Mental Health Models
We looked at one definition of mental health here. But, there is no shortage of attempts to define mental health. A 2022 review in the Journal of Mental Health examined over 100 publications and identified 34 different theoretical models, grouped into five broader categories of Biology, Psychology, Social, Consumer (these focus on the lived experience, not the doctor or clinician as expert) and Cultural (including spiritual and traditional understandings). Many models overlap one or more of those categories; e.g., biopsychology. The researchers found that no definition or model should be preferred over the other, but that each provides a different lens through which we can look at things.
The biological lens or model focuses on how mental health is shaped by our bodies, brains, neurons, chemistry, gut microbiome, etc. This model places mental health treatment closer to that of physical health treatment. The premise and promise here is that when we know enough about how biology affects the brain, we will be able to precisely address mental health problems through medications and other means that directly affect our biology. The biological lens has led to both medications to help certain conditions, and a greater understanding of the physiology of mental health.
The psychological lens focuses on how we think, what we believe, and the stories we tell about ourselves and our experiences. The core insight is that our interpretation of events shapes our emotional response to them as much as the events themselves. Two people can experience the same loss and respond entirely differently, depending on the meaning they make of it. This lens gave us cognitive behavioral therapy, narrative therapy, and a growing body of research on how the stories we carry about our own lives are significantly associated with mental health outcomes over time.
The social lens looks outward. It argues that mental health is not primarily a disorder of individuals but a response to the conditions in which people live. Poverty, discrimination, housing instability, adverse childhood experiences, and social isolation are statistically some of the most powerful predictors of mental health outcomes we know of. This is the lens that social work was built on. It asks not just what is wrong with this person, but what happened to them, and what conditions they are living in.
The consumer lens centers on the lived experience of people with mental health challenges rather than the perspective of clinicians or researchers. It emphasizes recovery, self-determination, and the importance of peer support. It challenges the idea that the clinician is the expert on a person's experience.
The cultural lens recognizes that mental health is understood, expressed, and treated differently across cultures, communities, and spiritual traditions. What one culture calls illness, another may call spiritual awakening or crisis, social rupture, or a call to transformation. This lens resists the assumption that “Western” biomedical frameworks are universal.
The important thing to remember is that no single lens is complete. It does a disservice to insist that one lens can stand on its own. Each illuminates something the others miss. In future posts, we will look at each of these more closely. For now, the important point is this: how we understand mental health shapes how we treat it, how we talk about it, and how we experience it ourselves.
Mike O'Rourke is a Licensed Clinical Social Worker Candidate in Montana, available for in-person and telehealth therapy. Book a session or consultation.