Underlying Conceptual Frameworks Used to Understand Mental Health by Disabled Members of UK General Public

This research explores how disabled members of the general public understand mental health and it’s causes, from the perspective of public mental health (PMH) and the social determinants (SDH). All participants self-identified as disabled based upon diagnosis received from healthcare professionals. Existing research into PMH and SDH does not distinguish mental from physical health. This qualitative research into health generally suggests the public have complex understandings of structural causes. Psychological research does examine mental health independently but does not incorporate structural explanations. It is therefore unclear as to how the public conceptualise mental health, its causes or what influences different frameworks being drawn upon. Within SDH research, lived experiences and many social locations have been excluded, included disability.
The current research utilised qualitative interview methodology and thematic analysis to examine how disabled members of the public conceptualise mental health, its causes, and what processes influence different models being drawn upon.
Four themes were constructed. The first regarded the impact of the language of health. The second identified that ‘mental health’ was conceptualised through social norm violation. The third incorporated the participants negotiation of labelling using psychiatric diagnosis and social categories. The final theme included different causal models of mental health, namely individualised, embodied causes relating to physical disabilities, oppressive ideologies and institutions.
There were many complexities to this research, including the multiple definitions and meanings of disability with their corresponding epistemological stance, multiple ideological frameworks that influence the SDH and difficulties with utilising an intersectional lens. Exploring these themes whilst conducting the research has raised more questions than answers, and as such it has been challenging to draw concrete conclusions. Despite this, I have suggested that future research considers the role of emotional processes in influencing which conceptual models are drawn upon at different times, and have I tentatively suggested potential priorities for PMH.
Firstly, to work with the public to develop a shared language for different conceptualisations of mental health, causal models and social locations. Secondly, before work can begin on primary prevention, I would suggest that PMH may work with public services including health and social care and the police to minimise iatrogenic harm that serves to perpetuate the unequal access to resources by marginalised groups who experience health inequalities.