The Biopsychosocial (BPS) Model of Health is a welcome departure from the biomedical model, which has dominated medical practice for over 50 years. Central to this model is “disease as a condition caused by external pathogens or disorders in the functions of organs and body systems” (Havelka et al., 2009). The BPS model of health, instead, is a more holistic approach and acknowledges key determinants of health and the complex integration of biological, psychological and social factors in the assessment, prevention and treatment of diseases (Havelka et al., 2009). The model was first developed by Georg Engel in 1977, who saw the biomedical model as “reductionist”, placing too much focus at the cellular level. “Engel believed that to understand and respond adequately to patients’ suffering—and to give them a sense of being understood—clinicians must attend simultaneously to the biological, psychological, and social dimensions of illness” (Borrell-Carrio et al., 2004).
The BPS model expands beyond organ and tissue functioning and explores wider psychosocial aspects of diseases with the patient at the center of care. The model is designed to support a preventative approach to incidents of chronic diseases while shedding light on the mechanisms of psychological stress and the development of somatic diseases. The BPS model led to applied approaches to psychology and highlighted the importance of an interdisciplinary focus to care (Havelka et al., 2009).
An example of a Biopsychosocial approach to detecting and treating depression begins with validated systems for identifying patient-reported outcomes (PRO). “Patient-reported outcomes (PROs) can promote person-centered biopsychosocial health care by measuring outcomes that matter to patients, including functioning and well-being” (Van Orden et al., 2022). The researchers applied a universal screening approach using a depression PRO screen in routine outpatient care. The aim was three-fold. 1. To examine the number of patients with clinically significant depressive symptoms (detected by the screening). 2. To estimate the number of patients with clinically significant depressive symptoms (detected by the screening) in a large health-system and 3. To examine connections between biopsychosocial patient-reported-outcomes (PRO’s) for ex. physical, psychological (depression) and social health (Van Orden et al., 2022).
Their results support the need for universal depression screening that goes beyond the traditional clinical/hospital setting. The article provides an example of a multilevel approach to identify sociodemographic indicators of depression in a diverse patient population. I appreciate that the responsibility of detection can be shared amongst health care providers in varied settings. The screening also prompts communication to enhance therapeutic rapport while promoting linkages to biopsychosocially-relevant resources in the health system and community. This approach to screening offers a person-centered and cost-effective means for engaging providers across the health care system (Van Orden, 2022).
References
Borrell-Carrió, F., Suchman, A. L., & Epstein, R. M. (2004). The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Annals of family medicine, 2(6), 576–582. https://doi.org/10.1370/afm.245
Havelka, M., Lucanin, J. D., & Lucanin, D. (2009). Biopsychosocial model--the integrated approach to health and disease. Collegium antropologicum, 33(1), 303–310.
Van Orden, K. A., Lutz, J., Conner, K. R., Silva, C., Hasselberg, M. J., Fear, K., Leadley, A. W., Wittink, M. N., & Baumhauer, J. F. (2022). URMC Universal Depression Screening Initiative: Patient Reported Outcome Assessments to Promote a Person-Centered Biopsychosocial Population Health Management Strategy. Frontiers in psychiatry, 12, 796499. https://doi.org/10.3389/fpsyt.2021.796499
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