Treating mental illness. Understanding the wellness model & the medical model

When treating mental illness, no two patients are the same. While many options are available, one size certainly does not fit all. Those with mental illness may find medication to be the best option for treatment, while others may not. No matter the severity of the illness, alternatives treatment options may be of equal success. Exploring both the medical model and the wellness model for treatment can place a patient on the right track to absolute recovery.

The Medical Model: This treatment model is based on the principle that mental illness and behavioral abnormalities should be viewed and treated in the same capacity as physical diseases or disorders. Relying on science (e.g. research & adequate biological diagnoses), the medical model heavily depends on scientific evidence relating to pathological processes or “treatment interventions” that can be reproduced in other forms of research/studies. With this model, treatment options are determined by assessing what is “wrong” with a patient, so to speak.

As counselor Charmaine Perry states, “the benefit of the medical model is that it is heavily based on scientific studies which allow for more objective results.” She further states, “With the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), we are still heavily tied to the medical model. With the setup of big business insurance, this may likely never change.  The medical model is tied to pathology and focuses on the things that are wrong with clients.  The model has been working for many decades but is rooted in psychiatry and medicine as is the history of mental illness.  The benefit of the medical model is that it is heavily based on scientific studies which allow for more objective results.  The drawback of the medical model is that it is heavily based on pathology and tends to ignore the clients’ strengths which may be vital to helping clients overcome or manage their mental illnesses. Oftentimes, the answer may be medication first without consulting alternatives, which can especially be an issue if clients are opposed to the medication.  Ken Duckworth, M.D. emphasized that there doesn’t need to be an either/or approach when working with clients, which I completely agree with.  It is our duty to assess our clients and see where they are at and then use the best approach that will help our clients stabilize quickly and maintain their stabilization”.

The Wellness Model: “Wellness is both a dynamic process of physical, mental, and spiritual optimization and integration and an outcome of that process” (Hettler, 1984). Differing from the medical model where the focus arguably lies in viewing the parts that are “wrong” with a patient, the wellness model focuses on a patient as a whole being. What this means for a patient is that treatment will involve consideration for their complete and true selves, including their strengths and weaknesses. According to counselor Charmaine Perry, “each person’s wellness should be based on where that person is and that person’s ideal state of wellness”. As humans, our whole selves are made up of many parts. With the wellness model, those various parts and how they contribute to the whole person is what's of most value for treatment.

Going back to the idea that an individual's wellness should be based on their ideal state of wellness … according to an article published by the American Counseling Association, nearly every form of counseling emphasizes “the importance of individual decision making.” With that in mind, one can draw the conclusion that counseling at its core, is a “natural partner in the wellness movement.”

According to an article published by Delaware’s Health and Social Services Department, the wellness model holds that:

“1.) It is our human birthright to recover and be well.

2.) It is our right to express and enjoy our recovery in our lives without suffering preventable diseases and without suffering premature death.

3.) We must have hope in the truth that we can enjoy lives that are quality infused and characterized by longevity.

4.) We have the ability to make choices for our lives that support our greater health, safety, and well-being.

5.) We are inherently whole at the deepest level of our being, and the path to wellness is the journey of discovering and expressing this wholeness.

6.) Our deep wholeness can be used as to guide us in making choices about what we need to be well.

This intuitive sense is powerful when combined with information and all available resources to make informed choices for lifestyle development.

7.) A key to wellness is kindness, gentleness, and a non- judgmental stance toward self and others. We cannot push ourselves or other people into wellness. We can offer hope, and as Patricia Deegan said, “We can, with understanding, create conditions that potentially excite motivation.”

8.) Keys to success include having the intention to guide one’s life to express one’s potential while at the same time accepting one’s self and intentionally communicating positive expectations and acceptance for self and peers.”

Considering a patient’s individual needs are vital during the course of treatment, with the medical model, we see that all parts of an individual may not be considered during treatment, whereas the wellness model’s foundation is in contrast to that very idea. Therefore, the argument for the wellness model to be of primary consideration when creating a treatment plan is one of strong validity.