The Bigger Picture

The Many Models of Disability

Madison Sideleau, Student, Fitchburg State University

We have come up with multiple different “models” or frameworks for diagnosing, treating, and interacting with disability. As the years go on, more models have been introduced in order to keep up with our ever-changing understanding. Each model has its own way of explaining what a disability is. While there are a multitude of different models, there are two main models used. These include the medical model and the social model. Though each model does its job to frame this topic, since disabilities are such a complex issue, it is difficult for us to frame it with just one model.

The Encyclopedia of Clinical Neuropsychology defines the medical model as ​a model of health "suggests that disease is detected and identified through a systematic process of observation, description, and differentiation, in accordance with standard accepted procedures, such as medical examinations, tests, or a set of symptom descriptions. There are three major criticisms of the model that: (1) it supports the false notion of dualism in health, whereby biological and psychological problems are treated separately; (2) it focuses too heavily on disability and impairment rather than on an individual’s abilities and strengths; and (3) it encourages paternalism within medicine rather than patient empowerment" (Swaine). This model was developed in replacement of the moral or religious model. Contrary to this model that viewed disability as an act of God, typically as a punishment, the medical model was created as a way to explain disabilities in terms of physical problems such as disease, illness, trauma, etc. With the medical model, a disability is seen as a personal issue that should not be the concern of anyone but the person in which it affects. It is based on the belief that difficulties associated with a disability should be dealt with by the person with the disability only (“Models of Disability: Types and Definitions.”). Though the medical model helped to explain the physical manifestation of disability in medical terms, it has been met with some criticism.

One of the major criticisms the medical model is the fact that it suggests a person with a disability is potentially helpless, that the disability was a part of the person and they could not do anything about it unless there was a "cure." In terms of the medical model, a person with a disability might not be equal to those without them. Another major criticism of the medical model was that it defines disability in terms of an abled norm. Meaning those who lack a disability or are “abled” are seen as “normal” and those with a disability are the odd ones out. Of course, we know just how common disabilities actually are. In fact, one in four adults in the United States alone live with a disability (“CDC: 1 in 4 US Adults Live with a Disability”). Thus, stating that a disability is outside the norm would not be correct seeing as how many people live with a disability.

With all of this criticism against the medical model, a new set of frameworks were needed to look at disabilities. Thus, the social model was created. The social model of disability is a more contemporary model that puts more of an emphasis on how society perceives disability rather than the medical aspect. The social model states that a medical condition does not cause a disability, but rather disabiilty is defined by the attitudes and structures of society (“Social Model of Disability,” Mental Health Foundation). While the social model does not disregard the medical diagnosis of a disability, it focuses on the affect society has on our view of such conditions. It aims to accommodate those impairments by making our society more fit to deal with them. The major point raised by the social model is if society was made to be accessible to those with disabilities, they would not be excluded or restricted (“Social Model of Disability,” ​People with Disability Australia​). Like the medical model, the social model has been met with criticism as well. A critique of this model is the fact that it views disability in the eyes of society only and not on the impacts of the actual impairment on the person. This can lead to problems because the disability itself may not get the attention it needs in order to improve the condition of the person whom it affects.

While these models help us to understand different aspects of disability, there are certain conditions that would not be able to be defined under just one of the models alone. If you take blindness as an example, you could use both the medical and the social model to define it as a disability. Blindness can be defined as a disability under the medical model because it is a medical condition that impairs an individual by causing them to be unable to see. It could also be defined as a disability under the social model because our society is not fit to accommodate those who are unable to see efficiently. Thus, these individuals must adjust their daily lives to fit into our society (see, for instance, the story of Tim Vernon). Another example of a condition that may be difficult to define as a disability with just one of the models would be a disease such as Crohn’s disease. Crohn’s disease is an inflammatory bowel disease that affects the lining of the digestive tract (“Crohn's Disease”). It is easy to see how this condition could fit under the medical model because it is a medical condition that impairs a person’s everyday functioning. It can also fit under the social model because in our society it is difficult for someone to live a “normal” life with a condition like this (see, for instance, the story of Alfred the Great).

Under these two models, it is difficult to see where mental illnesses and other mental conditions fit because both models seem to put most of their emphasis on physical disabilities. The medical model puts a lot of its focus on treating medical conditions in order for a person to become more “abled.” The social model puts its focus on adjusting society in order for a person to become more “abled.” When we are discussing the topic of mentality, it is not as simple. Most of the time, a mental condition is personal and cannot be fixed by adjustments like those. With all these criticisms and problems with the two models, it is difficult to determine which is best fit to use.

