Mental Illness as a Social Construct

11 Key excerpts on "Mental Illness as a Social Construct"

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  Handbook of Social Problems

  A Comparative International Perspective

  • George Ritzer(Author)
  • 2003(Publication Date)
  • SAGE Publications, Inc

    (Publisher)

  Mental Illness as a Social Construct At the outset, the distinction must be drawn between the social attribution of mental illness and the phenomena that evoke the attribution. Behaviors, including the communications of thoughts, feelings, and perceptions, may appear universally but be attributed to mental illness only in certain societies. In other societies, the behaviors in question may be attributed to simple malevolence or physical illness. The responses that are signs of mental illness may be incorporated into social roles as appropriate to those roles. The social roles themselves may be defined as deviant, but in those deviant roles, the behaviors may be appropriate to the role. Even in societies in which the concept of mental illness exists, the groups of which the individual is a part may find the attribution of mental illness to be too threatening to the continuity of the group and so may be normalized or otherwise defined in more acceptable terms, such as eccentric rather than mad. Whether or not certain behaviors or the psy-chological structures that are inferred from such behaviors will be interpreted as indications of mental illness depends upon the cultural context, including the social identities of the individuals displaying the behaviors. When and where the concept of mental illness or some functionally equivalent term exists, behavioral manifestations or putative underlying psychological structures that are said to be indicative of mental illness fall within one or more of the following categories: 1. Severe and Prolonged Subjective Distress. Whether or not the occurrence of severe and pro-longed and subjective distress is understandable in light of an individual's unfortunate life circum-stances, the presence of distressful states such as chronic depression or anxiety are often taken to be indicative of mental illness.

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  The Language of Mental Illness

  Corpus Linguistics and the Construction of Mental Illness in the Press

  • Hazel Price(Author)
  • 2022(Publication Date)
  • Cambridge University Press

    (Publisher)

  Consequently, research into mental illness that takes a social constructionist perspective focuses on highlighting the contingent, socially produced character of categories of mental distress and of associated professional practices. Within this paradigm, thus, classification, the dominant system of knowledge regarding mental distress, and diagnosis, the practice of assigning a psychopathological category to a person, are not taken as given or as resources, but rather are treated as topics of investigation in their own right. The aim is to examine how these systems of knowledge and practice have 18 The Language of Mental Illness come to take their current form, how they are accomplished in practice and finally the consequences for mental health institutions and for individuals in distress. (Georgaca, 2013: 56) Georgaca argues that by challenging underlying common-sense under- standings of mental illness diagnoses, stakeholders in mental illness activism can provide alternative, more empowering understandings of mental illness. Further to this, Conrad and Barker (2010) state that social constructionist research in the field of medical sociology has made “significant contributions to our understanding of the social dimensions of illness” (Conrad & Barker, 2010: 567). However, the use of social constructionist theory in medical settings is not without its problems. As Bury states, if we were to take a purely social con- structionist approach to medicine, “the stable realities of the human body and disease are in fact ‘fabrications’ or ‘inventions’ rather than discoveries” (1986: 165). Bury raises an interesting point here about the intersection between the objective nature of medicine and the constructed nature of knowledge.

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  Mental Health Care Financing in the Process of Change (Volume 8.0)

  • Ingrid Zechmeister(Author)
  • 2018(Publication Date)
  • Peter Lang International Academic Publishers

    (Publisher)

  These are likely to differ from expert ones due to different perspective and different personal concerns. These fragmented sets of perspectives show that diverse concepts are not merely a matter of terminology but also reflect different types of reality. While the positions summed up so far emphasise the factual reality of mental illness, some researchers have raised a rather contrasting perspective. Thus, some sociologists and also psychiatrists themselves have argued that the whole concept of mental illness is nothing else than a social fabrication which is scientifically worthless and socially harmful (e.g. Szasz 1974). An additional critical approach is provided by the so-called 'labelling-theory'. It is mainly concerned with how individuals react to and categorise deviance, the associated negotiation and maintenance of the patient's role and the way symptoms become diagnosed as mental illness (e.g. Goffinan 1973). These theories are either entirely or at least partly based on a social constructivist position. Some of the critics mentioned have also specifically addressed the role of professionals in context with concepts of mental illness. While conventional historiography by psychiatrists describes medicalisation of psychiatry as revolutionary breakthrough, other writers have contrasted this view with the argument that mental illness has been constructed and used by professionals to legitimise their position. Thus, the rising profession of psychiatrists gradually discovered the 'insane' as their clientele, only to finally replace old places of social control with new ones, which were the mental hospitals (e.g. Domer 1974). In the critics' view, the beginning of the medical treatment of mental illness was neither due to an altruistic motive nor was it the Ingrid Zechmeister - 978-3-631-75434-4 Downloaded from PubFactory at 01/11/2019 04:56:41AM via free access

