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Open Access Open Badges Commentary

A diagnosis of conflict: theoretical barriers to integration in mental health services & their philosophical undercurrents

Nathan M Gerard

Author Affiliations

Columbia University, Teachers College, Program in Social-Organizational Psychology, 525 W 120th Street, New York, New York 10027, USA

Philosophy, Ethics, and Humanities in Medicine 2010, 5:4  doi:10.1186/1747-5341-5-4

Published: 4 February 2010


This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practitioners holding divergent theoretical orientations towards the phenomena being treated. Such conflicts, although steeped in history, have become revitalized by recent attempts at integrating mental health services that have forced diversely trained practitioners to work collaboratively together, often under one roof. Part I of this paper examines how the history of these conflicts can be understood as a tension between, on the one hand, the medical model and its use by the dominant profession of psychiatry, and on the other, those alternative models and practitioners in some way differentiated from the medical model camp. Examples will be given from recent policy and research to highlight the prevalence of this tension in contemporary practice. Part II of this paper explores the deeper commonalities that lay beneath the theoretical conflict outlined in Part I. These commonalities will be shown to be apart of a captivating framework that has continued to grip the conflict since its inception. By exposing this underlying framework--and the motivations inherent therein--the topic of integration appears in wholly different light, allowing a renewed philosophical basis for integration to emerge.