Models of mental health care by Henrietta Ross

Perhaps Quaker William Tuke was right. When he opened the York Retreat in the 1790’s he shunned physical restraint and incorporated what became known as ‘Moral Treatment’. Psychiatrists encouraged by Tuke’s philosophy believed that a carefully designed and regulated environment helped to restore a patient’s sanity.

antidepressantFor a time ice cold baths, isolation and physical restraint became a thing of past until the 1900’s when psychiatry began experimenting with what it considered to be cutting edge treatments such as ECT and Lobotomies. However, everything changed with the advent of a new drug in 1951. In the 1940’s and early 1950’s, a French pharmaceutical company were investigating drugs for sedating patients and it was during this research that they came across Chlorpromazine. There findings soon attracted psychiatrists who up until this point had only a small number of sedatives to work with in controlling (pacifying) patients.

Following on from this newly found wonder drug, laboratories helped by pharmaceutical industries and professionals went on to discover and make a wide variety of other drugs that would become widely available in treating mental illness. Today, some sixty years on, we now have a multi-billion pound industry in America affectionally called Big Pharma. Once they realised the impact of Chlorpromazine, there was no stopping the avalanche of new drugs that they were willing to research and produce for psychiatric purposes, as their profits reached atmospheric levels.

When one considers Psychiatrists, it is all to easy to see how their love of the medical model which essentially involves looking for specific patterns of behaviour – diagnosing (not necessarily correctly) – and prescribing in one swift swoop fits in well with the drug companies who many of them are in bed with as we speak. What is most concerning however, is that neuroscience is an inexact science, meaning that we know and understand very little about the complexity brain. Therefore, to use drugs whose properties are usually for physical aliments to treat an organism that we have only a partial understanding of is unsafe and perilous. Psychiatrists additionally have very little pharmacological knowledge regarding the potent chemicals they are administering to individuals. They well may know what a specific drug is good for re Bipolar Disorder, Anxiety so forth but will often have no comprehension of side effects or possible complications of those drugs.

Ten years ago I was diagnosed with Bipolar Affective Disorder. Once diagnosed, quite rapidly, I was prescribed a cocktail of drugs which over a short space of time alarmingly caused me more problems than the disorder itself. The mood stabilizers caused excessive weight gain which not only caused me to feel severely unfit but also impacted upon my self esteem and served to lower my mood further. The anti-psychotics I was prescribed that kept being continually increased caused cognitive impairments, an increased need for sleep and perpetual drowsiness when awake, lack of motivation and diminished levels creativity.

When I complained worryingly and frustratingly of the side-effects I was quite regularly told rather patronizingly ‘but you’re well’ almost as if a diminished, only partial existence can be equated to a life well lived, if one is not conflicted with mental illness at any point.

For me the medical model has limitations. If I want a Psychiatrist to look at a sample of my behaviour, if I am looking for a diagnosis and/or if I am willing to take psychotropic medications, then it works well. I myself have benefited from a competent Psychiatrist diagnosing me and I still use a very small amount of drugs myself when need be.

However, after diagnosis and/or prescriptions, I find Psychiatrists become rather redundant. The medical model which focuses on the brain seems to rather perplexingly see the mind and the body as two separate entities acting independently of each other. Additionally, many psychiatrist see mental illness in terms of the brain being diseased which is understandable given their training but does very little to inspire hope in one’s patients and certainly gives the subconscious message that any aspirations one may have need to be reduced and/or re-aligned in relation to the disability and consequent restrictions that having a mental illness will cause.

If the mind and body are understood, wrongly, to be two separate entities then it makes perfect sense that Psychiatrists seem to spend very little time considering the overall health of their patients. For example, they do not seem inclined to look at a patient’s diet and how food not only has an impact on the body but also substantially on the brain of an individual or exercise and the resultant release of endorphins which can be particularly beneficial in an individual suffering form mental illness as well as the benefits of simply being fit and healthy on one’s life.

Surely to understand and treat any individual we need a ‘holistic approach’ one that understands and considers the whole person, instead of simply following ‘a one size fits all’ medical model that offers very little to an individual in the way living their lives. An individual rather than simply being their illness could slowly learn the art of living with their illness, in a way that ultimately feels authentic to them, taking into consideration their own unique personality, beliefs, values and given understandings. Rather, that is, than accepting a life spent taking toxic chemicals that they know very little about, an in-built pessimism about their life chances which psychiatry happily peddles out and the depressing reality of a life only half-lived.

Maybe Tuke was right, agreed his patients were in an asylum but I’m not talking about the environment that the care was administered in but the approach used, which was essentially the moral treatment beloved by the Victorians.

If Psychiatry nowadays could understand that individuals need to heal, rather than necessarily be cured, if they understood the value and impact of kindness and measured, ‘holistic’, humane treatments rather than pacification through chemicals, if they comprehended the innate need humanity has to be social and work together, how important purpose is to each of us and how regular routines and habits create structure in what were once chaotic lives then maybe we could move forward, just a little.

Henrietta Ross is a writer and Blogger from the UK. She has her own personal blog at and also writes for online magazines and websites.


One thought on “Models of mental health care by Henrietta Ross

  1. Lovely article. I’ve just Tweeted it on Twitter. I am training to be a mental health nurse and agree we must take a holistic approach. Someone once said to me “treat the person in front of you, not the disorder”. Well, there is a lot to be said for that. I’m not saying disregard diagnosis, as it’s important. But we must treat the person in front of us! The individual. That unique human being!!!

    @AJ628studentMH (Twitter)

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