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  A Handbook for the Study of Mental Health

  Social Contexts, Theories, and Systems

  • Teresa L. Scheid, Eric R. Wright(Authors)
  • 2017(Publication Date)
  • Cambridge University Press

    (Publisher)

  As this overview should indicate, there is much more research that needs to be done to extend our understanding of mental health and illness before we will be able to resolve the ongoing debates on the existence and causes of mental illnesses, much less on suitable treatments. We do know that social conditions and environments are critical not only in understanding what constitutes a mental health problem, but in the course and outcome of mental health problems as well. However, the mecha-nisms through which the social environment influences mental health have not been thoroughly studied (Morgan, McKenzie, & Fearon, 2008 ). Part II will direct more focused attention to the social context of mental health and illness. 6 Sociological approaches regard mental health and illness as aspects of social circumstances. One type of sociological study examines the sorts of social conditions that influence levels of mental health and illness such as negative life events, ongoing stressful circumstances, demanding social roles, levels of social support, and the strength of cultural systems of meaning. Another type of study focuses on how social and cultural influences shape the definitions of and responses to mental health prob-lems. These kinds of studies show how key recent trends including the medicalization of a growing number of conditions, the increased use of prescription drugs to deal with mental health problems, and a greater willingness to identify emotional suffering as mental illnesses that require professional help, are transforming how modern societies deal with psychological problems. The sociological study of mental health and illness is both distinct from and complementary to more individ-ualistic psychological and biological approaches to these topics.

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  The Sociology of Health, Illness, and Health Care

  A Critical Approach

  • Rose Weitz(Author)
  • 2016(Publication Date)
  • Cengage Learning EMEA

    (Publisher)

  Different social groups consider different behaviors comprehensible and acceptable. The friends of a drug-using teenager, for example, might consider drug use a reasonable way to reduce stress or have fun. Their views, however, have little impact on public definitions of drug use. Similarly, members of one church might consider a woman who reports talking to Jesus a saint, whereas members of another church would consider her mentally ill. The woman ’ s fate will depend on how much power these opposing groups have over her life. The definition of mental illness, then, reflects not only socially accepted ideas regard-ing behavior but also the relative power of those who hold opposing ideas. KEY CONCEPTS Models of Mental Illness The Medical Model The Sociological Model Mental illness is defined by objectively measurable conditions. Mental illness is defined through subjective social judgments. Mental illness stems largely or solely from something within individual psychology or biology. Mental illness reflects a particular social setting as well as individual behavior or biology. Mental illness will worsen if left untreated but may improve or disappear if treated promptly by a medical authority. Persons labeled mentally ill may experience improvement regardless of treatment, and treatment may not help. Medical treatment of mental illness can never harm patients. Medical treatment for mental illness can sometimes harm patients. 154 C H A P T E R 7 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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  The Sociology of Health, Illness, and Health Care

  A Critical Approach

  • Rose Weitz(Author)
  • 2019(Publication Date)
  • Cengage Learning EMEA

    (Publisher)

  7. According to the medical model of mental illness, (a) objectively measurable conditions define mental illness; (b) mental illness stems largely or solely from something within individual psychology or biology; (c) mental illness will worsen if left untreated but is likely to lessen if treated promptly by a medical authority; and (d) treating mental illness rarely if ever harms patients. 8. The sociological model of mental illness argues that definitions of mental illness reflect subjective social judgments regarding whether behaviors are acceptable and understandable. Behaviors are labeled mental illness when they contravene cognitive norms, performance norms, or feeling norms. 9. Research suggests that psychiatric diagnoses are neither valid nor reliable and that the psychiatric diagnostic system has developed through an overtly political process. Copyright 2020 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 166 CHAPTER 7 10. Premodern societies often could find informal ways of coping with individuals we would consider mentally ill. When they could not do so, they typically blamed the problem on supernatural forces. The development of a capitalist economy fostered a need for new formal social institutions to address mental illness. The 19th century’s “moral treatment” movement aimed to improve conditions at those institutions. 11. According to Sigmund Freud, mental illness occurred when children did not respond successfully to a series of early childhood developmental issues linked to the biological body.

