Individual Approaches
Key Features
- Approaches to wellbeing emphasising internal factors shaping mental health
- Genetics
- Personality
- Personal experiences
- Focus on the person’s thoughts, emotions & behaviours
- Emphasizes that people have personal responsibility for their mental health
- Commonly uses one-on-one interventions
- CBT, psychoanalysis, narrative therapy
| Strengths | Limitations |
| – Builds personal skills – Highly tailored to specific individuals | – Overlooks external factors – Might not address the root cause of distress – Expensive therapy – Focus on short term immediate relief might not fix underlying issues |
Systems Approaches
Features
- Focus on the broader environment
- Family, community & societal factors
- Interventions involve multiple stakeholders
- Family Therapy
- School & Community Programs
- Policy Changes
- Recognises that people are impacted by many interconnected systems
Assumptions
- Interconnectedness of systems
- Role of external factors
- Preventative & holistic focus
- Importance of cultural context
Bronfenbrenner’s Ecological Systems Theory
Overview
- A model that shows how people are shaped by many interacting factors in their environment
- Emphasises the importance of context
- Doesn’t see people as isolated from external factors
Ecological Systems
Multiple, interacting layers of environment that influence human development & wellbeing
Layers of Influence
Levels of an environment from immediate surroundings to broader forces that influence a person.
Reciprocal Interaction
The two-way influence between a person and their environment, where they both affect each other.
Proximal Processes
Ongoing, direct interactions between people or objects in their immediate environment.
Dynamic Interactions
The changing, evolving relationships between people & their environments.
The 5 Concentric Circles
Microsystem
- Environments where people have direct interactions
- Family, friends, classmates, neighbours
- Has the strongest immediate impact on a person
- Relationships have reciprocal influence
Mesosystem
- The connections between microsystems
- Strong positive interactions = better wellbeing
- Conflicting interactions = lower wellbeing
Exosystem
- Environments a person doesn’t directly participate in but which still impact their life
- Indirectly impacts their wellbeing through ripple effects
Macrosystem
- Broader cultural, social, economic contexts in which other systems exist in
- Societal values, laws, customs, ideologies
- Shapes attitudes & policies
Chronosystem
- Influence of time on all the other systems
- Life transitions & historical events
- Shows how proximal processes evolve over time
Applications of Bronfenbrenner’s Model
Education
- Curricula & classroom design
- Considering students’ backgrounds, peer relationships, community resources
Mental Health
- Development of therapeutic approaches
- Systemic family therapy
Social Work
- Assessing client needs & context
- Identify strengths & barriers at multiple levels
Policy
- Designing interventions to address social determinants of health
Strengths & Limitations
| Strengths | Limitations |
| – Holistic Perspective – Versatile across fields | – Complex to apply – Hard to track changes in each systems – Might not be easily adaptable across cultures |
The Meikirch Model
Overview
- A model that sees health as a complex & adaptive system
- Integration of individual potential & social/ environmental context
- High biological potential + strong social support = best chance at coping with life demands
Demands of Life
- Challenges people face in daily living
- Stress, responsibilities, life changes
Biologically Given Potential
- Innate physical skills people are born with
- Strength, immunity, inherited traits
Personally Acquired Potential
- Skills, knowledge, experience gained over time
- Education, learned behaviour
Social Determinants
- Non biological factors that influence health
Environmental Determinants
- Impact of the natural & built environment
- Clean air, housing, green spaces
How do they interact?
