Transcript Mental Illness
G672
Definitions
Individually:
On your mini-whiteboards, write a short definition of what you understand by the term ‘mental illness’.
What is Mental Illness?
There is no real agreed definition: There is a lot of controversy regarding what mental illness is, what causes it and how best to treat it.
There are also arguments, often controversial, that there is no such thing as mental illness – or at least, not in the way that we often think about it.
Discuss
How common do you think mental illness is?
In what ways do newspapers – and other areas of the media – often portray mental illness?
Mental Illness
According to MIND, around 1 in 4 people in the UK today have some form of mental illness… …However, only around 1 in 7 claim to have a mental illness at some stage of their lives...
Exactly what qualifies as a ‘mental illness’, however, is a source of debate.
Activity (Pairs)
Decide which of the following you consider to be mental illness. Justify your decisions.
Panic attacks
Anxiety disorders
OCD
Phobias
Post-natal depression
Manic depression (bipolar disorder)
Schizophrenia
Explaining Mental Illness
There are three main theoretical approaches to mental illness.
Biological Theories
Mental illnesses are due to biological problems and require treatment
Psychological Theories
Mental illnesses are diseases of the mind, not the body – often the result of difficult experiences.
Sociological Theories
Mental illness may not exist...if it does, it stems from a relationship between the individual and their society.
Diagnosis/ definition Causes Treatment Goal
Biological
A symptom of bodily illness. Diagnosed by doctors, based on clearly defined criteria.
Psychological Sociological
Diseases of the mind. Diagnosed by doctors or therapists. Difficult to diagnose as the social factors need to be studied. Behaviour is often ‘labelled’ as illness due to the situation in which it occurs.
There is growing evidence of genetic predisposition and biochemical causes.
Medical, surgical and nursing care.
To restore patient health through treatment; to prevent symptoms worsening.
Experiences in the patient’s past; particularly childhood experiences.
Various e.g. Behaviour modification; Psychoanalysis.
To give the patient an insight into the source of their problems and help them develop coping strategies.
Triggered by social circumstances which create stress, low self esteem etc.
Changes have to be made to the person’s life/social situation.
To help reduce rates of mental illness by revealing social influences.
Patterns of Mental Illness
Black people in the UK are more likely to be diagnosed with schizophrenia and depression than other ethnic groups.
People of South Asian origin are the least likely to be diagnosed with a mental illness.
Women are significantly more likely than men to be diagnosed with depression or anxiety.
Mental illness is more frequent, severe and longer lasting among the poorest people in society.
We will explore in detail if and how factors like ethnicity, gender and social class impact people’s health/illness in a later section of the unit.
1.
Interactionism
Check your G671 workbooks for a brief summary of the general interactionist view.
Mental Illness is not Real!
Structural theories (like Marxism) might consider how mental illness is unequally distributed in a society...
...Interactionists on the other hand are more interested in exploring why certain behaviours are labelled as mentally ill.
Interactionists challenge the existence of mental illness by suggesting it is a social construct.
Mental Illness as a Social Construct
What is considered mental illness is relative to time and place. It is culturally variable… Calling conditions ‘mental illness’ is just a reflection of the dominant medical model of that society/time.
Activity
Study the ‘timeline’ handout and consider the following:
In each period, what are considered the causes of abnormal behaviour?
How have explanations changed over time?
How is mental illness viewed today? Is the bio medical model or the psychological model more prominent?
Scheff (1996)
There is no such thing as mental illness: There is only behaviour which doesn’t make sense to others.
A stereotyped view of mental illness is learned early in childhood and inadvertently confirmed throughout life.
Discuss
How are our views of mental illness reinforced by the media?
Can you think of any specific examples in the media of mental illness being portrayed in a stereotypical way?
Abnormality & Mental Illness: Whiteboards
For each of the following, decide – on a scale of 1-4 – how abnormal each is (write your response on your whiteboards).
Also decide which ones you think are caused by mental illness.
What does it tell us about the social construction of mental illness?
A man shouting at himself in public A man shouting at himself in his house A crowd shouting at a football match A cleaner who thinks she is the Queen A child with an imaginary friend A woman who hears voices in her head telling her to be quiet A woman who hears voices telling her to kill all men Someone who claims to be heterosexual Someone who claims to be homosexual A man who claims to be a messenger from God A man who feels constantly depressed A woman who feels she cannot face housework any more
Mental Illness as a Social Construct
Every society is convinced by its own explanations and laughs at those of other societies or other times...
