Disease and disability. The ICF model

Diagnoses alone, e.g. according to the international classification of diseases 10 (ICD-10), do not give information on the illness severity, treatment needs and consequences. This depends on the functional health status, e.g. according to the international classification of functioning, disability and health (ICF) which discriminates between impairment of functions, limitations in activity and capacity and participation restrictions. The German social law (SGB IX) defines disability as a chronic health status which lasts longer than 6 months and which results in participation restrictions. Participation restrictions are impaired capacities which not allow context or role requirements to be fulfilled. There are many instruments to measure capacities, such as the Mini-ICF-APP which was especially developed for mental disorders. As most mental disorders are chronic illnesses which lead to participation restrictions they must be conceptualized as mental disabilities. The consequence is that they must be treated under a social psychiatric perspective focussing on functions, capacities and context alike.