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  Health

  • Mildred Blaxter(Author)
  • 2018(Publication Date)
  • Polity

    (Publisher)

  Constructivist approaches are easiest to accept in cases where great variation exists between cultures and societies and organic signs are lacking (as in some mental disorders, such as the example of schizophrenia in the USA and the UK). Mental illness was in fact one of the first areas where these ideas were applied, sometimes in extreme form. In the USA, Szasz was the best-known proponent of the view that the conditions psychiatrists treat did not exist in the same way as organic diseases. He claimed that in most cases it had never been demonstrated that there is a physiological abnormality in those called mentally ill, and their ‘illness’ simply consisted in behaving in ways which alarm or offend others, or in holding beliefs contrary to those usual in their society. In the UK, Eysenck suggested that the traditional field of psychiatry should be divided into a small medical part, including actual biological abnormalities or lesions, and a larger behavioural part. Another prominent name in this movement was Laing, who argued that schizophrenia, far from being a disease, was the only sane or rational way that some people have of coping with the stresses with which they are surrounded.

  It is generally accepted that perhaps this goes too far. Many mental illnesses do exist as biological states, and most are more than simply a reaction to a label. Still, mental illness does remain as one of the clearest examples of how diseases can obviously be constructed, as demonstrated at different times and in different cultures.

  Constructivism and disability

  The ideas of constructivism and ill health as ‘deviance’ have been particularly important in the field of disability and chronic illness during the last half-century. Freidson was one of the early influential writers in the USA to point out that, like other stigmatized persons, people with disabilities tend to be evaluated as a category, rather than as individuals. Indeed, two stereotypes are usually involved, both predominantly negative: the label attached to the general category of ‘disabled’ and that which describes the particular impairment (crippled, blind). Since ‘… by definition, a person said to be handicapped is so defined because he deviates from what he himself or others believed to be normal and appropriate’ (Freidson 1965: 72), then labelling, segregating and feed-back processes apply to the disabled as to other deviants. As sociologists went on to point out, there are problems about the concept of disabled people as a stigmatized minority group, and there are spokespeople for lobbies for disabled people who vigorously oppose the idea. However, in practice these processes have clearly been illustrated for a range of visible and stigmatized conditions of the sort first, historically, defined as ‘handicap’ – disfigurements, epilepsy, sense deprivation. That a state of deviance may be created by the very agencies which are supposed to identify and help was demonstrated memorably by Scott (1966), who showed the relevant welfare agencies for the blind as engaged in ‘… a socialisation process, the purpose of which is to prepare a disabled person to play a type of deviant role’ and construct blindness by ‘making blind persons out of people who cannot see’.

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  The International Handbook of Sociology

  • Stella R Quah, Arnaud Sales, Stella R Quah, Arnaud Sales(Authors)
  • 2000(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  International Handbook of Sociology 443 21 Mental Health and Illness Research: Millennium and Beyond Rumi Kato Price, Clyde R. Pope, Carla A. Green, and Susan C. Kinnevy In the study of mental health and illness, social scientists have pursued a better understanding of the societal and micro-environmental factors that influence the development, treatment, and outcome of mental health and psychiatric disorders. In 1994 a review of developments in the field of mental health and illness research was submitted to the World Health Organization (Price, et al., 1994). That review covered conceptual and historical issues. This chapter focuses on applications and discusses contributions of social science perspectives to the areas of mental health and illness research that are expected to become increasingly salient toward the Millennium and beyond. Three such areas involve cross-cultural and international research, child and adolescent mental health and illness, and mental health care utilization. We conclude with an assessment of the potential value of future social science research in general, and in the three areas, in particular. A. Introduction A.1. Previous Work Our 1994 review identified historical tensions that exist between medical and social science understandings of the etiology of mental health problems and psychiatric illness. We also argued that there is a discrepancy between theoretical developments and the mission of mental health researchers to provide knowledge that leads to tangible solutions for mental health problems (Price, et al., 1995a). These tensions may be attributable to the fact that a majority of mental health practitioners — psychiatrists, clinical psychologists, psychiatric social workers, psychiatric nurses, and occupational therapists — treat and counsel patients and, to a lesser extent, teach students of these professions. Their contributions have generally been clinical, 443

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  The SAGE Handbook of Mental Health and Illness