In premodern times when our medical knowledge and technological advancements were different than they are now, it would be easy for us to categorize a disability under one set of frameworks or model, but we can see how complex disabilities can actually be. Because the topic is so complex, it cannot be defined by just one set of frameworks. All models have been met with criticism, and as a society, we must evaluate these criticisms as well as our knowledge in order to gain a better understanding of how to approach disability.

Throughout history people have experienced many forms of disabilities. Some people experience physical disabilities which can be temporary like a broken limb or chronic like scoliosis. Others may experience mental health disabilities' this form of disability is not as well known as a physical disability because it can be harder to notice due to the sheer fact that it is invisible. Mental health disabilities can take many forms: they can be temporary like a stand-alone anxiety attack or more chronic like depression, but like a physical disability, it can affect a person in many aspect(s) of their life. But one question can be asked: in both the premodern and modern era of society, why do we mostly only acknowledge the disabilities that can be seen, usually physical, and why can’t we understand that people can have more than one disability, both physical and mental?

A very important factor is to understand disability both on a physical and mental level. A physical disability is something that affects a person's functioning. This can include a limitation to a person's mobility, dexterity, and even stamina. There are many physical disabilities that can affect someone's way of life; some of these include a physical trauma like an amputation or a medical condition like COPD that limits a person's ability to do daily tasks. Mental disability or illness is a condition that affects a person’s thinking, feeling, or mood. There are many different factors that can cause someone to have a mental health condition. Some of these include genetics, environmental and lifestyle influences, and traumatic events that occurred in someone's life. Some conditions include ADHD, anxiety and depression (“What Is Mental Health?”). Disability affects many people both mentaly and physically in society during the modern era, but the history of disability has spanned across human history.

In premodern times disability was perhaps looked at differently than it is now due to changes in society, social norms, and other outside factors. In today's modern society, there have been numerous changes in the way we look at disability. Today we have many resources that allow us to engage those with disabilities. There have been great improvements in modern medicine to help those with disabilities, like the advancements of prosthetic devices and other forms of therapy of physical and occupational therapy (“A Brief History of the Development & Evolution of Prosthetic Limbs”). There have also been developments for those with mental health disabilities as well. This includes developments in therapy, in schools where there are professional counselors for students who need help with stress, among others. Society as a whole has also learned more about disability due to technology and the increase in the use of social media, that has allowed for commercials and other online campaigns to reach communities and spread awareness more quickly (“Mental Health Guide”).

But some things within society have not changed. As a society we see physical disability but mental health disability is still a form of taboo today and is still neglected for that reason. For those with physical disabilities, there are many services for them, but with mental disabilities there can be a harder time to be recognized as having one to receive care. Mental health disabilities are at an all time high due to many reasons; some of them include social media, school, and other societal stigmas that are felt by people today. Today’s society has come a long way since the premodern era in terms of technology, but there are many improvements to be made and the major one is to understand people can have more than one disability and also recognize that there are more than just physical disabilities.

Why is it that in today's society we believe that people only experience one type of disability?. There are many reasons why we think that. A good place to start is the fact that we can’t see every disability both physically and mentally. Disability can be very hard to see and also recognize. Some physical disabilities can be easy to see, such as an amputation, but some are hard to see like fibromyalgia. Mental health disabilities can be very difficult to notice because they are invisible to the naked eye due to the fact they are hidden on the inside of a person.

Some mental health disabilities come and go like panic and anxiety attacks. Many people across the world experience a mental illness every year that is temporary and doesn't last long. On the other hand, there are many mental health illnesses that are chronic, such as depression and bipolar disorder, and these can be hard to see due to the fact that those diagnoses can be on and off occurrences depending on the severity (“My Parents' Support Shaped My Recovery”).

Another reason behind this thought process is the stigmatizations and stereotypes believed about disability in today's society. Social media and other wide-spread information allows us to see and show only what we want so as a society we sometimes don't see everything that exists. For example, with soldiers that come home from war, we see the physical scars that are left behind but not as much as the mental scars. Also in movies and books the authors and directors get to choose the characteristics of the characters: this means that they often have only one disability at a time. A Fault in Our Stars, which is a movie about two teenagers who have cancer that fall in love, primarily focuses on their love and their battle with cancer and not as much as the mental challenges you might experience with cancer, let alone other possible disabilities one might have.

Societies, both in the premodern and modern eraa, have had many different viewpoints on disability, but one thing we can do is try to come to a better understanding of disability so that we can grow as a society and better ourselves to fully understand the effects of disability.