Friday 19 August 2011

The 4 continua of mental health

Mental health is not a nebulous concept. This is just an excuse so it
can be used for whatever people want to use it for.

There are at least 4 continua I can think of.
Psychopathology - the power of psychiatry essentially. This is what
mental health is defined as in psychiatric textbooks. So homosexuality
was an example of psychopathology. This s about behaviour and emotional
regulation.
Psychological distress - this is meant to be what psychologists are
interested in but from my experience - certainly of the NHS psychologist
who refused to help me - they don't give a shit and are just like
psychologists. This is what Mind use to further their work. This is
about emotional suffering.
Flourish - this is a new term coined by Dr Jo Nurse as part of the work
which went into the New Horizons strategy. It either means the person
reaching their potential for society or for themselves.
Individual measure - this is about what patients want. Essentially it
may be the simple question - do you feel better or do you feel unwell?
It may be associated with the psychological distress continuum for many
people but not all. There is also resilience to factor in. People may
also have their own models of madness, their own personal measures of
mental health and lack of mental health.

Dangerousness seems also to be something that some people want to
include in definitions of mental health. This may be part of the
psychopathology continuum as it evolves but is forced upon it by
sociopolitical forces. It is why the Mental Health Act was amended to
allow indefinite incarceration without crime or treatment made
available. It was the risk of "people with a dangerous personality
disorder" which is not a medical diagnosis nor a crime but a
medico-political concept.

It is fascinating to think that a century ago some people called mental
health "mental hygiene" so a person with poor mental health would have
an unclean mind.

In all of this madness it is important to remember that mental illness
is not a real illness. Psychiatrists simply used biomedical evidence to
support a preconceived position which came about after the creation of
the asylum system. I think older psychiatrists know they're not treating
real illnesses. They're just suppressing emotions and behaviour using
chemical means.

Of course in centuries to come people would look back at modern mental
health and weep. The public don't care about what it really means so
doctors can do whatever they want to them.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"