Mental IllnessG672

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 attacksAnxiety disordersOCDPhobiasPost-natal depressionManic depression (bipolar disorder)Schizophrenia

Explaining Mental IllnessThere are three main theoretical approaches to mental illness.

Biological TheoriesMental illnesses are due to biological problems and require treatment

Psychological TheoriesMental illnesses are diseases of the mind, not the body – often the result of difficult experiences.

Sociological TheoriesMental illness may not exist...if it does, it stems from a relationship between the individual and their society.

Biological Psychological Sociological

Diagnosis/definition

A symptom of bodily illness. Diagnosed by doctors, based on clearly defined criteria.

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.

Causes There is growing evidence of genetic predisposition and biochemical causes.

Experiences in the patient’s past; particularly childhood experiences.

Triggered by social circumstances which create stress, low self-esteem etc.

Treatment Medical, surgical and nursing care.

Various e.g. Behaviour modification; Psychoanalysis.

Changes have to be made to the person’s life/social situation.

Goal To restore patient health through treatment; to prevent symptoms worsening.

To give the patient an insight into the source of their problems and help them develop coping strategies.

To help reduce rates of mental illness by revealing social influences.

Patterns of Mental IllnessBlack 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.

Theories of Mental Illness1. 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.

ActivityStudy 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 onlybehaviour which doesn’t make senseto others.

A stereotyped view of mental illnessis learned early in childhood andinadvertently confirmed throughoutlife.

DiscussHow 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: WhiteboardsFor 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 publicA man shouting at himself in his houseA crowd shouting at a football matchA cleaner who thinks she is the QueenA child with an imaginary friendA woman who hears voices in her head telling

her to be quietA woman who hears voices telling her to kill

all menSomeone who claims to be heterosexualSomeone who claims to be homosexualA man who claims to be a messenger from GodA man who feels constantly depressedA 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...

...20th 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 20th 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

DiscussIn 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’.

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...

Withdrawal

Conversion

Rebellion

Play it cool

Institutionalisation

The process of learning to be mentally ill (Goffman)

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.

DiscussHow 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?

HomeworkWatch 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 ViewSome 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 ClassGenderEthnicityAge

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]