...It is therefore logical to assume that they way mental illness is defined/explained is based purely on the values of the time/place in which it occurs...
...20
th Century Western explanations may eventually seem primitive and laughable.
Foucault (1973)
The language we use to talk about the issue today is revealing...
We call it mental illness and talk about symptoms and diseases...
...Yet at the same time, few of us assume that mental illnesses can be ‘caught’ or act in the same way as physical illnesses.
This discourse shapes the way we think about mental illness and encourages us to place it in the hands of supposed ‘medical professionals’...
...Without that sort of language, mental illness could be considered just an unusual way of behaving, which has nothing to do with being ill.
Foucault (1973)
Defining people as mentally ill is a form of social control.
For example, unmarried mothers were incarcerated in mental hospitals in the first half of the 20 th Century.
Szasz (1971)
Agrees that the label of mental illness has been used for social and political control.
Dissidents in the former USSR were sent to mental institutions.
Slaves in the US deep South who fled their masters were labelled as suffering from drapetomania (a mental illness).
Those whose behaviours the powerful do not like have often been diagnosed as mentally unwell.
Evaluation
The problems with the view that mental illness is socially constructed are:
It ignores the personal suffering that mental illness can cause and the reliefs that can be given through psychiatric treatment.
It fails to address the way in which people are labelled as ‘mad’ and how this can affect
them...(luckily, we’re about to study labelling).
Labelling Theory
“Social groups create deviance by creating the rules whose infraction constitutes deviance and by applying those rules to particular people and labelling them as
outsiders.” (Becker; 1963) A Label can result in a Self-Fulfilling Prophecy
Discuss
In pairs, identify AT LEAST FIVE groups in society who have been given a ‘deviant’ label.
Where do these labels come from, and what is the effect of them?
Labelling of Mental Illness
At one time, those whose behaviour deviated from social norms were labelled as idiots, lunatics or even as possessed by evil spirits or demons.
Today, they are more likely to be labelled as being mentally ill and therefore in need of care and treatment.
Goffman
–
Asylums (1968)
Studied how the mentally ill were labelled within mental institutions.
The mentally ill do not get “cured” – they learn to act “mad” and this reduces their chances of returning to the outside world.
They lose their own identity and assume a new identity as ‘mental patients’.
The process of learning to be mentally ill (Goffman)
Withdrawal
Mortification of the Self
(the patient loses their identity and has it replaced with a new one e.g. A ‘number’)
Learning a new Social Role
(those who comply are rewarded; those who don’t are punished e.g. With isolation/medication
Responding to the Label...
Rebellion Institutionalisation Conversion Play it cool
Rosenhan (1973)
Conducted an experiment on the labelling of people as ‘insane’.
Eight ‘sane’ people were sent to different mental institutions in the USA, claiming to ‘hear voices’ and asking for help.
Once admitted, they stopped pretending and behaved normally. None were recognised as fakes: All were diagnosed as schizophrenic.
Discuss
How does Rosenhal’s experiment support the view that mental illness is not real?
Do you think the experiment was unethical?
Problems
…
?
Labelling theory does not explain why some people are more likely to be diagnosed as mentally ill than others.
What factors can you think of that might make someone more likely to be diagnosed as mentally ill?
Homework
Watch the film One Flew Over the Cuckoo’s Nest (on Clickview: Link will be on Moodle) and write a review (min. 500 words) on your blog. Include your views on the following:
Which of the patients do you feel were NOT mentally ill and why?
Do you believe care of patients was adequate? Explain your response.
Evaluation: The Social Realist View
Some behaviours may not be recognised as mental illness in all cultures and at all times, but… …mental illness does exist, and is a real condition with recognisable causes that require treatment.
Discuss
In pairs, identify at least two explanations for why each of the following might influence a person’s likelihood of being diagnosed as mentally ill:
Social Class Gender Ethnicity Age
Write: 30 mins
“There is no such thing as mental illness: Only behaviour that does not make sense to other people.”
Outline and evaluate this viewpoint. [33]