Mental illness is a social construct that is influenced by normative expectations in society. Gender and race impact diagnosis and treatment, as women are more likely to be diagnosed with certain disorders and minorities often receive poorer care. The anti-psychiatry movement critiques psychiatry for medicalizing social problems and coercively targeting marginalized groups.

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