The effectiveness of the medical model Essay

The medical model describes that: mental disorders are caused by abnormal physiological processes rather than psychological causes.

The medical approach is very broad and focuses on the role of genetic, neurological and biochemical factors in the onset of mental disorders. For example, with genetics, the research into concordance rates has shown that if one of a monozygotic twin pair develops schizophrenia, there is a 50% chance that the other will also develop it. Anxiety disorders are explained by defects in the nervous system causing the person to be too easily aroused; depression is seen as a dysfunction in the neuronal transmission process. Other causes may include structural abnormalities of the brain or abnormal hormone levels.

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The approach practices reductionism; the view that complex phenomena (such as thoughts, feelings and emotions) can be completely understood and explained at a more basic level; as biological processes. This simplification has been criticised for being insufficient for truly understanding psychopathology “The crippling flaw of the medical model is that it…can make provision neither for the person as a whole nor for the data of a psychological or social nature” (Engel, 1980). This statement implies that biological explanations of what occurs cannot explain their ‘function’. For example blushing. At its biological level, it is simply a change in the vascular blood flow. Psychologically, a person blushes when they are embarrassed. Socially, they blush when embarrassed in a public setting. No single level can sufficiently provide an explanation of blushing

Because of the fact that the patient is seen as having a ‘disease’ they are subsequently seen as a victim and are therefore not responsible for their actions and in need of care. This can be very controversial as diminished responsibility may lead to sectioning or involuntary treatment.

Sectioning involves taking the patient into care against their will and treating them involuntarily

This is very controversial as the persons basic human rights are being taken away. Sectioning is not very effective as psychological illnesses can only really be treated if the person wants to be treated.

Since they view the disorder as being due to a biological cause, the treatments they use aim to alter biological variables. The most widely used treatment is drug treatment. There are three main types of drugs used, anti-anxiety, anti-psychotic and anti-depressant drugs.

There are many criticisms of drug treatments. Anti-anxiety drugs do have a beneficial effect in reducing anxiety on a short-term basis, however long term use can lead to dependence. These drugs can also be very easily be over-used. Anti-psychotic drugs are more effective than any other type of drug treatment for schizophrenia but are insufficient unless combined with other types of psychotherapy. There are also some side effects to anti-psychotic drugs, which are not always reversible. Anti depressant drugs relieve the symptoms of depression but are only marginally effective in the treatment of depression. There is one more type of treatment known as anti-bipolar drugs, such as lithium salts, which are used to treat manic-depressives. These seem to be the most effective with an 80%success rate.

Another method of treatment used in the medical model is ECT; Electroconvulsive shock treatment. ECT involves passing an electrical current of between 65 and 140 volts through the patients brain. They believe this will change the chemical balance of the brain, thus curing the depression.

There are a number of issues to consider when looking at how effective this is. On the up side the effects are immediate, which is particularly important in suicidal depression patients, however there is no evidence to show that it does actually save lives. It is very controversial as no-one appears to be sure of how it works or how extensive the side effects are. It is thought that it may work by destroying neurones responsible for emotion or affecting the balance of neurotransmitters. One side effect noted is amnesia, however it is claimed that this is only short term. If used regularly it may also induce permanent organic changes to the brain.

The third and least used type of treatment is psychosurgery which involves, inserting a probe, through either the eye socket or a hole drilled into the skull. This probe s targeted at the area of the brain which is suspected of causing the disorder. This is the most controversial of the treatments as it inevitably causes brain damage of whichever area is targeted, and there is very little evidence that they have a significant effect on behaviour.

The medical model uses DSM to classify disorders and help in diagnosis of mental illness. This makes the medical model a lot more scientific as it brings about a culturally universal classification of symptoms. However, there are many criticisms of DSM. Firstly, there is a considerable overlap between disorders classified. 30-50% of agoraphobic patients are initially diagnosed with panic disorder. Schizophrenics are sometimes diagnosed as hyper-manic.

There are biases against it, Szasz argued that abnormality simply does not exist and is merely a way of coping with the madness in society. Classifying people as being mentally ill creates a social stigma. This can interrupt with their normal life and cause them to be ‘excluded’ from normal social activity.

There is also a lot of political influence on DSM, for example PTSD (Post Traumatic Stress Disorder) was included into the new manual in order that Vietnamese soldiers could claim sickness benefit; Homosexuality was dropped in 1973 due to pressure from Gay Rights groups; Masochistic and Sadistic Personality Disorder were dropped as they would allow abusers legal protection due to diminished responsibility.

The medical model is very controversial as most mental disorders do not display many physiological characteristics and rather are manifested by psychological imbalances.

For example: A concurrent physiological cause has not yet been found for schizophrenia yet drug treatments are often used to try to treat it. This is often criticised yet psychiatrists argue that there was no known physical cause for Parkinson’s Disease when treatment began on that. This implies that a physiological cause, although not yet known may later be discovered and that if these drug treatments alleviate symptoms then there is no reason why they should not be used.

The medical model overall, although mostly objective in its approach, does not seem to be very effective. The approach does not seem interested in prevention or cure, but is interested mostly in the acquisition of scientific knowledge about the nature of the disease. Treatments work short term, but unless treatment is sustained then the condition will often return. They do not seem to offer a ‘cure’ for the illness, rather just cause side effects which stop some of the symptoms. However as it only looks at the biological level, thoughts and other aspects will still be repressed and not treated. This may later lead to more serious mental illness.

In conclusion, the medical model is good for immediate relief from symptoms but in order to offer a ‘cure’ it also needs to use therapy.