of living in a busy, sometimes confusing world.
Our mental health depends on so many factors.
Basic issues such as financial stability and safe, secure accommodation are vital to our wellbeing. Knowing where your next meal is coming from and where you are going to sleep tonight obviously have a huge impact on mental health.
We all need access to clean air and water, safe streets and freedom from exploitation, homophobia, racism, sexism, violence and abuse. Access to reliable medical treatment and healthy food also helps.
We take some of these things for granted, but for many people in Australia and around the world, these are not things they can rely on. The ability to feel safe in our community and at home influences our stability and our sense of wellbeing.
Other Things that Contribute to Good Mental Health:
Supportive relationships where you can feel safe to talk about your fears and worries
Good networks with extended family and friends
A caring community and a sense of connection
The conviction that life is worth living
A sense of meaning and purpose, faith and trust
Good physical health
Access to nature and beauty
Warm hugs now and then
A pet you can snuggle up to and care for
As a social worker, I have been trained in systems and context - in relationships and how the social world and our containing structures influence our well-being.
For some people like my Zoom client, sadness and anxiety are natural responses to an insecure and unpredictable environment and enforced isolation.
The medical model of mental health with its classifications, systems of diagnosis and medication regimes often fails us by ignoring this wider context.
Its best to keep this limitation in mind when visiting your GP to get help for mental health.
7 Things to Keep in Mind When Visiting a GP for your Mental Health
Medication isn’t always the answer.
When a doctor hands out SSRIs or sleeping tablets, they are feeding into our desire for quick fixes and the pressure to get patients out the door quickly. Medications can get us through a bad period and help stabilise our mood, but they aren’t the answer to long-standing issues.
Life is challenging.
Sometimes our life situation can cause us to feel insecure, frightened, stressed or sad. These are not mental health issues that can be treated or cured, although we can seek support to develop strategies for dealing with difficult times.
One size does not fit all.
People are individuals and what works for one person’s mental health doesn’t always work for others.
RCTs don’t tell us everything.
Treatments that fit into the scientific model of proof and testing are normally prioritised by medically trained practitioners and referrers like GPs. These paradigms also help governments save money by justifying shorter term solutions. The reality for most people is that while cognitive-based treatments work in the short term, the gains made dissipate after 3-6 months. For real change to occur, people need to stay with therapy and find the empathic connection that can help them achieve lasting change and growth.
Therapy is a relationship.
The emotional connection we make with our therapist is part of what heals. This process can’t be quantified and finding a therapist who is a good fit is part of the work of getting the right treatment for you.
Real change is hard.
In order to make a shift in our lives, we need to make a commitment to doing the hard yards of therapy. Expecting to achieve long-term change through a single insight or short term strategies just isn’t realistic.
Treating the symptoms rather than the underlying cause doesn’t work in the long term.
Surface symptoms like anxiety are often signs of more serious underlying problems such as childhood trauma, attachment disorders or problems with identity. Unfortunately these underlying issues can’t be resolved with medications or short-term treatments.