This is the seventh in a series of blogs and the third that will address replacing the current disease model of serious mental illness with other treatment models, particularly one linked to ACEs (Adverse Childhood Experiences) and rooted in individuals’ traumatic life experiences. This blog will focus on the nuts and bolts of replacing the disease model, viz., on underlying values and practice principles; on several treatment models; and on the training of helpers.
My principal objection to the disease model is its reliance for treatment on psychoactive medications, particularly the atypical neuroleptics, that have been documented to shorten the lives of those prescribed them by as many as 25 years, and that appear to be iatrogenic, i.e., to exacerbate and even to cause the symptoms they’re supposed to relieve.
The disease model has also served to invalidate the use and the effectiveness of psychosocial treatment interventions, particularly those that impart life skills crucial to rehabilitation, an approach that has left most behavioral health practitioners untrained and ill-equipped to make use of them. Despite what I just wrote, I will not argue against the possibility that many individuals who have psychotic experiences do have some sort of biological vulnerability that undermines their resilience in highly stressful circumstances. I also won’t argue that trauma is the only way to understand why these individuals have the experiences they do, even though the great majority of persons with serious mental illnesses have been victims of trauma.
Cause is not crucial here; more importantly, how are folks to be helped and who is to help them?
Prospective treatment models will be described below; but discussion of specific treatment approaches must be preceded by consideration of underlying practice principles and values. Listed immediately below are those I consider crucial: