Beyond the Medical Model

Abstract

The medical model continues to dominate research and shape policy and service responses to suicide. In this work we challenge the assumption that the medical model always provides the most effective and appropriate care for persons who are suicidal. In particular, we point to service user perspectives of health services which show that interventions are often experienced as discriminatory, culturally inappropriate, and incongruent with the needs and values of persons who are suicidal. We then examine "humanistic" approaches to care that have been proposed as a corrective to an overly medical model. We argue that the focus on improving interpersonal relations set out in humanistic approaches does not mitigate the prevailing risk management culture in contemporary suicide prevention and may impede the provision of more effective care. Finally, we draw attention to the tradition of non-medical approaches to supporting persons who are suicidal. Using Maytree (a U.K. crisis support service) as a case study, we outline some of the key features of alternative service models that we consider central to the design of more culturally appropriate and effective interventions. We conclude by making three key recommendations for improving services to persons who are suicidal.

Hunting to Feel Human, the Process of Women’s Help-Seeking for Suicidality After Intimate Partner Violence: A Feminist Grounded Theory and Photovoice Study

“…Hunting to Feel Human offers substantial insights to helping women who are suicidal after IPV through a unique in-depth analysis of their help-seeking patterns and offers a critical lens that challenges the dominant medical model of the health care system. The status quo provision of services for suicide prevention and intervention is based on a hierarchal structure where patients have little agency in their treatment (Fitzpatrick & River, 2018). The medical model falls short of helping people with suicidality due to the emphasis on the bio-physiological (Koning et al, 2017).…”

Rethinking Suicide in Rural Australia: A study Protocol for Examining and Applying Knowledge of the Social Determinants to Improve Prevention in Non-Indigenous Populations

“…Moreover, the classification of symptoms without regard to aetiology in current medical practice means that many of the social factors that precipitate symptoms of depression, anxiety, and grief are not distinguished from those produced by some form of individual pathology. In such cases, it is not clear whether medical treatment produces better or more effective responses than social support or political action that directly targets the sources of this distress [19,59].…”

“…Societal and individual factors do not partition neatly across levels and, hence, suicide is irreducible to any one contributing factor—a common problem in biomedical and sociological approaches that presuppose a divide between proximal and distal factors [18]. Without an understanding of the interrelatedness of individual and social risk factors for suicide, traditional specialist mental health models and the suicide prevention strategies that support them, including mental health education and gatekeeper training programs, may be culturally unresponsive [19].…”

The Great Reveal: The Experiences of a Registered Music Therapist with a disability: an arts-based research project

“…Critical disability studies and studies in ableism have long detached from the medical model, and instead conceptualise disability as a social construct. The social model views disability as a consequence of societal oppression, implicating environmental, social, and attitudinal barriers as the disabling factors, rather than one's body or mind (Fitzpatrick & River, 2018;Gross, 2018;Haegele & Hodge, 2016;Riddle, 2013). The social model helps to illuminate the way that the medical model positions people with disabilities as problems to be fixed.…”