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Jetzt kostenlos anmeldenMental health is a historically deeply stigmatised topic that has been considerably demystified in recent years. Awareness campaigns and open conversations have brought the subject of mental health into the collective consciousness. But what does sociology have to say about it?
The sociology of mental health and illness is dominated by a number of ideas:
To understand sociological perspectives on mental health, we must first understand what we men by mental health, as well as the types of mental health conditions and illnesses people can suffer from.
This explanation is an overview. You can find more detailed information on each idea in separate explanations on StudySmarter.
According to the Cambridge Dictionary, mental health refers to "the condition of someone's mind and whether or not they are suffering from any mental illness".1
While there is no universal sociological definition of mental health, Allan V. Horwitz (2012) effectively summarises like so:
"Sociological approaches regard mental health and illness as aspects of social circumstances."2
There are dozens of mental health conditions, all with their own definitions, classifications, and symptoms. To simplify this a bit, Joan Busfield’s (2002) typology of psychiatric disorders categorises mental health issues into three broad types:
Disorders of thought, e.g. psychosis, schizophrenia, sociopathy
Disorders of emotion, e.g. depression, anxiety, phobias
Disorders of behaviour, e.g. alcohol and drug dependence
Sociological analysis of mental health attempts to understand how social factors influence and perhaps directly shape mental health and illness and experiences of it.
Social constructionism has been very influential in the sociological conception of mental illness. It is based on the argument that what is considered "normal" or "mentally ill" behaviour varies over time and from society to society.
Key theorists who espouse social constructionism are Michel Foucault (1965), Thomas Szasz (1973) and T.J. Scheff (1974).
According to Foucault, our modern conception of mental illness is a direct result of social changes during the 18th century. In the Age of Enlightenment, more traditional ways of thinking based on religion and emotion were gradually replaced by more rational, intellectually disciplined ways of thinking and acting.
Foucault argues that this shift was illustrated by the rising number of asylums created to contain those considered "mad" i.e. irrational. Madness and/or mental illness as we know and treat it today is therefore a relatively modern invention that emerged from the development of ‘rational’ ways of thinking and acting.
Scheff argued that the label "mental illness" is simply a convenient way to deal with behaviour that people find disruptive or socially unacceptable.
He points out that in society, there is always a group of people who refuse to abide by social norms and conventions or who cannot conform. This behaviour is seen as "bizarre" and these people are labelled "mentally ill" to explain away or justify that which cannot be made sense of or explained any other way.
The label of mentally ill forces people to adopt the "insanity role", reinforcing the cycle of mental illness.
According to this theorist, the role of psychiatry is to control deviant behaviour – behaviour that the powerful (as represented by doctors and psychiatrists) dislike, but which is not inherently pathological.
Up to the 1960s, homosexuality was viewed and treated as a mental illness due to societal prejudice.
Szasz also argued that judgements made by psychiatrists may be based on social values and cultural norms rather than scientific criteria. Thus, mental illness is a myth manufactured by psychiatry to justify its existence. It doesn't exist as a fact because it isn't diagnosed based on any biological symptoms or evidence.
There are a number of perspectives through which we can understand mental health:
The conventional model that seeks to explain mental health through scientific and medical knowledge is known as the biomedical perspective.
The sociological model, which focuses on social circumstances and explanations, includes interactionist and structuralist perspectives.
Let's go over each of these views in turn.
The biological or biomedical approach to mental health sees the causes of illness as situated in the physical or biological body.
It postulates that mental illnesses are the result of medical issues e.g. brain damage, tumours and lesions, faulty genes, chemical and hormonal imbalances, etc.
Some types of depression may be explained by a deficiency of a chemical in the brain called serotonin.
The biomedical-psychiatric approach generally believes that most symptoms of mental illness can therefore be scientifically diagnosed and categorised. As for treatment for mental illness, it favours cure-orientated treatments focused on the individual such as:
counselling,
psychotherapy,
medication, and in extreme cases,
electroconvulsive or shock treatment,
surgery, and
detainment.
As we have mentioned, the sociological approach is based on the idea that external social factors shape mental health/illness.
Let's look at the two main perspectives on mental health in sociology: interactionism and structuralism.
Interactionism, also known as labelling theory, is a perspective concerned with understanding human behaviour in face-to-face situations and how individuals and situations become defined or classified in particular ways.
Labelling theory points out that once a person has been labelled as mentally ill, there are a number of negative consequences for them. This is because it is then assumed that all their behaviour is evidence of their mental state.
Erving Goffman's (1968) research found that, once they are admitted to a psychiatric institution, people are stripped of all individuality and forced to conform to the label of "mentally ill".
He observed that after isolating them and systematizing all of their daily routines, mentally ill patients lose their sense of self and are coercively made to accept their "mentally ill" identities for fear of punishment.
Structuralists argue that there is a social pattern to mental illness. A range of cultural and material factors that structure society and can contribute to poor mental health explain these patterns. This suggests that mental illness cannot stem purely from biological or individual factors.
R. D. Laing (1960) challenged the biomedical approach to mental illness and methods of psychiatry upheld by the medical establishment at the time. He rejected the idea that mental illness originated in the physiological organs, pointing to structuralist explanations.
