MENTAL ILLNESS Sociological Perspectives If you talk to

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 Hard Medical Labeling

MEDICAL: Disease Model ► HARD § Mental illness is a disease like any other § Has biological basis § Popular in early to mid 1900 s § 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 60 s: Psychosocial Model (psychoanalysts) ► Mental illness is a result of unresolved conflict from childhood ► Since 1960 s, 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? Medical B. Labeling A.

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 1970 s--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 1950 s-60 s

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 1960 s 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 1950 s ► 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/