People face challenges every day -> they draw on their biological & personally acquired potentials -> social & environmental factors impact how hard life’s demands hit someone -> people get feedback in coping with challenges, either building resilience or leading to needed support
Applications
- Healthcare System Design
- Informing public health policies
- Guides practitioners to be holistic in clinical work
- Increases health literacy in people
- Supports research on social determinants of health
Meikrich Model & Policy Applications
Community Health Initiatives
- Used to address broader determinants of health
- Safe spaces
- Community gardens
National Policy Programs
- Bringing together healthcare providers, universities & community organisations to address complex social issues
- “Improving Health System Responses to Family & Domestic violence” program
Multidisciplinary Teams
- Encourages healthcare teams made up of a variety of professions
- Doctors, social workers, psychologists, community workers
Peer & Social Support
- Social support helps people build resilience and deal with life demands
- Group therapy
- Clubs
Strengths & Limitations
| Strengths | Limitations |
| – Holistic integration – Flexible across populations and issues | – Complex – Needs significant resources – Subjective measurement of health – Harder to compare to other programs – Can be too simple for complex trauma & severe mental illness |
Bronfenbrenner vs Meikrich Model
| Feature | Bronfenbrenner | Meikrich |
| Systems & Structure | Layered, concentric environmental structures. Nested Systems. | Interaction between 5 core elements. Dynamic Interplay. |
| Focus of Influence | How specific environments affect individuals. | Balance between personal potentials & demands of life |
| Dynamic Processes | Reciprocal proximal processes between people & environments. | Adaptive balance between demands & resources. |
| Application Scope | Developmental psychology, education, mental health | Healthcare, public health & policy |
| Strengths | Detailed mapping environmental influences. Diverse application. | Holistic integration of biological, personal, social factors. Adaptable to community health. |
| Limitations | Complex to apply, overlooks biological factors. Hard to quantifiable measure. | Resource intensive, doesn’t align with other mental health. Hard to quantifiable measure. |
| Used For | Mapping out layers of influence. Individual clinical care. Research. | Assessing resources. Community, public health. Policy development. |
Strenths & Limitations of Systems Approaches
Definition
- Approaches that focus on the broader context surrounding a person
- Emphasizes the interconnectedness of systems
Key features
- Focus on environment
- Interconnected Systems
- Multi-Stakeholder Interventions
- External Determinants
- Prevention & community focus
Benefits
Improved Mental Health Outcomes
- Addressing multiple levels of influence –> better mental health
- Involving multiple stakeholders reduces isolation
Prevention & Early Intervention
- Reduces escalation of severe issues
Community & Social Support
- Reduces isolation
- Encourages people to build strong social supports to buffer against stress
Policy & Practice Impact
- Informs effective mental health policies
- Allows them to make targeted interventions for different communities
Challenges
Complexity & Coordination
- Requires multiple sectors to work together
- Risk of conflict
- Difficulties sharing resources
Resource & Funding Demands
- Needs lots of time, money and people
- Hard to sustain long term
Measurement & Evaluation
- Hard to measure to effectiveness due to subjectivity
- Hard to show long term impact for funding
Integration with Individual Approaches
- Might not align with existing frameworks that focus on individual diagnosis
Cultural & Contextual Barriers
- Needs to be adapted to different cultural contexts
Australian Systems Initiatives
Multisystemic Therapy (MST)
- Family & community based treatment program addressing antisocial behaviour in youth
- Intensive, home based services
- Works with youth, family, school, community
- Reduces rates of reoffending
- Very resource demanding
Headspace
- National youth mental health foundation
- Connects youth to mental health, physical health, education & employment services
Community Health Programs
- Bringing together primary health practitioners, universities, government
Policy Advocacy
- Lobbying of clinicians & academics for new programs/ funding
Steps in multi-sector partnerships:
- Needs assessment
- Stakeholder engagement
- Resource Allocation
- Program Design
- Evaluation & Feedback
- Sustaining Change
Critical Evaluation of Ecological Systems Theories
Core Strengths
- Holistic Perspective
- Relevance across contexts
- Integration of multiple influences
- Adaptibility
- Policy & impact
Limitations
- Complexity in applications
- Measurement & evaluation challenges
- Resource intensiveness
- Integration with existing frameworks
- Oversimplification
- Contextual limitations
Cultural Differences in Practice
| Western Contexts | – Individual autonomy, self-expression, personal responsibility – Models should emphasise personal agency |
| Non-Western/ Collectivist Contexts | – Family & community play central role in wellbeing – Models should include extended family, community & use existing social structures |
| Mixed/Globalised Communities | – Adapt model to be sensitive to diverse values, beliefs & expectations |
Steps for Future Direction
- Ongoing critical evaluation
- Cross cultural research
- Methodological Innovation
- Integrating Individual & Systemic Perpectives
- Policy & Practice translation
