Beyond the Disease Model of Mental Disorders

Kiesler's Beyond the Disease Model of Mental Disorder goes beyond recent volumes which argue that psychotropic medications are being overused and abused in contemporary mental health settings. Elliott Valenstein, for example, an emeritus professor of psychology and neuroscience at the University of Michigan, recently argues that people should be highly suspicious of the claim that all mental illness is primarily a biochemical disorder. In his 1998 book, Blaming the Brain: The Truth about Drugs and Mental Health, Valenstein does not argue that drugs never work or that patients should discontinue taking medication. Valenstein's central point, instead, is that drugs do not attack the real cause of a disorder, since biochemical theories are an unproven hypothesis and probably a false one. Inasmuch as Kiesler's volume is concerned exclusively with scientific explanations of mental disorders, it does not review at all the evidence for psychotropic medications or for other treatments of mental disorders. Kiesler does highlight a message similar to that of Valenstein, who rejects the hypothesis that mental illness is primarily a biochemical disorder. After a comprehensive review of the relevant scientific evidence, Kiesler concludes that henceforth the study of mental disorders must be guided by multicausal theories and research that systematically include an array of biological, psychological, and sociocultural causal factors. Kiesler adds that, in order for this to be accomplished, the mental health field and the public at large must first abandon the invalid monocausal biomedical (disease) model of mental disorder.

DONALD J. KIESLER is Professor and former Director of the doctoral program in clinical psychology at Virginia Commonwealth University in Richmond, Virginia.