Re-Framing Mental Illness as a Bio-Psycho-Social Condition

In order to combat something, one first must learn everything one can know about the subject at hand. Meaning, if we are to fight stigma, we need to know why it exists, what motivates its spread and what purpose it serves for those who endorse it.

It’s frightening to think that our general societal distaste for people with mental illness has actually gotten much better in the past fifty years. It sadly wasn’t long ago that people with mental illness were all blanketed as ‘crazy’ or ‘lunatics’ and locked up for the rest of their natural lives. There was no differentiating between mental illnesses.

Lunatic Asylums

Those poor people, locked away in asylums were all painted with the same brush whether they were depressed, anxious or suffering from delusions. Stigma thrived as society hid the mentally ill in beaten-down old hospitals and society felt safe from the dangerous lunatics.

Around the 1950’s, medications became available that helped off-set some of the symptoms of mental illness. It was around this time that mental illness began being spoken of as a brain disease, under the belief that it would help reduce stigma.

‘It was thought a biological understanding would reduce stigma, since it’s not fair to blame someone for a diagnosis of a disease that’s beyond their control. Despite good intentions, evidence actually shows that anti-stigma campaigns emphasizing the biological nature of mental illness have not been effective, and have often made the problem worse.’ (Angermeyer, M. & Matschinger, H. (2005)

What’s So Different About Mental Illness?

It’s interesting to note that while the public may assign less blame to individuals for their biologically-determined mental illness, the very idea that their actions may be beyond their conscious control can create fear of their unpredictability and thus the perception that those with mental illnesses are dangerous. (Angermeyer, M. & Matschinger, H. (2005)

A 2008 survey by the Canadian Medical Association found these shocking and disheartening statistics:

* 42% would no longer socialize with a friend diagnosed with mental illness;
* 55% wouldn’t marry someone who suffered from mental illness;
* 25% were afraid of being around someone who suffers from mental illness; and
* 50% would not tell friends or coworkers that a family member was suffering from mental illness.

Us and Them

After the anger from the above statistics abates, there is actually a powerful message in those dismal numbers: we need to step up our game and bring anti-stigma campaigns to a whole new level. The ‘Us and Them’ attitude that exists in society needs to be expunged. When mental illness is viewed solely as a brain disease, it creates a unique difference between the sane and the insane. It also serves to not only stigmatize the individual, but also their entire family.

A Bio-Psycho-Social Condition

So, what’s the answer then? People who work in the field of mental health stigma need to all be on the same page and endorse the well-researched and fundamentally sound concept of mental illness as a bio-psycho-social condition.

This model eliminates the simplistic notion of mental illness as purely a brain disease and instead offers up empirical evidence that it results from a complex interplay between biological, psychological and social factors. This model takes into account matters such as trauma, sexual abuse, substance abuse, poverty, unemployment and its treatment involves exploring each of the three distinct factors and how they relate to one another.

Mental illness isn’t simple.

And we don’t do ourselves any favours by dumbing it down to a purely biological condition beyond our control.

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