8 Key excerpts on "Sociology of Mental Health"

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  eBook - ePub

  The Sociology of Healthcare

  • Alan Clarke(Author)
  • 2013(Publication Date)
  • Routledge

    (Publisher)

  In a similar vein, Ustun (1998) comments upon operationalising the concept of mental well-being as contained in the WHO’s definition of mental health quoted above. He describes the concept of mental well-being as covering four major dimensions: ‘the capacity to live, function and enjoy’, ‘the optimum development of mental abilities’, the ‘subjective feeling of well-being’ and ‘the interaction and equilibrium between the individual and the environment’ (Ustun, 1998, p. 72). According to this comprehensive approach, the attainment of mental stability is dependent upon the individual having the psychological processes and mental ability to cope with any problems they encounter. There is also the recognition that as a result of environmental factors opportunities for personal growth might be limited, thereby preventing people from realising their full potential.

  Sociological approaches to the study of mental illness

  Not all sociological work on explanations of mental disorder is grounded in social epidemiology. Some sociologists of deviance, especially writers of a symbolic inter-actionist persuasion, … have paid particular attention to interpersonal dynamics in the development of disorder.

  (Busfield, 2001, p. 8)

  There is more than one sociological perspective on mental illness. Two major perspectives are reviewed in this section: the interactionist and the social causation or structuralist. These are founded upon different assumptions about such fundamental issues as the nature and origin of mental disorder.

  Interactionist perspective

  This perspective has its philosophical roots in a theoretical approach in sociology known as symbolic interactionism, which when applied to the study of deviance in the 1950s and 1960s gave rise to social reaction theory, also commonly referred to as the labelling perspective. Thomas Scheff (1966) is often credited with being the first theorist to produce a coherent sociological theory of mental illness based on the labelling approach. To appreciate his contribution we need to understand something about the basic thinking behind the labelling theorists’ interpretation of deviant behaviour in general.

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  An Introduction to Mental Health

  • Jo Augustus, Justine Bold, Briony Williams(Authors)
  • 2019(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  9 Societal Influence on Mental Health Jo Augustus

  Learning Objectives

  After studying this chapter you will be able to:

  • consider societal influences on the perception of mental health;
  • describe the historical context of societal influence;
  • understand barriers that may restrict access to recovery;
  • understand theories and models that underpin stigma and discrimination.

  Introduction

  Societal influence is a term often used to describe the influence an individual or individuals can have on one another. For example, this could be a change in our belief system or behaviour as a result of an intentional or unintentional behavioural change of another individual. Such influence can have a profound impact on individuals accessing mental health services (Kawachi et al. 1997). As a culturally diverse society, mental health service provision has to be responsive to the social and cultural needs of its local population. Here culture is referred to as shared sets of beliefs and values between social groups (Hofstede 1991). Therefore, cultural and societal influence, are closely linked. It is important to note that culture is not the only factor to consider when trying to understand the issues surrounding access to services. It is evident that misinterpretation of culturally bound symptoms can impact on access to mental health services (Webber, Huxley and Harris 2011). Therefore, organisations need to be competent in the services they provide. However, in order to provide culturally competent services, there has to be an understanding of the influence of society and culture on mental health, which this chapter will explore (Kawachi et al. 1997).

  The Culture of the Individual and the Professional

  Historical context

  At the beginning of the nineteenth century, Western medicine recognised that the social aspects of an individual had an impact on disease, which arguably led to the advent of public health. The mid-nineteenth century saw the introduction of psychoanalysis as a way to treat mental health. The twentieth century brought an understanding that social and psychological components are of importance, in addition to the bio-medical (Porter 1997). There have been extensive developments in the provision of mental health services since the 1970s. In particular, the shift towards care provision in the community rather than inpatient settings and the awareness of cultural diversity (Shorter 1997). In addition, the publication of DSM-IV in 1994 gave more detailed references to cultural variation than earlier editions, encouraging a cultural formulation approach to be taken within the assessment (APA 1994). Although the bio-psycho-social model is subject to current criticism, it remains a helpful frame of reference (Engel 1980; Pilgrim 2011). Such an integration of approaches to the assessment and treatment of mental health enables a whole-person or holistic approach and provides the platform to meet specific cultural needs. See Chapter 1

