Introduction: The Disease Model of Mental Health: A System in Crisis

Abstract

Jacqui Dillon is a writer and campaigner on mental health issues. She has both personal and professional experience of working with trauma and abuse, dissociation, ‘psychosis’, hearing voices, healing and recovery.¹ Jacqui’s autobiography — the ‘Tale of an Ordinary Little Girl’ — tells of how she had ‘… the misfortune to be born to parents who [were] simply unable to provide the most basic necessities … to be fed and to be kept warm and safe.’ She describes a terrible but sadly not uncommon childhood where she ‘… inhabits a dual world. In one, she is a normal child with normal parents, a gifted child who goes to school, plays with her friends, and likes wearing ribbons in her hair. In the other world, she is a dirty little bitch, evil and unlovable, treated with cruelty and contempt by anyone who can get their filthy hands on her….’ Unsurprisingly, Jacqui suffers as a result, and starts hearing voices, ‘… voices that talk to her, talk about her, who comfort her, protect her and make her feel less alone. In time, they control and terrorise her but help her to stay alive’. When Jacqui herself becomes a mother, she describes how she ‘… becomes convinced that someone will try and hurt her and her baby because she knows how dangerous the world can be for little children. She becomes intensely fearful; terrified to leave the house in case someone tries to abduct them and take them to the underworld to kill them.

Traditional thinking about mental health care is profoundly flawed, and radical remedies are required. Our present approach to helping people in acute emotional distress is severely hampered by old-fashioned and incorrect ideas about the nature and origins of mental health problems, and vulnerable people suffer as a result of inappropriate treatment. We must move away from the ‘disease model’, which assumes that emotional distress is merely a symptom of biological illness, and instead embrace a psycho-logical and social approach to mental health and well-being that recognises our essential and shared humanity.