A recent national study in the UK canvassed a diverse range of mental health service users/survivors opinions about the relevance of the social model of disability (Beresford et al, 2010). In conclusion, the authors pointed to the need for a social model of madness and distress. One approach, they suggested, would be for proponents of the social model of disability to consider how it might be made more accessible to mental health service users, enabling them to explore its relevance to their own lives. They also called for mental health survivor leaders and activists ‘particularly those concerned with the movement's value base and philosophy’ (Beresford et al, 2010, 31) to engage with the social model of disability in more depth.

This chapter takes up this challenge. We contend that the Capabilities Approach provides a way forward in this ongoing debate about the social model in disability and mental health. Although the Capabilities approach was developed in economics to analyse issues related to standards of living and the underlying axioms guiding international aid and poverty abatement, we believe that the framework may be deployed to address critical issues in social response to mental distress, support and recovery.

We think the Capabilities Approach offers a solid underpinning which service users, survivors and allies need to mount a serious challenge to the dominance of the medical model. This is because it supplies what is usually missing in even expanded medical models (like the biopsychosocial model) – a profound understanding of structural constraints and enablements. It provides a clear, practical and rightsbased answer to the call for a social model of mental health which could offer a real alternative to the medical model in terms of policy and planning; engagement of service users in creating new services to meet their expressed needs; and research and evaluation of service outcomes. Therefore, this chapter will outline what the Capabilities Approach offers our understanding of disability and how it can be applied to mental health to prevent long-term ‘psychiatric disability’.

Before we explain this in more detail, we need to understand how the Capabilities Approach differs from other approaches to disability.