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  The Sociology of Health and Illness

  • Sarah Nettleton(Author)
  • 2020(Publication Date)
  • Polity

    (Publisher)

  5 The Sociology of Mental Health and Illness Introduction Previous editions of The Sociology of Health and Illness did not include a chapter on mental health and illness, in part to avoid reinforcing a mental and physical health dualism. Furthermore, there are several excellent texts already available (see, e.g., Rogers and Pilgrim, 2014; Busfield, 2011; Cockerham, 2017; Scheid and Wright, 2017). But there is a good reason to include such a chapter here. Mental illness is a topic that feels close to home. In the Introduction to this fourth edition of this textbook, we saw how issues of health, illness and medicine intertwine with the life-course and the lives of each and every one of us. Mental health problems were evident in my childhood in the 1960s and 1970s as I witnessed my mother taking prescribed medications for her ‘bad nerves’ – the then commonplace euphemism for anxiety and depression – a historical legacy of the term neurasthenia used by neurologists in the nineteenth century. In later life, by then living with dementia, she lived in a care home on a floor labelled at that time as EMI (elderly and mentally infirm). In the 1970s, when in my teens, to my regret, I took anti-psychotic medications that my GP prescribed without questioning me about the aspects of life that might have been impacting on my mood. As a university teacher, I am aware of the issues of anxiety, depression and other mental health disorders that are experienced among young adults who often struggle to access sustained support. What these reflections highlight is how societal responses to mental health change over time. The treatment of depression with medications from the late 1950s is indicative of the so-called ‘pharmaceutical revolution’ and subsequent biomedicalization (Clarke et al., 2003). The emergence of a plethora of practitioners who work in the field of psychological health care burgeoned from the late 1970s (Rose, 1985, 1998)

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  Essentials of Mental Health Nursing

  • Karen Wright, Mick McKeown(Authors)
  • 2018(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  “In order to build trust and to understand an individual you also need to understand where they came from, their relationships, their culture and their beliefs. They all have different backgrounds, and these affect who they are and how they view their treatment. It also changes the way that they view us. I always make a point of asking not just about them, but also about their family and things that are important to them. That way, they know how important they are to me, as a person, not just a patient.

  Gemma McDermott, student nurse”

  Visit https://study.sagepub.com/essentialmentalhealth to access a wealth of online resources for this chapter – watch out for the margin icons throughout the chapter. If you are using the interactive ebook, simply click on the margin icon to go straight to the resource.

  Introduction

  This chapter deals with the range of sociological understandings of mental disorder, and also considers the lesser scrutinised topic by sociologists of positive mental health and wellbeing. Given the contested aspects of psychiatry and mental health services and the affinities for alternative provision or different ways of making sense of human experiences, sociological theories hold appeal in adding to a more plural range of understandings. Sociology aims to make sense of society or phenomena within it in social terms: that is, with regard to social factors and in consideration of social relations between people, groups and institutions. There is no single, overarching sociological theory; rather, there are a number of perspectives which emphasise different ideologies or dimensions of society. Many of the most notable critiques of bio-psychiatry have emanated from a sociological perspective. Indeed, a social model of mental distress has been suggested as a conceptual alternative to a pathologising psychiatric knowledge base (Beresford, 2002).

  Nurses and other disciplines can share in contesting psychiatric dominance and orthodoxy, and sociological ideas can prove to be useful in this regard. Similarly, the very nature of nurses’ work and how this is organised is amenable to sociological insights. The disciplinary ambivalence about mental disorder

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  A Sociological Approach to Social Problems

  • Noel Timms(Author)
  • 2014(Publication Date)
  • Routledge

    (Publisher)

  Finally, some sociological studies have been made of the ways in which the personnel of the services devoted to mental illness and mental disturbance describe their help and its objectives. Many of the innovations in recent years have arisen from and been justified by the Mental Health Movement (e.g. the child guidance clinic in the U.S.A. and Great Britain). This Movement encouraged people to think of mental health as a condition of well-being (variously but always most vaguely defined) and not simply the absence of mental illness. Conditions which had previously been considered ‘bad’ were now to be seen as symptoms of an illness. The literature of the Movement is as considerable as its influence, but the validity of this influence has been questioned in the sociological analysis of the literature.

