What is Mental Health?-II. Normality.

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So in the last article I talked about how complicated it is to define ‘mental health’. Today, let us take a look at one of the earliest models proposed to define mental health. This method sought to create a test that would rate people on the basis of their mental wellbeing. If a person got a score that is above normal, they would be considered mentally healthy. There is a lot of historical context that comes with it though. So let us take a look at that first

History of Defining Mental Health

Around the 1830s, there was a lot of statistical work going to the study of ‘healthy’ individuals. Scholars of the time believed that there was too much focus on illnesses. That is the first effort at looking into the definition of mental health.

Until sometime after the Second World War, most psychiatrists agreed with Freud in that mental health was a work of ‘ideal fiction’. They didn’t believe the actually existed; neither did they think that it was a definable concept. It was Jahoda who changed the perception of mental health as she gave a 5 point definition of mental health. This definition included being able to resist stress, being able to work, play and being efficient in problem solving. It also included being in touch with one’s own identity and feelings and be empathetic.

She brought a sea change in the outlook of mental health but couldn’t prove her definition as being based on scientific evidence. Her definition was based more on platitudes rather than evidence.

Health Sickness Rating Scale

Luborksy developed a test (scale) that would test the psychological functioning of the study subjects. This scale was later adapted to the DSM-III and named Global Assessment Scale. It was found to be highly reliable and since has been widely used to differentiate between people on the basis of psychological functioning.

The premise of this test was simple, if anyone scores above normal (~90), he/she is mentally healthy. If someone scores below normal (~40), they are deemed to be in need of psychotherapy. This therapy can then get their score to a normal level (~75).

Drawbacks

The main drawbacks that this model faces are that it tells us everything mentally healthy people are not; instead of telling us what they are. This again works on the principle that mentally healthy people are the ones who are not mentally ill. Also it tells us that we can get scores from 40 to 75 but doesn’t discuss how we can get them from normal (75) to above normal i.e. the mentally healthy range (90).

To Be Continued…

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