Rethinking mental health for the twenty first century

As the government embarks on a high profile campaign to get many thousands of mental health service users off benefits and into employment, it may do well to listen to what they have to say if it is serious about wanting to support them to live more independently.

This new service user-led study, which explores mental health service users’ own views, suggests that prevailing approaches to thinking about and treating them are actually making things worse. They see the medicalised approach to understanding mental wellbeing issues which they feel still dominates UK political, professional, public and indeed, most service users’ understandings of mental health issues, as having few benefits to offer and as largely negative in effect. This is because it stresses that ‘something is wrong with you’ and ‘blames the individual’.

They see this kind of ‘medical model’ approach as being at the heart of the stigma and negative stereotyping which continue to create problems for those service users trying to lead ordinary lives. They are not saying that nothing’s wrong, or they don’t have problems or need support. Instead they stress the value of a more social approach to making sense of their difficulties and responding to them, which addresses the barriers and material problems that they face.

The disabled people’s movement developed the ‘social model of disability’ to challenge discrimination and help them live on more equal terms. It has become embodied in public policy and legislation. Mental health service users don’t have an equivalent. Our project suggests that some have doubts about whether framing themselves in terms of disability necessarily offers an answer.

But what they do make clear is that a more rounded way of thinking, which takes account of the ‘whole person’ and which doesn’t just see the person as a set of symptoms to be fitted into diagnostic categories, is needed for the twenty first century.

Old ways of thinking have increasingly cast mental health service users in terms of dependence and danger. The message from this study is that discussion needs to develop to explore more helpful and robust ways of thinking. This can most helpfully start among mental health service users and their organisations, as well as drawing in professionals and policymakers, to look at how new social approaches to mental health issues, policy and practice may provide a basis for improving the life chances of mental health service users.

By Peter Beresford
Peter Beresford is a long-term user of mental health services. He is Professor of Social Policy at Brunel University and Chair of Shaping Our Lives, the service user organisation and network. He is a writer, researcher, educator and campaigner with a long-standing involvement in issues of participation and empowerment.