  Each of these four areas of potential and actual contribution by sociological study will now be considered in more detail. The study of therapeutic organisations

  The study of therapeutic organisations (those which are entitled to describe themselves as treating the mentally ill) starts with the investigation of those relationships and processes whereby people begin to think of themselves as ‘mad’, and are so defined by their relatives, friends and neighbours. It has been argued, for example, that a family with a mentally ill member can be seen and sees itself as part of a minority, with feelings of under-privilege and marginality. The family lives in an environment which must consist of many unknown reactions from others as well as expected and experienced social distance. The family engages in a number of defensive tactics: it attempts concealment, and interprets ambiguous social contacts as rejection. Gradually, it may come to accept the negative evaluation of others, but this is often an ambivalent acceptance which exists side by side with the search for other groups with the same characteristics and experience as theirs (ed. Clausen, 1955).

  These kinds of social process do not, of course, occur in a vacuum; they are always related in some way to the kind of services of help that are available, which in turn reflect more general attitudes and beliefs. In the study of the services at the stage when the person sees himself, or his relatives are beginning to see him, as at least a potential patient particular attention has been given to the social class factor. Hollingshead and Redlich, for example (1958), found that the different forms of ‘treatment’ were not distributed randomly amongst patients in New Haven. The social class proportion of cases in custodial care (no treatment) increased markedly as one moved from the higher to the lower social strata, as did the proportion of cases receiving some form of organic treatment. In the case of patients receiving psychotherapy, on the other hand, the opposite progression was at work. It appears, then, that different treatments ‘attract’ different social classes. Other studies confirm that a relationship exists between a patient’s social class and whether he is accepted for therapy (Myers and Schaff er, 1954), but there seems to be no agreement that there is also a relationship between a patient’s class and the training and experience of the therapist to whom he is assigned (ed. Riessman, 1964). In the case of the treatment of mentally disturbed children the influence of class factors is less obvious, though it is still apparent (Maas, 1955).

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  Applied Sociology for Social Work

  • Ewan Ingleby(Author)
  • 2017(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  The two quotations from the authors Sylvia Plath and Ken Kesey highlight concerns that have existed over mental illness in the West. Some academics (for example, Thomas Scheff) have drawn attention to the controversy that is present in this area of health and care. There is even a question as to whether or not mental illness actually exists. The argument runs that mental illnesses are forms of deviant behaviour, and the behaviour of those who are mentally ill is troubling for the social order. This requires intervention and control. This theme will be explored in this chapter. Mental health is a key area of social work. In order to develop our professional work as social workers in this area, it is important to reflect on what sociologists are interested in when they consider the nature of mental illness.

  Functionalist interest in mental illness

  We have seen that functionalists are interested in wider social factors. With mental illness, they consider the social organisation of health systems. Functionalists regard key social organisations as similar to the vital part that key organs play in the human body. The health system of a social group is visualised as being akin to the role that the heart plays in the body – as long as the heart remains healthy, so the body functions effectively. Similarly, as long as the health system of a social group is effective, so that social group can function efficiently. Functionalist sociologists are also interested in the ways in which understandings of mental illness have changed in societies over time. A number of social scientists have reflected on changing interpretations of mental illness to outline the social factors that influence our understanding of the mentally ill. Hirst and Woolley (1982) apply the work of the French philosopher Foucault in order to demonstrate how wider social structures change and, in turn, impact on our understanding of mental illness. Hirst and Woolley reveal that, in societies such as England’s, there has been a change in perceptions of what contributes to mental health and well-being. In Victorian England, religious explanations were applied in order to help understand mental illness. The mentally ill were literally removed from society and placed in asylums – institutions that were isolated from the rest of society. The mentally ill and their families were regarded as being punished by God for some kind of transgression against ‘his divine law’. Hirst and Woolley (ibid.) reveal that, over time, this social interpretation of mental illness changes in societies such as the UK’s. Through the nineteenth century, a scientific interpretation of mental illness replaces this religious explanation. There emerges a medical model of mental illness: Hirst and Woolley suggest that this medical model depends on a particular train of thought. ‘Condition A’ is expected to respond to ‘Treatment A’ and to improve. The challenge with many mental illnesses appears to be that they do not respond to this course of action. In the quotation from Plath, her treatment sounds more like something you would experience upon being tortured! The problem for the doctors and nurses treating mental illnesses is that the illness does not appear to improve following this medical model of care. Hirst and Woolley (1982) outline which social factors influence mental health and this is of interest to functionalist sociologists. Mental illness is reinterpreted, and we see the emergence of ‘care in the community’ in the UK in response to a failing set of arrangements for the mentally ill. The asylums are closed and a new form of treatment is offered that appears to be less punitive and more humane. The critical factor in these changes is not so much the ‘illness’, but the social understanding of mental illness.

