MENTAL ILLNESS
Sociological Perspectives
“If you talk to God, you are praying. If
God talks to you, you have
schizophrenia.” (Thomas Szasz)
ISSUES:
► Difficulty
in classifying illnesses
 Measuring issues
 Validity in diagnosis
► Social
Factors
 Social Class
 Gender
 Race & Ethnicity
Before we move on to this…
► Classical
school of criminology
 Rational choice
 Maximize pleasure/minimize pain
 Punishment should fit crime
►Be
sufficiently harsh to deter but not overly harsh
►This will lead to rational calculation to conform
►What
deviance does this not explain?
Classifications
► Organic
Disorders (brain damage, head
injury, aging, drug abuse, etc.)
► Functional disorders
 Psychotic Disorders
►Schizophrenia,
manic-depressive
 Neurotic Disorders
►Anxiety,
Obsessive-Compulsive, Depression, etc.
 Character Disorders
►Sociopathic,
antisocial personality
How do we measure mental illness in
a population?
► Do
we look at who is admitted to mental
institutions?
► Do we look at who visits therapists and
psychiatrists?
 Can you see why this might be problematic?
 How else would we count the numbers and distribution
of mentally ill?
 How do we know the diagnostic categories we use
really indicate mental illness?
Social Factors
► Sociologists
distribution
interested in patterns of
 Most consistent finding across studies is that
lower socio-economic groups have greater
amount of mental illness
►Why?
Why? Well, two possibilities…
►Social
Selection:
 Lower class position is a consequence of mental illness
 Mentally ill people drift downward into lower income
groups/neighborhoods
►Social
Causation:
 Lower class position is a cause of mental illness
 Social stress causes mental illness; lower income people
experience more social stress
► Which
do you think it is?
GENDER
► Studies
conflict as to whether women or
men have higher rates of mental illness and
about which groups suffers more social
stress
 Men have higher rates of antisocial personality
and paranoia, and substance abuse disorders
 Women have higher rates of certain illnesses
►Depression
►Anxiety/panic
WHY the gender difference?
► Socialization
to Social Roles
 Women more likely to turn stress inward
 Men more likely to turn stress outward
 Women believed to be more socially connected
and integrated so less likely to act out
aggressively against others
 Men more vulnerable to “material loss” than
women
Perspectives on What Mental
Illness Is…
Hard
Soft
Soft
Hard
Medical Medical Labeling Labeling
MEDICAL: Disease Model
►
HARD
 Mental illness is a disease like any other
 Has biological basis
 Popular in early to mid 1900s
 Many psychiatrists hold this view
►
SOFT
 Mental illness is like a disease
► Most
do not have true bio basis but some do
 After WWII thru late 60s: Psychosocial Model (psychoanalysts)
► Mental illness is a result of unresolved conflict from childhood
► Since 1960s, social stress like loss of loved one, etc.
LABELING: Socially Constructed
► SOFT
 Sociological View
► Some
based
mental illness exists but most is probably not biologically
 Over-diagnosed and over-medicated
 Cultural tendency to create to treat behaviors medically
► HARD
 Mental illness is a myth
► It
does not exist at all; it is simply a label for behavior that is
problematic or that we do not understand
► The behaviors we associate with mental illness exist but there is
no evidence they are caused by a mental problem
 Simply non-normative behaviors!
Summary
► Medical
Model vs Labeling Model
 These reflect expert opinions about the nature
of mental illness
 Most psychologists take soft medical view
►Not
actual illnesses in traditional sense but respond
well to treatment so we treat!
 Most sociologists take soft labeling view
►Too
many behaviors are labeled as illness
►Pathologizes behavior, medicates people
unncecessarily
In the Rosenhan reading, the author’s study
would fit into which perspective?
A.
B.
Medical
Labeling
50%
50%
Medical
Labeling
Rosenhan Study
► What
does this study demonstrate?
 Expert medical authority/power in diagnosis
 The “stickiness” of the label
 Lack of clarity regarding indicators of mental
illness
►This
study was from the 1970s--do you think this
study would have relevance today?
Medicalization of Deviance
► The
process by which medical experts
assert authority over an aspect of behavior
previously seen as simply “deviant”
 Has been a trend since the 1950s-60s
Medical-Industrial Complex
►A
term used to refer to the coinciding
interests of physicians, and the
pharmaceutical industry to expand
diagnoses
•
American Medical Association and
American Psychiatric Association have
monopolies on diagnosing and treating
illness
► Some
behaviors that were seen as prompted by
“free will” or individual difference or character
flaws that are now seen as illnesses:








Alcoholism/addiction
Attention deficit disorder (hyperkinesis)
Compulsive gambling
Compulsive shopping
Internet addiction
Sex addiction
Eating disorders
Learning disabilities
MEDICALIZATION OF DEVIANCE
► Tendency
since 1960s and increasingly to treat
deviant behaviors as medical conditions
► POSITIVES:
• Many people helped by medications and educational
accommodations
• Illness diagnosis is less stigmatizing than a “deviant”
label
• Parents embrace the idea that behavior is “genetic” or
“biochemical”—why?
Concerns
►
Pharmaceutical revolution
 Since the 1950s
► Medical
Social Control
 Problematic behavior medicated rather than
addressed substantively
► AMA/APA
monopoly
 Who has a lack on categorizing, diagnosing and
prescribing?
Example
► Person
who is completely sane and functional in all
aspects of life but…
 Wants to amputate his leg
 Has felt his whole life that he is in the wrong body
► Called
“Amputee Wannabes”
Is this person mentally ill?
What is normal?
How do you know?
Is he only if we create a diagnostic category for him?
Do you think there is a diagnosis?
Body Integrity Identity Disorder
► To
get the diagnosis a person must be deemed
otherwise mentally healthy (i.e. not psychotic)
► Depression and sadness about not being an
amputee
 Feeling incomplete with all limbs
 Wants elective amputation
 Reports having felt this way since childhood
► Do
you think this is a mental disorder?
 How would you know for sure?
► Could it be just “difference”?
For more info…
► www.CHADD.com
► www.BIID.org
► http://www.pbs.org/wgbh/pages/frontline/s
hows/medicating/