  • David Pilgrim, Anne Rogers, Bernice Pescosolido, David Pilgrim, Anne Rogers, Bernice Pescosolido(Authors)
  • 2010(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  The discussion of this litera-ture here is framed by a broader consideration of the structural, cultural and psycho-social properties of stigma itself, references being made also to chronic physical illness and disability. After all, mental illness represents but one 11 Stigma and Mental Disorder G r a h a m S c a m b l e r B OX 11.1 Stigma models (in chronological order) Stigma: notes on the management of spoiled identity (Goffman, 1963). Stigma is ‘the situation of the individual who is disqualified from full social acceptance’ (preface). The stigmatized individual is ‘reduced in our minds from a whole and usual person to a tainted, discounted one’ (p. 3). Goffman emphasizes stigma as enacted in ‘mixed interactions’ between stigmatized and non-stigmatized individuals and how stigmatized individuals manage those interactions. Social Stigma: the psychology of marked relationships (Jones et al., 1984). ‘The stigmatizing process involves engulfing categorizations accompanied by negative affect that is typically alloyed into ambivalence or rationalized through some version of just-world hypothesis’ (p. 296). Jones et al. identify six dimensions of stigmatizing ‘marks’: conceal-ability, course, disruptiveness, aesthetic qualities, origin and peril. Modified labelling theory of mental disorders (Link et al., 1989). Socialization leads to beliefs about how most people treat mental patients. When individuals enter psychiatric treatment, these beliefs become personally relevant. The more patients believe they will be devalued and discriminated against, the more they feel threatened by interacting with others. They may employ coping strategies that can have negative consequences for social support networks, jobs and self-esteem. Identity threat models (Crocker et al., 1998; Major and O’Brien, 2005; Steele and Aronson, 1995). Possessing a stigmatized identity increases exposure to potentially stressful, identity threatening conditions.

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  The Stigma Effect

  Unintended Consequences of Mental Health Campaigns

  • Patrick Corrigan(Author)
  • 2019(Publication Date)
  • Columbia University Press

    (Publisher)

  M ENTAL ILLNESS STRIKES with a two-edged sword. On one side are the harmful effects of symptoms and disabilities that prevent people from achieving personal goals. On the other are the egre-gious effects of stigma, the prejudice and discrimination of a community that blocks personal aspirations. Chapter 1 reviewed what research shows to be barriers wrought by psychiatric illness. The chapter also examined how unintended consequences of this research might fan the flames of stigma. In chapter 2, I begin to examine the gist of this book—what is known about stigma and the ways it harms people labeled with mental illness. Psychia-try frames illness as a problem of the individual. Hence, treatment is largely oriented to impacting that person. Stigma is a problem of the community. Resolving it requires targeting where everyone lives, works, and plays. I begin this chapter by providing a social-psychological model of stigma that focuses on its cognitive constructs and specific functions: stereotypes, prejudice, and discrimination that manifest as public or self-stigma. I then address a social-developmental question: why has stigma emerged in cul-ture as such a harmful force? I seek to illustrate these points by drilling down into the effects of the worst of mental illness stereotypes: dangerous-ness. Why does viewing people with mental illness as homicidal maniacs endure? This dovetails with an independent but equally egregious set of socially sanctioned stereotypes of behavioral health, that are experi-enced by people with substance use disorders. This work is governed by 2 WHAT IS THE STIGMA OF MENTAL ILLNESS? 42 WHAT IS THE STIGM A OF MENTAL ILLNESS? recommendations that comprised the National Academy of Sciences report on addressing the stigma of behavioral health. The second half of this chapter sets the frame for the remainder of the book. How might the stigma of mental illness be erased? This is an espe-cially important focus for social progressives.

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  Mental Illness

  • Tim Thornton(Author)
  • 2022(Publication Date)
  • Cambridge University Press

    (Publisher)

  This section will examine a different reason for thinking that psychiatric kinds may have a distinct status from the kinds found in physical medicine. Physical illnesses are universal in this sense: although their rates may vary geographically, the nature of the illnesses does not. There are examples of what look like niche specific physical illnesses. ‘Phossy jaw’ was an occupational hazard of people who worked in the match- stick industry in the nineteenth and early twentieth centuries and is now, fortunately, rare. It is, nevertheless, universal in this sense: anyone suitably exposed is liable to suffer from phosphorous necrosis. The causal conditions may be local and culturally determined by social and economic factors but the constitution of the illness is universal. Transcultural psychiatry, however, suggests that mental illnesses may not be universal in this sense. The nature and the possibilities of illnesses themselves may vary from culture to culture. And hence, there may be genuine, but merely local, illnesses. This section will examine whether this is a cogent possibility and, if so, how. In the next part, I will set out the way in which DSM-IV and DSM-5 (the title changed from Roman to Arabic numerals) have addressed cultural factors in part through the description of cultural concepts and idioms of distress and guidance on cultural ‘formulations’. In the subsequent part, I will examine an influential picture of the role of culture in shaping mental illnesses in a two- factor model comprising ‘pathogenic’ and ‘pathoplastic’ aspects. This suggests the possibility of three possible models: the two-factor model just mentioned and two single-factor models. In the final part of the section, I will use these to examine whether there could be genuine but local mental illnesses and whether the examples given in the DSM might suggest how. I will argue that there could be but that the approach taken by the DSM is unlikely to account for them satisfactorily.

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