Thick description and systems thinking: Reiterating the importance of a biopsychosocial approach to mental health

Abstract

Study AimsThe article aims at reiterating the importance of a biopsychosocial approach to mental health, taking stock of the critiques that have been raised and moving forward throughout a reconsideration of the theoretical background of systems thinking and emphasizing the relevance of the concept of thick description for the promotion of an adequate reflection on methodology and case formulation.Literature ReviewIt is our opinion that the biopsychosocial approach is still a powerful framework for making sense of the growing data collected in the different fields related to mental health and for designing proper treatment plans. A crucial challenge for mental health is that of surpassing the dichotomies and ideological disputes that still contaminate the field with detrimental effects on the advancement of knowledge and on the integration and continuity of different kind of interventions.ConclusionsThe time is ripe for building bridges among neuroscience, humanities and social sciences, and this can only happen within the umbrella of a biopsychosocial perspective reinstated into its systems thinking background.

Evaluation of collaborative mental health services in Latin America: Theoretical and methodological basis

“…It is important to note that a local CMHC is a system in its own right and that this system is embedded within organizations, communities and a larger social context 75,76 . In particular, the concept of “complex adaptive systems” 77 needs to be explored for its implications for CMHC 78 .…”

“…A comprehensive approach 75 should integrate qualitative and quantitative methods in an appropriate design following the standards of professional evaluation practice 101,102 . Any method used to evaluate complex collaborative care models will have pros and limitations.…”

“…73,74 It is important to note that a local CMHC is a system in its own right and that this system is embedded within organizations, communities and a larger social context. 75,76 In particular, the concept of "complex adaptive systems" 77 needs to be explored for its implications for CMHC. 78 Complex adaptive systems (CAS) encompass the following characteristics 79 : (1) they feature an entangled web of relationships among many internal and external agents and forces; these influences cause constant change in an unpredictable, nonlinear manner; (2) CAS are self-organized: patterns of behaviour that emerge through complicated relationships, influences and feedback loops inside and outside the system, that can be shaped, but not forced; (3) CAS do not move predictably toward an end goal; (4) communication is heaviest at the boundaries of a CAS; ( 5) system-wide patterns of behaviours can be observed; (6) feedback loops (they carry information, material and energy) are the mechanisms for change in a system; and (7) patterns of behaviour may repeat themselves at different levels of a system and across systems.…”

From theory to practice: The pragmatic value of applying systems thinking and complexity sciences in healthcare

“…The articles [19][20][21][22][23] in this edition of the Complexity Forum provide further insights that will shape the ongoing development of systems thinking informed healthcare. Sturmberg and Marcum discuss the philosophical basis and consequences of systemic thinking on research and conclude that the observable outcomes of health, health care delivery and health systems are governed by causes and effectsevery cause leads to effects that themselves become causes for other effects.…”

“…Fanali and colleagues 20 point out that mental health disorders arise from the complexities between the biological blueprint and the environment. Managing mental health disorders – we would go one step further and argue ALL disorders – requires a complex adaptive health system, one that “ capture [s] the whole picture, and … put [s] together … a coherent map of the complex dynamical system …, where clinical and population‐based intervention … [can] coevolve .” As they point out, failure to do so results in a mere aggregate of unrelated elements that fails to grow based on sharing information.…”