Subjective accounts of the causes of mental illness in the USA

Background: Psychiatrists and advocates for persons with mental illness in the USA argue that the biomedical model of mental illness as a brain disease is both accurate and effective in reducing stigma. Few studies have queried individuals diagnosed with mental illness to determine the extent to which they define their condition as biologically based versus caused by social and psychological factors. Method: Fifty inpatients in a behavioral health unit of a non-profit hospital in Western USA were interviewed in depth regarding their perceptions of the nature and causes of the condition that brought them into the hospital. Results: The vast majority of patients, regardless of diagnosis, emphasized painful life experiences brought about by others and outside their own control as the primary cause of their mental illness. Conclusions: The biomedical model of mental illness does not necessarily dominate the minds of people with mental illness; therefore mental health practitioners should understand and respect their patients' explanatory models in order to enlist their trust and compliance.