A Guide to the Biopsychosocial Model of Mental Health

Psychological Factors

Psychological factors, like self-esteem, can affect your mental health.⁷ On its own, low self-esteem isn’t technically a symptom of mental illness. But it can lead to more severe issues. For example, one study found that people with less self-esteem had a higher risk of anxiety, depression, and attention problems.

Cognitive Processes

A cognitive process is the way your brain performs a task.⁸ Learning, decision-making, and paying attention are all examples of cognitive processes. 

Mental illness affects your cognitive processes. For example, data shows that depression interferes with memory formation.⁹ And ongoing memory problems can affect your work, social life, and overall well-being.

This connection goes both ways. Poor cognitive processing¹⁰ increases your risk of developing a new mental illness. Without proper treatment, this can lead to a spiral of worsening symptoms. 

Social Factors

Interpersonal relationships have a major impact on mental health.¹¹ Social support lowers your risk of developing mental illness and addiction. And if you do have mental health issues, strong relationships improve your chance of recovery. 

Cultural Norms

There’s more to your social life than relationships. Your cultural background also influences your mental health.¹² That’s because your values affect the way you think about your behavior. In some cultures, for example, it’s okay to have a beer with friends after work. In others, drinking is strictly taboo. Either way, your beliefs may affect how you define alcohol abuse. 

It’s important to find treatment that supports your values. With the biopsychosocial approach, clinicians may design a clinical care plan just for you. They may employ a variety of treatment methods, depending on your unique recovery goals. 

Socioeconomic Status

Your economic status matters, too. Researchers correlate lower socioeconomic status with higher rates of mental illness.¹³ This is probably due to the chronic stress of financial insecurity. That stress can also damage relationships, cutting you off from valuable social support. And what’s more, a lack of resources makes it harder to afford mental health treatment.

Application of the Biopsychosocial Model in Assessment

Under the biopsychosocial model, treatment starts with a comprehensive assessment.¹⁴ This approach to diagnosis is the standard of care. In other words, experts agree that it’s an effective way to start planning your long-term recovery. 

During the assessment, your care team will ask a series of questions¹⁵ about your physical, mental, and social well-being. These interviews are extremely detailed and may vary between providers. However, most assessments will include certain basic questions:

• Do you have any past or present medical diagnoses?
• Do you have any past or present mental health diagnoses?
• Do you have a family history of any physical or mental illnesses?
• What symptoms are you currently experiencing?
• Do you now, or have you ever taken illicit drugs?
• What is your living situation?
• How much sleep do you normally get in a night?
• Who is part of your support network? Does it include family, friends, healthcare providers, etc?
• What is your highest level of education?
• Are you currently employed?

Clinicians use this information to understand how your symptoms fit together. If you don’t already have a diagnosis, they may give you one before discussing treatment. Either way, the next step is to develop your plan of care. 

Treatment and Interventions

Despite the evidence that supports it, biopsychosocial treatment is not widely available.¹⁶ One study found that in hospital settings, few doctors perform comprehensive assessments. Instead, most providers focus on physical symptoms. If you’d like to receive treatment under the BPS model, you may need to seek out a specialized program.

By definition, biopsychosocial care includes multiple types of treatment.¹⁷ Each one addresses a different aspect of your health. For example, your care plan might include some or all of these therapies:

• Biological: Medical care, nutrition counseling, physical therapy
• Psychological: Talk therapy, behavioral therapy
• Social: Family therapy, support groups

In many programs, your clinicians will work together¹⁸ to provide integrated treatment. You may meet with your care team as a group, and they may meet privately to discuss your case. This close communication allows them to track your progress and make adjustments to your care plan if necessary.

Limitations and Criticisms

While biopsychosocial assessment is the standard of care, this model has some limitations.¹⁹ Specifically, it focuses more on diagnosis than treatment. Without formal guidance on how to design a care plan, every provider takes a slightly different approach. This makes it hard for patients to know what they can expect during recovery. 

Some experts argue that the biopsychosocial approach is outdated.²⁰ Critics say that scientific breakthroughs “have changed the very face of psychiatry in the last few decades,” leaving Engel’s theory behind. This new research suggests that some mental health issues have purely biological causes. However, we need much more data before we can confirm these theories.

The BPS model is more holistic²¹ than other approaches—maybe to a fault. S. Nassir Ghaemi, Director of the Mood Disorder Program at Tufts Medical Center, explains that “its boundaries are unclear.” In the effort to include so many dimensions of health, Engel left room for practitioners to interpret information as they see fit. As a result, their personal biases may affect treatment. Biopsychosocial treatment “gives permission to do everything, but no specific guidance to do anything,” Ghaemi writes. 

Future Directions and Implications

Despite these critiques, other experts say we can keep learning from this approach. For example, experts posit that focusing on the biopsychosocial model might reduce burnout among medical students.²² This could have far-reaching implications for the future of treatment. By setting an example for the next generation of healthcare providers, we might be able to reduce the stigma around mental illness. 

Biopsychosocial care also offers unique opportunities during recovery. Because treatment is so personalized,²³ you and your care team may develop a closer bond. That connection can help you commit to treatment more fully. 

For a complete assessment of your physical, mental, and social needs, reach out to a treatment center and inquire with their admissions team. From there, you can begin planning the next phase of your recovery journey—and the rest of your life. 

Frequently Asked Questions About the Biopsychosocial Model of Mental Health