Health psychology, is an ambiguous field of psychology with many people asking, “so what is it you do exactly?”, whilst it says what it is on the tin- the psychology of health, the potentials of health psychology exceed current specialisms they work in.
I am admittedly a masters student in health psychology with clinical skills (and therefore arguably biased), I am also passionate about mental health. I like to zoom out from the micro investigations of health psychology to the macro level applications and interconnectivity of overall physical and psychological health, an either harmonious or discordant duo.
What Health Psychologists Do & Their Roles
Health psychologists utilise the Biopsychosocial model (Engel, 1980) a triad of factors; biological, physiology and genetics, thanks to the splicing combination of your mum and dad; psychological, our quirks and toolkit of skills in navigating life; and social, our tribe and environment, all of which contribute to our overall health and well-being.
Health psychologists’ roles vary from supporting individuals in the management of illnesses and understanding the incurring social and psychologically impact and how to help, particularly important in the knowledge of terminal diagnosis’s. We are interested in understanding individuals adherence or lack of, to medication and the reasons for the lack of engagement in health checks and health screening.
In case of more intimate and personal inquiries of sexual health and screening of breast, cervical and testicular cancer, we are interested in how we can break down barriers to encourage engagement and enable prevention, early detection and treatment.
Interested in General Health & Well-Being
Health psychologists further advise individuals on lifestyle behaviours with smoking cessation, weight management and healthy living programs to improve health and reduce the risk of noncommunicable diseases (NCDs, are non-infectious and non-transmissible diseases that are often preventable through lifestyle alterations, as promoted by the World Health Organisation campaign).
This inclusive approach to health means health psychologists are the ideal candidate for reviewing and advising towards public health reforms and health initiatives. Essentially anything related to health and an individuals’ mentality around it, you will find a curious health psychologist wondering why.
Generally, we know that eating a whole bag of doughnuts is not good for us and that the extra bottle of wine the night before was not necessary (although this may only be acknowledged the next morning).
We know exercise is good for us; both physically and neurochemically releasing a whole load of feel-good chemicals and stress is bad for us, chronic stress being a catalyst to a whole range of ill-health. Those cooped up in our study’s for days working on projects and dissertations, arguably teeter on the verge of cabin fever and are likely, stressed, intuitively crave human contact.
“Whosoever is delighted in solitude, is either a wild beast or a god.” Francis Bacon.
This intuitive need as humans is being recognised in the medical community with an increasing number of doctors breaking out of the biomedical bounds, prescribing not pills but nature, gardening, exercise and play (specific for children, however arguably great for big kids too).
Scotland is at the forefront of this engagement with Shetland island now prescribing rambling and birdwatching for individuals’ health, whilst the Scottish Government is rolling out social prescription, engaging individuals in holistic alternatives in the community.
Community engagement further addresses the epidemic of loneliness, found to attribute to worsened physical and psychological health; community engagement provides opportunities for developing interpersonal relationships, which as a social species we thrive from and are hard-wired for.
These holistic treatments have long been recognised in the mental health community in the utilisation of art, drama, dance and group therapy, it is a novelty in the treatment and management of physical health, despite its comorbidity with psychological well-being. The further adoption of Eastern approaches in the West with mindfulness, meditation and yoga, has been found to mitigate symptoms in both physical and psychological ill-health.
Health Psychology’s Place & Impact
So where do health psychologists stand in this new shift of health? Whilst holistic prescriptions are being sprinkled around like fairy dust (rare but can still happen in the case of Peter Pan’s gang in this case Scotland), general practice services remain inundated and mental health services waiting lists are ever growing.
In the United Kingdom, 1 in 3 of general practitioner consults relate to mental health and 1 in 5 to medically unclassified symptoms (MUS are physical complaints without any organic explanation, often a manifestation of psychological distress).
General practitioners are further pressured by GP shortages and a 9-minute consultation to speed talk about all your concerns and find a resolve (the U.K ranks highest on the scoreboard for the shortest appointment duration in the whole of Europe). This limited time means that the nature of MUS are not investigated and are subsequently treated as a physical complaint and reports of mental health symptoms are diagnosed with the self-administered Patient Health Questionnaire-9 (PHQ-9).
The PHQ-9 is a series of 9 questions in the diagnosis of common mental disorders, mainly depression and anxiety, a positive score concludes in a proposed diagnosis and a referral to mental health services, a prescription of anti-depressants or a combination.
A valid and reliable self-administered measure, with established use in primary care settings, what it doesn’t do and GPs don’t have the time to do is explore other life factors that are impacting on health.
Consider a few scenarios; you work nights and are a single parent, you have a few hours of sleep between chores and collecting the children before returning to work in the evening; you are carer for a family member and also study and work; you are in an abusive relationship and managing your own business; or you are young mum recently diagnosed with breast cancer.
All of these situations have the potential to make us feel exhausted and affect our psychological health, this does not necessarily equate to individuals’ having the underlying pathology of a mental health disorder instead it is understandable in the circumstance.
“Before you diagnose yourself with depression or low self-esteem, first make sure you are not, in fact, surrounded by arseholes.” Sigmund Freud.
All health symptoms, in non-emergency circumstances, will primarily present in general practice, the introduction of health psychologists could enable an encompassing biopsychosocial enquiry into individuals’ life circumstances and lifestyles.
Generally, individuals are resistant to disclose honestly about our bad lifestyle choices to GPs, yet the confidentiality bounds of psychologists may enable an open disclosure. This is particularly important in high-risk groups with men presenting physical ailments in cases of psychological distress and in the recognition of intimidating partner violence.
Maybe the next step for health psychologists could provide a service between mental health and general practice services, referring individuals to the likes of social prescriptions or programs to improve lifestyle and for individuals to be embraced and supported in their community. The awareness of what health psychologists do and what we can do to help you is critical in the assurance of the profession and individual engagement to becoming a less ambiguous speciality.
Many thanks to GetPsyched for letting me feature as a guest blogger and to those who have read this blog I hope you found it of interest.
For those who would like to share their view on the introduction of health psychologists in general practice, I would love your contribution to my research, please click here and complete the questionnaire, it takes about 20 minutes.