Welcome to the World of Mental Health!
Hello there! Welcome to one of the most fascinating parts of your Psychology course. This chapter, Issues in Mental Health, is part of the Applied Psychology section. We are going to explore how people have viewed mental illness throughout history, the "medical" way of looking at it, and some alternative ways to understand the human mind. Don't worry if it seems like a lot at first—we'll break it down step-by-step!
Section 1: The Historical Context of Mental Health
Psychology hasn't always been the scientific subject you study today. In the past, people had very different ideas about why someone might act "abnormally."
1.1 Historical Views of Mental Illness
Think of this as a timeline of how we’ve treated people with mental health issues:
• Ancient Times: People often believed mental illness was caused by evil spirits. They used a process called trepanning (drilling a hole in the skull) to "let the spirits out."
• The Humours: Ancient Greeks like Hippocrates thought the body had four liquids (humours). If these were out of balance, you became ill. Analogy: Imagine a car engine needing the right mix of oil and fuel to run smoothly!
• The Asylum Era: By the 18th century, people were kept in large "madhouses." Treatment was often cruel, focusing on confinement rather than curing.
1.2 Defining Abnormality
How do we decide if someone is "abnormal"? Psychologists use several "yardsticks":
• Statistical Infrequency: If a behavior is very rare (like a genius IQ or a rare phobia), it is statistically abnormal.
• Deviation from Social Norms: If someone breaks the "unwritten rules" of society (like wearing a swimsuit to a funeral).
• Failure to Function Adequately: When someone can no longer cope with daily life, like being unable to get out of bed or go to work.
• Deviation from Ideal Mental Health: Looking at what makes someone "perfectly healthy" (like high self-esteem) and seeing what's missing.
1.3 Categorising Disorders
Today, doctors use "manuals" to diagnose patients, much like a librarian uses a system to organize books. The two main ones are the DSM (used mostly in the USA) and the ICD (used by the World Health Organization).
Quick Review: The 4 Ds
A simple way to remember how doctors look for abnormality is the 4 Ds:
1. Deviance (being different)
2. Distress (feeling upset)
3. Dysfunction (not coping with life)
4. Danger (risk to self or others)
Key Research: Rosenhan (1973) - "On Being Sane in Insane Places"
This is a "classic" study you need to know. Rosenhan wanted to see if doctors could actually tell the difference between "sane" and "insane" people.
What did they do? (The Procedure)
1. Eight healthy people (the pseudo-patients) went to different psychiatric hospitals.
2. They all complained of hearing a voice saying "thud," "empty," and "hollow."
3. Once they were admitted, they stopped acting symptoms and behaved completely normally.
What did they find? (The Results)
• Every single one was admitted to the hospital.
• They were all diagnosed with Schizophrenia (except one).
• The real patients often realized the pseudo-patients were sane, but the doctors didn't!
• The doctors interpreted their normal behavior (like writing notes) as "abnormal" because of the label they had been given.
Key Takeaway: Rosenhan showed that the "label" of a mental illness is very powerful and can change how people see everything you do. Common Mistake: Don't forget that the pseudo-patients acted completely normal as soon as they entered the hospital!
Application: Characteristics of Disorders
You need to know the basic features of three types of disorders:
1. Affective Disorder (e.g., Depression): Focuses on mood. Symptoms include extreme sadness, loss of interest (anhedonia), and changes in sleep.
2. Psychotic Disorder (e.g., Schizophrenia): A loss of contact with reality. Includes hallucinations (seeing/hearing things) and delusions (false beliefs).
3. Anxiety Disorder (e.g., Specific Phobias): Intense, irrational fear of an object or situation that is out of proportion to the actual danger.
Section 2: The Medical Model
The Medical Model treats mental illness just like a physical illness (like a broken leg or the flu). It suggests the cause is inside the body.
2.1 Explanations of Mental Illness
• Biochemical: This is about brain chemistry. For example, low levels of Serotonin are linked to Depression.
• Genetic: This suggests we inherit mental illness from our parents through our DNA.
• Brain Abnormality: This looks at the physical structure of the brain. For instance, some people with Schizophrenia have larger ventricles (fluid-filled gaps) in their brains.
Did you know?
Serotonin is often called the "happy chemical" because it helps regulate our mood, sleep, and appetite!
Key Research: Gottesman et al. (2010)
This study looked at whether children inherit mental illness if their parents have it.
Findings:
• If both parents had Schizophrenia, the child had a 27.3% chance of developing it too.
• If only one parent had it, the risk dropped to 7%.
• For the general population, the risk is only about 1%.
Conclusion: Genes definitely play a role, but because it's not 100%, something in the environment must also matter.
Application: Biological Treatment
Because the Medical Model sees the cause as biological, the treatment is usually biological too. The most common is Drug Therapy. For example, SSRIs (Selective Serotonin Reuptake Inhibitors) are used to treat depression by increasing the amount of serotonin available in the brain.
Section 3: Alternatives to the Medical Model
Not everyone agrees with the Medical Model! Other psychologists believe our environment and thoughts are more important.
3.1 The Behaviourist Explanation
Behaviourists believe mental illness is learned through our environment. Think of the Little Albert study (learning to fear a white rat).
• Classical Conditioning: Learning by association (e.g., fearing dogs because you were bitten once).
• Operant Conditioning: Learning through rewards (e.g., if you get lots of attention for being "anxious," you might continue the behavior).
3.2 The Cognitive Explanation
This is all about faulty thinking. Imagine looking at the world through "dark-tinted glasses."
• Beck's Cognitive Triad: Depressed people have negative thoughts about the Self, the World, and the Future.
Memory Aid: The Cognitive Triad
Remember S.W.F.
"I'm rubbish" (Self)
"Life is unfair" (World)
"It will never get better" (Future)
Key Research: Szasz (2011) - "The Myth of Mental Illness"
Thomas Szasz was a very controversial psychiatrist. He argued that mental illness isn't actually a "medical" disease at all.
His main points:
1. The mind isn't a physical organ, so it can't be "diseased" like a heart or a lung.
2. Mental illness is just a name we give to "problems in living" or people who don't fit into society.
3. Giving people labels like "mentally ill" takes away their power and responsibility.
Don't worry if this seems tricky! Szasz isn't saying people don't suffer; he's just saying that calling it a "medical disease" is wrong and unhelpful.
Application: Non-Biological Treatment
A major alternative to drugs is CBT (Cognitive Behavioural Therapy). This treatment helps patients identify their "faulty" thoughts and change them into more positive, realistic ones. It also encourages them to change their behaviors (like going out more).
Key Takeaway: While the medical model uses pills, alternatives like CBT use "talking and doing" to help the mind heal.
Final Quick Check!
• Can you explain the difference between the ICD and the DSM?
• What did Rosenhan find out about psychiatric labels?
• What is the difference between a hallucination and a delusion?
• How would a Behaviourist explain a phobia?
You've got this! Keep reviewing these key studies and you'll be an expert on mental health in no time.