The term mental health problem refers to emotions, thoughts, and behaviors—psychosocial phenomena—that are experienced as problematic in a certain context from someone’s perspective. Observed psychosocial problems are simplified by classifying them into psychiatric or neuropsychiatric diagnoses according to predetermined symptom criteria.

Symptom-based diagnostics enable a reductionist way of studying and treating psychiatric problems, wherein psychosocial issues are assumed to be reducible to their components. For example, certain symptoms are taken to indicate a particular disorder, which should then be treated using methods developed for that specific disorder. Or it is assumed that a given disorder or symptom can be traced back to specific causal factors such as life events, psychological processes, or bodily functions like brain activity. Mental health care then focuses on identifying and treating these presumed causes.

However, psychiatric or neuropsychiatric diagnoses do not, in fact, explain the cause of the observed or experienced problem—they are conventional symptom descriptions, essentially synonyms for the observed issue. Psychosocial problems that appear similar are not necessarily caused by the same underlying factors, just as human thoughts, emotions, or behaviors are not universally reducible to specific causes. Furthermore, whether a particular emotion, thought, or behavior is considered problematic depends on context—how such traits are culturally perceived and what is expected of individuals.

There are challenges inherent in the dominant reductionist view of mental health. First, categorizing psychosocial problems can lead to a situation where these conventional symptom descriptions begin to appear as actual diseases that cause the observed issues. People may then start explaining their difficulties in terms of a psychiatric or neuropsychiatric diagnosis—resulting in a self-perpetuating circular argument. This also narrows the public understanding of what is “normal,” medicalizing a wide range of traits, experiences, and life problems, and placing them under the control of mental health professionals. As a result, demand for services increases, and care becomes more focused on symptom management using predefined methods, rather than addressing the individual's unique life context and the specific factors maintaining the distress.

A holistic view of mental health offers an alternative to reductionism. According to holism, complex psychosocial phenomena cannot be fully reduced to their components because the whole possesses properties that do not exist in any single part.

The holistic concept of the human being sees a person as composed of body, consciousness, and context—inseparably intertwined (Rauhala, 1985). While bodily and psychological traits are necessary conditions for psychosocial problems, the problems themselves cannot be fully reduced to individual traits, because their problematic nature depends on context and the meanings attributed to them. This helps explain why phenomena categorized as mental health problems have not been conclusively linked to psychological or biological components that can be objectively verified through psychometric tests, brain imaging, or lab tests. It also helps make sense of research showing that the effectiveness of mental health treatment often depends less on the specific method or diagnosis, and more on common factors: the quality and intentionality of the therapeutic relationship, sensitivity to situational factors, and the human-level impact of medications on thoughts and emotions—regardless of diagnostic categories.

In my research, I have formulated a unifying theoretical framework based on the holistic concept of the human being to support mental health care practices that prioritize situational appropriateness and responsiveness over fixed clinical assessment and treatment methods (Bergström, 2023). I have also been part of the World Health Organization’s (WHO, 2021) writing and review team developing guidelines to promote holistic practices, which are seen as potential solutions to the global mental health care crisis and poor long-term treatment outcomes. One example of a holistic model cited by the WHO is the Open Dialogue approach.

Currently, Finland’s social security and service systems do not support holistic approaches. In line with reductionist thinking, structures tend to promote the development and implementation of predefined treatments for predefined problems. While this works well for most medical issues, in the realm of psychosocial problems it can lead to overly specialized services and practices, which prevent the optimization of common therapeutic factors and likely contribute to chronic resource shortages. This helps explain why holistic models like Open Dialogue are not more widely adopted or sustained—even though many people would personally prefer them.

Widespread development of a more holistic system is not simple, because it would require a cultural shift in how we fundamentally understand phenomena labeled as psychiatric or neuropsychiatric. Such a shift is unlikely to happen on its own, as mental health language and ideas about professional help have become embedded in our shared understanding of reality. Additionally, the holistic mindset runs counter to our natural cognitive tendency to categorize complex things into simpler, more manageable forms in order to make quick cause-and-effect judgments essential for everyday survival. As a result, the holistic approach is harder to internalize and apply as a foundation for service system development.

Personally, I see it as crucial to create safe spaces where different perspectives can be explored—and challenged if needed. This is what I strive for in both my clinical and research work.

I’ve popularized my research topic in the non-fiction book Mieletön häiriö – Psykiatrian ongelma ja sen ratkaisu (PS-kustannus).