Medical Model

The Medical Model

Psychiatrist Laing coined the medical model. The medical model suggests that illnesses should be diagnosed based on a systematic process accepted by the majority. The systematic approach should identify how the condition differs from 'typical' behaviour and describe and observe if the symptoms match the description of the illness in question.

Medical Model Psychology Definition

Just like a broken leg can be identified through an x-ray and treated through physical means, so can mental illnesses such as depression (using different identification techniques, of course).

The medical model is how mental and emotional issues are related to biological causes and problems. The model suggests they can be identified, treated, and monitored by observing and identifying physiological signs. Examples include abnormal blood levels, damaged cells, and abnormal gene expression.

Medical Model Use in Psychology

So how is the medical model used in psychology? Psychiatrists/psychologists apply the medical model of mental health theory to treat and diagnose patients. They focus on using the approaches we discussed above:

• The biochemical.
• The genetic.
• Brain abnormality explanation of mental illness.

To diagnose and treat a patient, they use these approaches to assess the situation. Typically, psychiatrists assess the patient's symptoms.

Once a patient has been diagnosed with an illness, the psychiatrist decides on the best treatment. Various treatments exist for the medical model, including drug therapies. An old, outdated model is Electroconvulsive therapy (ECT), now a largely abandoned treatment because of some severe risks. Also, the treatment method is still not fully understood.

Medical Model of Mental Health

Let's examine the biochemical, genetic, and brain abnormalities theories used to diagnose and treat patients. These explanations are models of how mental health illness is understood.

Medical Model: Neural Explanation of Mental Illness

This explanation considers that atypical neurotransmitter activity is a cause of mental illness. Neurotransmitters are chemical messengers within the brain which allow communication between neurons. Neurotransmitters can contribute to mental illnesses in several ways.

• Neurotransmitters send chemical signals between neurons or between neurons and muscles. Before a signal can be transmitted between neurons, it must cross the synapse (the gap between two neurons).

• 'Atypical' neurotransmitter activity is thought to cause mental illness. When there is a low level of neurotransmitters, it makes it difficult for the neurons in the brain to send signals. This can cause dysfunctional behaviour or the symptoms of mental illnesses. Similarly, abnormally high levels of neurotransmitters can lead to brain dysfunction, as it upsets the balance.

Fig. 1 Dug therapy affects neurotransmitter abundance in the synapse and can be used to treat mental illnesses.

A psychiatrist who accepts the medical model school of thought may choose to treat a patient using drug therapy. Drug therapy targets receptors, which affect the abundance of neurotransmitters in the synapses.

Take depression, for example. The typical type of drug used for this treatment is selective serotonin reuptake inhibitors (SSRIs).

Medical Model: Genetic Explanation of Mental Illness

The genetic explanation of mental illness focuses on how our genes affect the development of certain diseases within the brain.

Scientists have identified that there are variants of genes that are associated with specific mental illnesses. Some biopsychologists argue that these variants are predispositions for mental illnesses.

This predisposition, combined with environmental factors such as childhood trauma, can lead to the onset of mental illnesses.

Medical Model: The Cognitive Neuroscience Explanation of Mental Illness

Gottesman et al. (2010) provided supportive evidence of the genetic explanation by calculating the risk levels of children inheriting mental illnesses from their biological parents. The study was a natural experiment and a national register-based cohort study based in Denmark and offers a great medical model example.

The variables investigated were:

• Independent variable: whether the parent had been diagnosed with bipolar or schizophrenia.

• Dependent variable: child diagnosed with mental illness (using the ICD).

The comparison groups were:

1. Both parents were diagnosed with schizophrenia.

2. Both parents were diagnosed with bipolar.

3. One parent was diagnosed with schizophrenia.

4. One parent was diagnosed with bipolar.

5. Parents with no diagnosed mental illness.

The table shows how many parents were diagnosed with schizophrenia or bipolar disorder and the percentage of their children diagnosed with mental illnesses by 52 years old.

When one parent had been diagnosed with schizophrenia and the other with bipolar, the percentage of offspring diagnosed with schizophrenia was 15.6, and bipolar was 11.7.

The more offspring are predisposed to a genetic vulnerability; the more likely the child will be diagnosed with a mental illness. If both parents have been diagnosed with the respective disorder, the higher the child's chances are of developing the disorder.

Pros and Cons of the Medical Model

The medical model has a vital role in psychology as it is a widely accepted school of thought for treating mental illnesses. This indicates that the model's views are widely applied to the psychological services available.

However, there are cons to the medical model that should be considered when applying the model for diagnosing and treating mental illnesses.

Pros of the Medical Model

Let us consider the following strengths of the medical model:

• The approach tends to be objective and follows an empirical approach to diagnosing and treating mental illnesses.

• Research evidence such as Gottesman et al. (2010) shows a genetic and biological component to mental illnesses.

• The medical model has real-life practical applications. For example, it describes how people with mental illnesses should be diagnosed and treated.

• The treatment methods used nowadays are widely available, relatively easy to administer, and effective.

Fig. 2 Psychologists who accept the medical model use various sources to make diagnoses, increasing the likelihood of a correct diagnosis.

Cons of the Medical Model

One of the major causes of schizophrenia is high levels of dopamine. The drug treatment of schizophrenia typically blocks dopamine receptors (stops high levels of dopamine released). This has been found to reduce positive symptoms of schizophrenia but has no or little effect on negative symptoms. This suggests that the biochemical approach partially explains mental illnesses and ignores other factors (reductionist).

The treatments in the medical model do not try to get to the root of the problem. Instead, it tries to combat the symptoms. There are also certain debates the medical model tends to fall into in psychology overall:

• Nature versus nurture - believes that genetic makeup (nature) is the root of mental illnesses and ignores other factors that may cause them. For example, it ignores the role of the environment (nurture).

• Reductionist versus holism - the model only considers biological explanations of mental illnesses whilst ignoring other cognitive, psychodynamic, and humanistic factors. This suggests that the model over-simplifies the complex nature of mental illnesses by ignoring important factors (reductionist).

• Determinism versus free will - the model suggests people have no free will over their well-being. For instance, the model indicates that their genetic makeup determines mental illness. This implies that you are helpless against developing certain mental illnesses and acting a certain way.