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  The Textbook of Health and Social Care

  • Darren Edwards, Stephanie Best(Authors)
  • 2020(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  Chapter 1 Sociology of Health and Illness Ashley Frawley

  Overview

  This chapter introduces the sociology of health and illness, first by considering the meaning of the ‘sociological imagination’ and associated importance of the concept of context to understanding human social life. It then discusses three contexts of health: socio-economic, institutional/professional and cultural. Within these contexts a number of key issues in the sociology of health and illness are considered: the social determinants of health, health inequalities, challenges to medical authority, social construction and health panics, medicalisation and growing cultural preoccupations with health risks.

  Learning Outcomes

  By the end of this chapter you will be able to:

  • Define the ‘sociological imagination’ and its relationship to the concept of context
  • Discuss the relationship between socio-economic context and health inequalities
  • Critically examine different explanations of health inequalities
  • Discuss several developments argued to indicate the decline of medical authority
  • Explain and apply theories of social construction and medicalisation to think critically about health risks and panics

  Introduction

  Health and illness may seem solely individual matters. However, sociologists draw attention to social patterns in health and illness, seeking to situate our experiences and beliefs within broader social, historical and cultural contexts. This chapter introduces key concepts from the sociology of health and illness, beginning with an exploration of the ‘sociological imagination’ and importance of ‘context’ to understanding human social life. First, we examine socio-economic contexts of health in relation to social determinants and health inequalities. The context of health care professions is then considered with attention to changing professional relationships as well as challenges to medical authority. Introducing social constructionism, the cultural context of health is explored with reference to medicalisation, moral panics and risk.

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  Psychology and Social Work

  Applied Perspectives

  • Gabriela Misca, Peter Unwin(Authors)
  • 2017(Publication Date)
  • Polity

    (Publisher)

  The ‘medical model’ (Laing, 1971) of treating mentally ill people in ways that sought to ‘cure’ them was increasingly challenged, and the 1960s saw a continued move away from large hospitals and a new generation of psychiatry which questioned traditional treatments. The medical model basically views mental illness in terms of diagnostic categories that are usually best treated by expert diagnosis and clinical intervention, often involving pharmacological treatments. Psychological and social factors are not given prominence under this model, which measures success in terms of individuals’ ability to accord with social norms and values as reflected in the categorizations of the main diagnostic framework, the International Classification of Diseases (ICD). By way of contrast, psychosocial models or systems theory (Payne, 2014) attach great significance to the wider factors that impact on individual well-being, such as the influences of family, culture, race and environment.

  Distinguishing between the behaviour of a person who is mentally unwell and that of someone who is just different is not a straightforward task. There are multiple ways of defining mental illness. One definition is based on the deviation from the ‘statistical norm’ – i.e., comprising all behaviour that falls outside the ‘normal range’ of behaviours. This approach is problematic, as it ignores individual differences. Moreover, deviation from the norm is not necessarily bad – for example, individuals with exceptionally high intelligence levels (IQ) fall outside the norm, but this is not a negative behaviour. Another perspective in defining mental illness is based on the maladaptive behaviour of mentally ill people, such as the inability to face, or a degree of difficulty in coping with, everyday life. This approach is used in official classification of mental disorders such as in the Diagnostic and Statistical Manual

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