Biomedical Explanations of Mental Illness

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PART A
Question 3. Biomedical explanations of mental illness
The biomedical model explains mental illness is a result of brain disorder, and specifically talks to chemical imbalances. Critically analyse and discuss why this model is problematic for critical social work practitioners undertaking anti-oppressive practice in the mental health field. Consider alternate ways of understanding and working with people who experience human distress and emotional suffering.
The biomedical model has been one of the most predominant views in the medical field for many years. When it comes to mental illnesses or disorders, the biomedical model focuses on the chemical imbalances in the brain and other probable biological abnormalities. This model has promoted the use of research when dealing with diseases which resulted to the discovery and development of various interventions. There is also an increase in the extent of knowledge that professionals know about mental health (Longino et al., 2020). However, there are problems that are continuously encountered when using the biomedical model in promoting mental health, especially for critical social work practitioners.
The biomedical model focuses too much on the illness or disorder itself, linking the cause of these to the biological abnormalities that a person has. This is a major part of why the biomedical model is problematic because it tends to ignore the other factors that may influence and affect mental health such as trauma, social disadvantage, or stress, among many others. Another characteristic of the biomedical model is its heavy reliance on pharmacological treatment to address the presumed cause which has two negative impacts. First, due to the belief that the mental health issues of an individual can be treated with medications, the prevention part of mental health is somehow neglected. Second, iatrogenesis happens because of heavy reliance on medications to address the symptoms of mental illnesses, leading to other health concerns such as obesity, diabetes mellitus, and heart disease (Beckett, 2017).
The aforementioned characteristics of the biomedical model contradicts the beliefs and operations of critical social work practitioners because critical social work looks into the social injustices that are contributing to the mental health issues of an individual. Some examples of the concerns that critical social work practitioners aim to address are poverty, racism, abuse, and exploitation. This is very much different from the biomedical model since critical social work involves the outside world rather than focusing on the disease or imbalance in an individual’s body. Social aspects like the relationships that an individual has on various levels are recognized, including its interconnectedness and impact on one another.
The biopsychosocial model is an alternative that can accommodate the positive aspects of the biomedical model and the principles in critical social work. This will help the individuals who are in distress and/or are undergoing emotional suffering to be viewed in a holistic manner, with consideration to the relationship of different factors that may affect mental health and wellbeing of an individual.
PART B
Question 3 Diagnosis (10 marks)
Informed by the information, including the MSE provided in the case study scenario; identify a DSM-5 diagnosis that you think “best” aligns with Chantelle’s presentation. In responding, clearly answer why the diagnosis best fits and why the other diagnoses were excluded. Pay attention to the list of symptoms and any other relevant guidance provided in the DSM-5 (ie. provide a rationale for your diagnosis). You can search for the DSM-5 through the library (put DSM-5 APA into the library search terms OR use: https://doi-org.ezp01.library.qut.edu.au/10.1176/appi.books.9780890425596. Choose one diagnosis from the following diagnoses:
1 Schizophrenia
2 Schizoaffective Disorder
3 Post-Traumatic Stress Disorder
4 Major Depression with Mood Congruent Psychotic Features
5 Generalised Anxiety Disorder
Based on the information about Chantelle in the case study scenario, among the five possible diagnoses, the diagnosis that best fits the presentation of the patient is schizoaffective disorder. In the diagnostic criteria of schizoaffective disorder, Chantelle exhibits the following symptoms: auditory hallucinations, delusions, catatonic behavior, and avolition, occurring at the same time as a mood episode. Based on Chantelle’s appearance, her manner of responding, and she and her boyfriend’s narration, she can be classified as having a major depressive episode. She reports having suicidal thoughts, changes in sleeping habits that lead to occupational issues, feeling of helplessness and hopelessness, inability to perform self-care such as taking a bath, not showing up at work, aside from not being able to enjoy things that she usually enjoyed doing or participating in. This depressive episode accompanied with the active phase of schizophrenia directs the diagnosis to schizoaffective disorder due to increased duration of depressive symptoms, the symptoms that are described or seen to be more serious than having diminished interest or pleasure, and the combination of psychotic and mood symptoms occurring at the same time. Also, Chantelle’s psychotic features, more specifically her delusions and hallucinations were already occurring even without the depression symptoms persisting, ruling out the possibility of having major depression with mood-congruent psychotic features. In relation to the schizophrenia spectrum, based on the maternal family history of Chantelle, her uncle was diagnosed with paranoid schizophrenia and committed suicide.
An evident symptom that is presented by Chantelle is her paranoia, one of the defining features of psychotic disorders under the schizophrenia spectrum. This is commonly seen as part of a delusion. The delusion of Brad being responsible for the death of her best friend Angela also has a persecutory theme, a very common type of delusion, which causes her anxiety because of the fear that Brad will harm her, just like what she thinks that Brad did to Angela. This is considered a delusion because it has no objective basis and even with the law enforcers and legal team already informing Chantelle that there is not enough evidence to point fingers at anyone, she still holds on to her beliefs that are mostly based on her dreams and “just knowing”. Other symptoms and presentations such as restlessness, irritability, sleep disturbance, and depersonalization can be parts of other diagnoses, however, the case scenario is viewed in consideration to the recent loss of Chantelle’s best friend, her possible expression of distress, duration of active symptoms, positive family history of schizophrenia and the presence of psychotic symptoms.
Question 4. Critical Analysis of the Mental State Examination (10 marks)
Critically discuss Chantelle’s MSE, reflecting on what information is contained in the MSE. Are there strengths in the MSE? Are there limitations? Are there gaps? Would a critical social worker be concerned about acting upon the information contained in Chantelle’s MSE? Make recommendations to your team around the need for further information about Chantelle. Clearly describe exactly what you would say when making these recommendations to your team, including your rationale for further information. Please note there are 5 marks for the critique of Chantelle’s MSE and 5 marks for the recommendation to the colleagues in your mental health team around the need for further information about Chantelle.
The...