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Lecture Notes SC326 term 1
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Detailed notes on each lecture of term one of the module, including detailed annotations of the key readings.
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SC326 TERM 1WEEK 2 – SOCIOLOGICAL APPROACHES TO PSYCHIATRY AND MENTAL ILLNESS
Psychiatry
- A branch of medicines that has main responsibility for the field of mental
illness in present day society
- It emerged as a professional grouping around the mid-19th century
- Psychiatry has key responsibility for mental illness
- Mental illness indicates a medical approach to the field
- Psychiatry gives special attention to the natural sciences
- Most of its attention surrounds genetics and neurosciences (study of nervous
system, particularly brain)
- If psychiatrists go beyond this, they tend to turn to psychology not sociology
Concepts
Lay concepts
- What we now call mental illness was first signalled out and described in lay
terms
- Common lay labels = madness/lunacy/insanity
- The term was applied to those whose behaviour seems seriously disturbed
and irrational
- There was language for less severe mental problems = troubled in
mind/suffering from nerves/distressed/disturbed
- It was ordinary people who identified and labelled mental problems
Concepts used by doctors and other professionals:
Concept
Mental illness Modelled on physical illness for illnesses of the mind
Mental disease Modelled on physical disease and suggesting a physical disease process
Mental disorder A broader concept that encompasses behavioural problems and learning
difficulties and so is used in psychiatric classifications, but it does not have the
same medical connotations as mental illness or disease
Psychiatric Like mental disorder but suggests the problems are the province of psychiatrists
disorder
,Psychological Like mental disorder but suggests the problems are the province of
disorder psychologists
Psychopatholog Disease of the mind – the term pathology refers to the study of disease
y processes
Mental health Either simply the absence of mental illness or it is given some content as, say, a
state of well-being, itself defined as a state of happiness and well-being
Judgements of mental functioning
- Both lay and professional terms involve social judgements of mental
functioning
- MENTAL FUNCTIONING = includes thinking (cognition), feeling (emotion of
affect) and acting (behaviour or action)
- To talk of mental illness is to assert something is wrong with some aspect of
thinking, feeling, or acting
- It is societies and cultures/people and professionals that construct the
category and apply to individuals
- This means they vary and change overtime
Sociological thinking about concepts – 1
- Sociologists emphasise the way in which they concepts we use are socially and
culturally shaped
- The involvement of doctors has resulted in viewing certain mental experiences
not just as problems but as illnesses or disorders
- Psychiatrists now set boundaries as to what is pathological and what is not
- MEDICALISATION = defining certain aspects of mental functioning as mental
illness
Sociologically thinking about concepts – 2
- The concepts we use also affect how we think and respond to experiences
- If we think of some phenomenon as an aspect of mental illness our
understanding and actions are framed in a particular way
- We see the individual as having a pathology (something wrong with them)
- If they turn to a professional they will be given a diagnosis
- Treatment will be recommended (most likely psychotropic medication)
Broadening the boundaries of mental illness
- The transformation of sorrow into depression (Allan Horwitz)
, - The creation of social phobia and social anxiety disorder
- Demidicalisation – the removal of homosexuality from psychiatric
classifications (Michael Spector)
Causes
- Sociology’s biggest contribution to this field is understanding its causes
- Genetic factors do contribute to the causation of mental illness
- However, they do so in interaction with environmental factors
- The role of the brain in causation is highly contested
- Social and cultural factors both in childhood and adulthood have importance
in causing mental illness
Causes 2
- Highly traumatic experiences can lead to mental illness e.g., PTSD
- Sexual and physical abuse are now widely studied
- Stressful events and ongoing difficulties can lead to mental illness
- E.g., marital breakdown/unemployment/made redundant/poverty
The social distribution of mental illness
Levels of mental illness vary
- AGE = there is an accumulation of cases with age
- GENDER = madness is sometimes said to be ‘female malady’
- ETHNICITY = higher levels of psychosis in black individuals
- SOCIAL CLASS = those of lower social standing have higher levels
- These patterns are not primarily explained by genetic factors, but provide clear
evidence of the role of social and cultural factors as causes of mental illness
Responses to mental illness: services and treatment
Sociologists have made a significant contribution in understanding the ways societies
deal with mental illness
- Analysis of mental health institutions and services
- Understanding the development of professional groups in the mental health
work force and their professionalisation
- Examination of social biases in provision
- A focus on the experience of those with a mental illness
, Mental health service providers
- Understanding of the development of professional’s groups and
professionalisation in the mental health work force
- Much of this is grounded in classic sociological work on medicine as a
profession
- Sociologists have contributed to specific discussions on the development of
psychiatry as a profession
Biases in services and treatment
Sociologists have studied biases using their standard categories:
- AGE = historically it was rare for children to be identified as having mental
illness
- GENDER = the identification of particular mental illness in men and women
and their treatment has been seen as the result of bias e.g., depression
- ETHNICITY = black individuals are more likely to end up compulsorily detained
in a psychiatric bed
- SOCIAL CLASS = this can affect access to treatment, the diagnosis and the
treatment given
Social class and mental illness (study)
- Study found those in a lower class were more likely to receive more serious
diagnosis of psychosis
- Also, more likely to receive physical than psychological treatment
- Social class and mental illness study (1958)
Experiences
- Most obvious sociological contribution is the examination of stigma (Goffman,
1963)
- There are many autobiographical and fictionalised accounts of mental illness
experiences
- Sociologists have focuses on their experiences as service users and on the
activity of user movements
Conclusion
- A study of psychiatry and mental illness needs to go beyond natural sciences
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