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A sociological treatment exploring the medical model in relation to the neurodiversity movement with reference to policy and practice
- Authors:
- CASANOVA Emily L., WIDMAN Cheryl J.
- Journal article citation:
- Evidence and Policy, 17(2), 2021, pp.363-381.
- Publisher:
- Policy Press
Background: The Medical Model of disability focuses on diagnosed conditions. It is used in policy particularly to categorise people. This enables predictions and forecasting about the size of policy needs but tends to homogenise disability representations, assigning a negative evaluation to illness that may be irrespective of patho-anatomical correlates. The Social Model considers disability as imposed by society through attitudes and barriers. The Neurodiversity Model is a type of social and cultural model with biological implications; it states that differences in brain and behaviour lie on a non-pathological spectrum. Critics say this whitewashes lived experience. Policymakers may devalue the Neurodiversity Model’s origins within activist neurodiverse communities. The model that policy and practice decision makers use has fundamental effects on their impacts. Aims and objectives: The Medical and Neurodiversity Models are reviewed in reference to their politicisation as ways to characterise disability, and identity politics. The implications socially and for disability policy and practice and evidence use are considered. Key conclusions: Both models fall short in addressing the needs of the broad community of the disabled, yet both have useful features. We propose the Biological Gradient Model (BGM), which integrates scientific theory while avoiding pathology-based concepts and value-laden judgments concerning ‘deficiency’. Its usefulness is demonstrated; it resolves some of the ambiguity and tensions that exist in the way people with disability are viewed by different groups and treated within policy. It has the potential to reduce issues of partial representation, where the voices of those who cannot self-advocate may be less heard. (Edited publisher abstract)
The medical model is dead: long live the medical model
- Authors:
- SHAH Premal, MOUNTAIN Deborah
- Journal article citation:
- British Journal of Psychiatry, 191(11), November 2007, pp.375-377.
- Publisher:
- Cambridge University Press
Many people criticise, and psychiatrists apologise, for the use of the ‘medical model’. The authors examine what is currently meant by this term and suggest a refinement of definition to reflect the ideals and contemporary practice of medicine. They propose that psychiatrists should use the medical model to improve and validate bio-psychosocial psychiatric medicine.
Transgender children and social work: theory, discourse and debates
- Author:
- BALKOW Michael
- Publisher:
- Centre for Welfare Reform
- Publication year:
- 2019
- Pagination:
- 24
- Place of publication:
- Sheffield
A discussion paper exploring how social workers and professionals can approach an understanding of the complexity of working with transgender children. Drawing on current literature, it attempts to locate a debate and discussion, within the key realms of social work; support, safeguarding and advocacy. It makes suggestions as to how this can be attained by placing the needs of the young person paramount, whilst paying attention to public and political debates that can amplify transgender issues in both positive and detrimental ways. (Edited publisher abstract)
Social workers’ perspectives on a medical home model for children and adolescents in out of home care – an interview study
- Authors:
- JOHANSSON Nina, FANGSTROM Karin, WARNER Georgina
- Journal article citation:
- BMC Health Services Research, 21(804), 2021, Online only
- Publisher:
- BioMed Central Ltd
Background: This study seeks to explore how social workers have perceived and experienced a medical home model for children and adolescents in out-of-home care in Uppsala County, Sweden. Method: A qualitative explorative study was conducted, which involved ten semi-structured individual telephone interviews with social workers. The study sample included employees within the social service, working in a specialised case unit who had experience of referring children and/or adolescents to the medical home model called Hälsofam. Data were analysed inductively using thematic analysis. Results: The findings of the current study indicated that working with Hälsofam has offered social workers a way into the health care sector and an active collaborative working situation, with focus on organised work across the ‘silos’ of care services. However, the findings raised the question of whether or not all children and adolescents have the same possibility to receive care from Hälsofam. Conclusion: The findings indicated that the Hälsofam model had a positive impact on the interrelations between the social service and the health care sector. Yet, findings showed that personal views of the social worker and the societal situation in which they operate create limitations for providing care for every child and adolescent. This study adds to the extant literature for it addresses the limitations within the work of children and adolescents in out-of-home care. (Edited publisher abstract)
Mad studies and social work: conceptualising the subjectivities of service user/survivors who experience significant mental health problems
- Authors:
- MACDONALD Stephen J., CHARNOCK Anne, SCUTT Jane
- Journal article citation:
- Social Work and Social Sciences Review, 19(3), 2017, pp.98-118.