Laing suggested that the causes of mental illness, particularly deeply misunderstood disorders such as schizophrenia, are located in the structure of society and in people's relationships with others, particularly the nuclear family.
Anne-Marie Barry and Chris Yuill (2008) add that experiences of oppression can be especially isolating and cause mental distress, saying:
People may be ‘tipped’ into mental illness, whether it is a woman expected to bring up children on her own and keep down a job or the experience of someone from an ethnic minority group of being racially abused by a neighbour; or the constant soul-destroying grind of poverty and not being able to lead the life that others enjoy."3
Sociologists also focus on examining how society can negatively impact an individual’s mental health. Therefore, it is important to study social inequalities based on factors such as class, gender, and ethnicity; and how they can cause or contribute to mental illness.
When looking at which subsections are most likely to suffer from high rates of mental illness, the poorest groups in society are massively over-represented.
J.C. Phelan and B.G. Link's (1995) research on the relationship between social class and mental illness concluded that there is a close relationship between high levels of deprivation and bad mental health.
According to data from a 2004 ONS survey, children in the bottom quintile of family income were around 3 times more likely to experience serious mental health disorders than children in the top quintile.4
In an analysis of data from the Millennium Cohort Study in 2012, it was found that children in the lowest income quintile were found to be 4.5 times more likely than those in the highest to experience severe mental health problems.5 This finding suggests that the impact of poverty on young people's mental health has gotten significantly worse over the past ten years.
Sociologists argue that the poor are less likely to have large social networks of support (Wilkinson and Pickett, 2009), as well as less access to the educational, social and economic resources that the middle class take for granted (Myers, 1975).
The stress of trying to cope with struggles or life crises on their own therefore manifests as mental illness, especially depression.
Statistics show that women are more likely than men to exhibit signs of mental ill-health. Overall, women's rates of mental illness are about a third higher than men's but are much higher for specific illnesses; for example, younger women are at least three times more likely than men to be treated for depression.
Sociologists such as George W. Brown et al. (1975) argue that this is because women are more likely to lead stressful lives due to:
poverty
debt
unemployment
poor housing conditions
having to work whilst also being responsible for childcare, etc
On the other hand, Graham Scrambler (2009) notes that male mental health is invisible in comparison due to stigma. Instead of reaching out, men tend to express their emotions through aggressive and/or criminal behaviour and are consequently punished rather than receiving treatment.
Members of ethnic minority groups have significantly different chances of mental illness compared to the majority white population:
British-Pakistani and Indian women experience more depression than men and women of other ethnicities (McCrone, 2008).
Men of African-Caribbean descent are between three and five times more likely to have schizophrenia than the population overall (Nazroo, 2001).
This can be explained in part by experiences of prejudiced attitudes, racist attacks, poverty, unemployment and other stressors faced by ethnic minorities.
However, Nazroo (2001) also found that other minorities who are equally deprived as African-Caribbean groups have much lower levels of mental illness. Therefore, poor mental health cannot always be explained by experiences of discrimination alone.
Rather, according to Nazroo, young Black men are particularly vulnerable due to institutional racism within criminal justice agencies and psychiatry that exaggerate their criminality, send them to mental health wards at much higher rates, and punish them more harshly.
The biomedical approach thinks of mental illness as being situated in the biological body and advocates for scientific diagnosis and medical treatments. The sociological approach is based on the idea that external social factors shape mental health/illness.
Interactionist approaches to mental health, such as Goffman's research, argue that labelling and institutionalizing those with mental health problems reduces them to their illnesses.
The structuralist approach to mental health, e.g. espoused by Laing, asserts that the structure of society and cultural/material factors are what contribute to mental health.
Experience of mental illness differs by social group e.g. by class, ethnicity, and gender. High levels of deprivation, gendered pressures, expectations and institutional racism can all lead to higher rates of mental illness.
The sociology of mental health and illness encompasses a number of ideas:
The social or sociological model of mental health is based on the idea that external social factors shape mental health/illness. It includes interactionist and structuralist perspectives. On the other hand, the biomedical perspective seeks to explain mental health through medical and scientific knowledge.
Mental health is an important topic in sociology because it is shaped by a number of sociological factors and groupings.
The social or sociological model is important in mental health because it explores the role of external environmental and social factors in mental health and illness.
Mental health is a social issue because it is shaped by social factors and affects various social groups differently.
What is mental illness?
Busfield (2002) classifies mental illness as:
What does Foucault say regarding mental illness?
According to Foucault, the modern concept of mental illness came about as a result of the process of rationalisation during and after the Enlightenment.
Why does Scheff consider mental illness a "label"?
Scheff believes that the label "mental illness" was conceived to explain away behaviour that people find bizarre or socially unacceptable.
Describe Szasz's views on psychiatry.
Szasz states that the role of modern psychiatry is to control deviant behaviour that the powerful do not like.
What is the biomedical approach?
The biomedical approach sees mental illness as being situated in the biological body and advocates for scientific diagnosis and medical treatments.
Define interactionism.
Interactionism or labelling theory is concerned with understanding human behaviour in face-to-face situations and how individuals and situations become defined or classified in particular ways.
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