This study was based on a review of over 100 publications that made reference to “mental health” or “mental illness” and identified 34 different theoretical models to understand the nature of mental health challenges. While understandings of mental health continue to evolve, it is crucial to include a variety of diverse perspectives to promote equitable outcomes.
Understanding the Research
For this study, researchers reviewed 110 publications and found that there was no clear consensus on if mental health phenomena is considered a disease, the cause of it, and what constitutes “a mental health problem.” Of 34 theoretical models identified, most were based on biological or psychological approaches, but included a few social, consumer, and cultural models, and some drew elements from different mental health approaches. Researchers found that most biomedical approaches assumed mental illness, while more social approaches questioned this, as oppression was taken into consideration in terms of its impacts on mental health. While a variety of possibilities for addressing these tensions are outlined by researchers, they stress that these discussions need to include perspectives from individuals with lived experience coping with mental health challenges.
Cultural and Social Factors Matter
Julian Lagoy, MD, a psychiatrist with Mindpath Health, says, “There are a wide variety of ways to classify what constitutes a mental health problem. There are many variables that determine which way is used to constitute a mental health problem, including cultural and social factors." While biological and psychological approaches have most often been used by psychiatrists and psychologists, Dr. Lagoy notes that other approaches by helping professionals need to be recognized for equitable outcomes. In this way, Dr. Lagoy highlights, “Having a more diverse outlook and listening to other points of view can only make one more understanding and better at treating mental health problems.” Dr. Lagoy explains, “What constitutes a mental health problem can be extremely subjective depending on the time and society in which one lives.” As an example, he notes that in the middle ages, schizophrenia was revered because people thought they had a connection with the divine. While understandings of mental health change, Dr. Lagoy highlights, “The study touches upon how we need to be more open and diversify the different approaches of classifying mental health and to also rely more on nonmedical personnel for their unique point of view.” Dr. Lagoy notes that this topic is not really covered much in the literature, so it is possible that medical professionals may have never considered different approaches in terms of what constitutes a mental health problem. Readers need to be aware of how biased many medical professionals may be in classifying mental health problems, according to Dr. Lagoy. “We need to be more open and learn about other traditions, as well as value unique opinions from those who are nonmedical personnel in the field,” he says. This study may be a catalyst to encourage more research, as Dr. Lagoy notes that mental health problems are seen differently across cultures and time periods. “When I see a patient who was born and raised in the US in his early 20s, I will treat him differently than when I see a patient from Afghanistan or India who is in their 70s,” he says. While Dr. Lagoy does not consider himself an expert on every culture, he notes that he tries to be open and listen to patients, with an understanding that there may be differences in how mental health is conceptualized.
No One-Size-Fits-All Approach
Psychotherapist, Matt Glowiak, PhD, LCPC, says, “Given the sheer number of theoretical models currently practiced by clinicians, it is telling that what we do requires some adaptation to the client and context.” Glowiak explains, “Contemporary research focused much more on Eurocentric individuals than minority populations, which has led to us needing to catch up today.” In this way, Glowiak recommends that mental health professionals need to cater to the individual, as failure to do so may lead to missed opportunities. Glowiak highlights, “An important thing for the public to know is that mental health is still highly stigmatized. Despite more media coverage since the onset of the pandemic, we are still facing an uphill battle.” The best approaches are those that are comprehensive, according to Glowiak. “People are complex entities, and to best meet their needs, we need to know what we are looking at,” he says. Glowiak explains, “A person is constantly interacting with the environment—adjusting to whatever needs they believe are expected of them while still trying to remain authentic to themselves. Unfortunately, the pressures upon us lead toward us losing this self-identity.” In this way, Glowiak notes that life satisfaction may dwindle, as mental health distress increases. “We cannot consider the individual without taking into context all of that which is in one’s experience,” he says. Glowiak highlights, “What works for one may not work for another, but there often is something that can help. Even when we cannot fully resolve a problem—perhaps it is something outside of one’s control—we do have tools to help improve life satisfaction, or help to ease the pain.”
Different Modalities Can Support Treatment
Psychotherapist, Lena Suarez-Angelino, LCSW, says, “Readers can apply some of the findings to their own lives, however, more research needs to be completed. Having additional studies to support these theories would be pivotal to the mental health field.” Suarez-Angelino explains, “Although the study mentions that mental health treatment is not a one-size-fits-all approach, I wish the public knew how many different modalities there are for finding support.” While there are often discussions about maintaining physical health, Suarez-Angelino notes that these are also needed to promote mental health. Suarez-Angelino highlights the need to break down the stigma that can accompany mental health, which includes challenging the histories and contexts in which the early theoretical frameworks may have been developed. Although it may feel intimidating to consider various theoretical models or therapeutic approaches, Suarez-Angelino notes that it can help to focus on the goal of improving overall mental health to invest in the work. Suarez-Angelino explains, “Developing models and frameworks based on people of similar age, race, gender, social-economic status, etc. can definitely impact and create a bias, or one-sided findings that may not be applicable to those of other backgrounds or life experiences.” Finding a framework and therapeutic approach that works for one’s needs can help in developing a therapeutic relationship, according to Suarez-Angelino. “Everyone has the right to heal,” she says.
