A Utilitarian Perspective of Social and Medical Contributions to Three Illustrative Conditions, and Recent UK NHS Policy Initiatives

Abstract

Background: To date debate concerning the relative merits of social and medical sciences has been
largely academic.
Aims: To outline and critically appraise a utilitarian approach to mental health research that reflects a
critical realist perspective.
Method: Consideration of the relative utility of differing approaches to illustrative ‘‘psychiatric’’
disorders, and recent policy initiatives.
Results: Socially relevant outcomes of Bipolar Affective Disorder are determined by influences that
operate independently of the characteristic instability of mood. There is now a highly specific and
effective psychological treatment for Panic Disorder. Its benefits are still not fully exploited because of
continuing lay and professional focus upon the condition’s social manifestations. Great numbers of
people presenting in primary care are unhelpfully caused to adopt the role of ‘‘patient’’ due to practices
limiting the professional response to a medical one. Such practices reflect public and professional
perceptions of the nature of ‘‘mental health difficulties’’ much more than they do the achievements of
medicine. Recent policy-supporting initiatives influencing UK NHS mental health services are much
more likely to be supported by social sciences than by medical research.
Conclusions: There is considerable scope for a contribution to applied mental health research from
frameworks and methodologies that are rooted in a social sciences perspective.