The Big Debate: How Should Mental Disorders Be Treated?

Image courtesy of Ambro at
Image courtesy of Ambro at

Treating mental health problems such as schizophrenia and bipolar disorder in the same way as physical illnesses is unhelpful, the UK’s Daily Mail newspaper has reported.  A statement released today by the British Psychological Society’s division of clinical psychology, and the basis for the Daily Mail online article, has called for a change in the way mental disorder is understood.

Even labelling the conditions is counterproductive they say, adding there is no evidence that a ‘breakdown’ or ‘severe emotional distress’ is the same as an illness with genetic or biological causes.

According to Dr Lucy Johnstone, a consultant clinical psychologist who helped draw up the statement: ‘……………we do have an overwhelming amount of evidence that even severe psychiatric breakdown is the end result of a complex mix of social and psychological circumstances – in other words, things that have happened to you’. Further. the article reports that she said ‘the new approach must regard mental distress as ‘people with problems, not patients with illnesses’.

Whilst I concur with the idea that mental illness is multifaceted, has a complex aetiology and the best outcomes occur when a multidisciplinary approach to management is undertaken, I have serious reservations about the British Psychological Society’s approach.  Treating serious psychiatric conditions such as Bipolar Disorder and Schizophrenia as ‘breakdowns’ , albeit serious ones, is problematic, to say the least.  Try treating either of these illnesses – and I use this descriptor deliberately – with purely psychological interventions, and the results could very well be less than satisfactory.

Almost everyone I know who lives with Bipolar disorder require medication; without it they would rapidly degenerate into a highly destructive – and perhaps even fatal – cycle of depression and hypomania/mania.  Yes, recognition of the psycho-social factors that feed in to an individuals illness is very important in ensuring a satisfactory clinical outcome, but psychiatrists are very much aware of this and already draw on other professionals where necessary.

Approaching Bipolar using the same conceptual framework as, say Obsessive Compulsive Disorder (OCD), is a mistake. Whilst the latter  generally responds very well to cognitive behavioural therapy (CBT), as far as I’m aware the same cannot be said for the former.  Also, there is increasing evidence that Bipolar has a genetic component.

Finally, it has taken huge amounts of effort to de-stigmatize conditions like Bipolar Disorder.  Incorporating them into a medical model has helped to break down the barriers of prejudice and ignorance that have for too long blighted the lives of those who live with these conditions.

You can read the entire article here:

One thought on “The Big Debate: How Should Mental Disorders Be Treated?

  1. Yet another foray into the chicken-or-egg debate… Psychologists and psychiatrists both need to lay their massive egos aside and recognize that both our genetics and our environment shape who we are.

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