- Publisher:
- Whiting and Birch
This article draws on contemporary and classical psycho–political theorists to conceptualise ‘mental illness’ as a social construct. The research employs a Mad Studies and anti-psychiatry perspective to reframe ‘mental illness’ from an individualised pathological defect to a socially constructed reality (Foucault, 1967; Menzies et al., 2013). The study applies a qualitative biographical methodology to analyse the subjectivities of people with severe mental health problems, their family members and mental health practitioners. In this study, once individuals were conceptualised as pathologically ‘ill’ they were then medicated and often institutionalised as a form of ‘treatment’. The findings present a theoretical analysis of participants’ subjectivities to examine historic and contemporary psychiatric practices. The article will conclude by discussing how Mad Studies can offer social work practice an alternative theoretical standpoint to conceptualise ‘mental illness’ as a social rather than a pathological phenomenon. (Edited publisher abstract)
Research into practice
- Author:
- COLOMBO Anthony
- Journal article citation:
- Community Care, 13.05.04, 2004, p.52.
- Publisher:
- Reed Business Information
Looks at recent research which found that a hidden medical model agenda may be damaging decision-making within mental health teams. The study found clear differences between practitioner groups with psychiatrists and community psychiatric nurses favouring a medical interpretation of mental disorder; while social workers showed strong support for the social and psychotherapeutic models.
Medical model on top
- Author:
- METTERI Anna
- Journal article citation:
- Community Care, 26.9.02, 2002, p.48.
- Publisher:
- Reed Business Information
Looks at Finnish mental health care policy where the medical model in psychiatry has been strengthened. Argues that it is now up to staff to move towards more collaborative methods of working.
Where next. Current thinking and future possibilities for people with dementia
- Author:
- GILLARD Jane
- Journal article citation:
- Generations Review, 12(2), July 2002, pp.13-16.
- Publisher:
- British Society of Gerontology
Provides a brief history of dementia and discusses the medical and social models of dementia. Looks at the social model of dementia as a means obtaining a better understanding of the needs of people with dementia.
From mental illness to a social model of madness and distress
- Authors:
- BERESFORD Peter, et al
- Publisher:
- Shaping Our Lives
- Publication year:
- 2016
- Pagination:
- 76
- Place of publication:
- London
This report draws on the views and experiences of mental health service users/survivors, regarding mental health policy, models and services. It aims to update findings of an earlier 2010 report, ‘Towards a social model of madness and distress?’, which found that mental health service users/survivors felt that a medical model dominated both public and professional thinking and that further discussions about more social approaches to mental health were needed. A total of 82 people took part in this second stage project through discussion groups, individual interviews, and an on-line survey. Participants included a diverse range of service users including, people from rural and urban areas, older women and people from black and minority ethnic backgrounds. Organised in six main sections, the report draws heavily on the comments of service users and includes quotations throughout. The six sections explore mental health service users’/survivors’ views on: a medical model of mental health; reclaiming the term ‘madness’; the social model of disability as applied to mental health; the idea and policy of recovery; social approaches to mental health; and taking forward social approaches to mental health. A final section brings together the findings from the project and offers a set of possible ways of taking them forward. (Edited publisher abstract)
Towards a social model of madness and distress?: exploring what service users say
- Authors:
- BERESFORD Peter, NETTLE Mary, PERRING Rebecca
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 4p.
- Place of publication:
- York
There has been more emphasis on social approaches to mental health in recent years, reflected, for example, in the establishment of the Social Perspectives Network. There have been some initial discussions about a social model relating to mental health among mental health service users/survivors. However, as yet, this has not been widely explored or developed. This report provides a summary of a national study which explores with mental health service users what models they feel underpin current thinking in mental health policy and practice. It asks what effects these models may have, and looks at what models service users think might be helpful. Key findings suggest that most service users believe that a medical model based on deficit and pathology still dominates public and professional understanding of mental health issues, shaping attitudes and policy. The idea of a social model of madness and distress, following the format of the social model of disability, met mixed views. The labelling and stigma following from a medical model of mental illness are major barriers for mental health service users. Service users see social approaches to mental health issues as much more helpful.