1. Sociology of mental illness
Week 22
Sociology of Health and Illness

2. Recap Thought about how health and illness are structured by society
Considered the ‘sick role’, medicalisation, surveillance medicine and ‘lay’ understandings of health
Considered social inequalities and health
The impact of chronic illness and disability

3. Outline Look at mental health and illness as social categories
Consider to what extent ‘diagnosis’ is linked to normative ideas
Look at the anti-psychiatry movement

4. What is mental illness?
What does the term mental illness mean to you?

5. Popular conceptions of mental illness
Often the vision we have of mental illness is linked to ideas of:
Hallucinations
Delusions
Threatening and/or disturbed behaviour
Acute withdrawal or anxiousness
Drug and/or alcohol dependency

6. Defining mental illness
The diagnosis of mental illness is not always straightforward
Identification of people who are finding difficulty with ‘normal’ expectations
Sociology of mental health looks at the ways in which categories come into existence, who gets diagnosed and how they are treated

7. Normative expectations?
What sort of behaviours count?
How are they linked to ideas current in wider society
Drapetomania
Homosexuality
Epilepsy
Sexual promiscuity

8. What do you think about these historical categories of mental illness?
Do you think it is possible that behaviour which we define as mental illness will be seen in future as ‘wrong’?

9. Gender and mental health
Statistics show that the diagnosis of mental disorders is gendered
Women are more likely to be diagnosed as having depression, anxiety or somatic complaints.
Men are more likely to be diagnosed with antisocial personality disorder or be alcohol dependant
Risk factors for mental illness are gendered
For women: violence, socioeconomic disadvantage, subordinate social status and unremitting responsibility for the care of others have all been highlight

10. Feminist theories of mental health
Feminism has understood mental illness as:
a consequence of social oppression
a social construct
Both consider it as an outcome
of social processes

11. Consequences of social oppression?
Social & economic circumstances associated with onset of depression in women.
Long term implications of life events?
Low self-esteem/inability to cope interacts with life events to produce depression.
Working class women at greatest risk.

12. Consequences of social oppression?
Post-Traumatic Stress Disorder is more common in women that men
Linked to high levels of sexual violence
DSM IV names ‘rape’ as a possible trigger for PTSD but not domestic violence
Women with PTSD reported have a greater symptom burden and longer course of illness

13. Mental illness as social construct
Studies have point out how frustration, unhappiness or rebellion labelled as mental illness in women.
Women who fail to comply with normative prescriptions of typical feminine behaviour judged as mentally ill.

14. Judged on femininity
‘Care with make-up and hair style were seen to be clear indications of getting better, likewise wanting marriage and children were viewed by some as part of recovery. I know of individuals who have been told that their problem would get easier if they acquired a boyfriend’
In Foster, Women and the Health Care Industry

15. To what extent do you think that normative ideas about feminine behaviour impact of the diagnosis and treatment of mental illness?

16. Racism and mental health
Statistics show that the diagnosis of mental disorders is related to ethnicity
Asian women high rates of depression and suicide
Black men higher rates of schizophrenia
Risk factors for mental illness have been related to racism
Socioeconomic disadvantage, subordinate social status and stereotyping

17. Racism and mental health
Institutional racism has been diagnosed within mental health care
Mental health outcomes for Black patients are shown to be poorer
Black groups are more likely than white people to go into specialist mental health care by coercion

18. David ‘Rocky’ Bennett
An African-Caribbean man who was eventually diagnosed with schizophrenia.
He made reports of being harassed and bullied by other patients
He was over-medicated (causing low blood pressure) particularly as he was seen as a nuisance
His cultural, racial, social needs were ignored
No attempt was made to engage his family in his care and treatment.
After a incident started by another patient he
was restrained, collapsed and died

19. Treatment by psychiatric services
Independent Inquiry into death of David Bennett found institution racism
Census of inpatients in 2005:
9% of in-patients were Black or mixed black-white ethnicity (3% of national pop)
Black patients were 44% more likely to have been sectioned & 50% more likely to have been put in seclusion
Black Caribbean men were 29% more likely to have been subject to control and restraint.

20. How important do you think racism is in explaining the rates, diagnosis and treatment of mental illness in minority-ethnic people?

21. Anti-psychiatry movement
The Anti-psychiatry has a long history.
It highlights psychiatry as using medical tools for social conditions
It focuses on coercion and the targeting of marginalised populations
Became prominent in the 1960s and 1970s and today often focuses on the role of pharmaceutical companies

22. Anti-psychiatry movement
R.D.Laing
Schizophrenia as understandable reaction to conflicts between family and self or through trauma.
Thomas Szasz
Mental illness a ‘metaphor’
Label for deviation from social norms
‘Problems’ cause by rigid society
Psychiatry as a tool of social and
political control.

23. Summary
Consider how mental health and illness and closely linked to social categories
Considered gender and racism in diagnosis and treatment
Look at the opposition in the anti-psychiatry movement