Mental illness
- Defined as alterations on thinking, mood, of behaviour that are associated with significant distress and impaired functioning
- consists of two commissions:
→ individual: the experience of an illness
→ social: the perceptions/treatment of those with an illness - reflects a process of social construction
- prevalence: in Canada 20% of adults have a mental disorder; 80% of adults know someone with a mental disorder (half of all Canadians will experience a mental disorder by the age of 40)
Patterns of mental illness
- Greatest predictor of mental illness is socioeconomic status
- social causation hypothesis: more life stressors and fewer resources to cope with those stressors contributes to the development of mental illness (is a product of one’s social position)
→ between adulthood and old age social causation plays a bigger role
→ mood and anxiety disorders are best explained by social causation - social selection hypothesis: because of their mental illnesses, people experience challenges maintaining their socioeconomic position; social drift is when people drift into a lower socioeconomic position
→ ADHD, conduct disorder, and schizophrenia are best explained by social selection - adolescents and young adults have higher rates of mental illness and major disorders emerge during this period (biological, psychological, social factors, marginalized youth)
- sex differences:
→ men: antisocial personality disorder and conduct disorders more common in men
→ women: mooin and andrett diserciers more common in women
Costs of mental illness
- Individuals and families
→ lower levels of educational opportunities, employment rates, and income
→ contributes to family instability given the challenges and stresses of mental illness
→ physical illness (links between certain diseases, less likely to comply with treatment) - society
→ health care expenses
→ lowered productivity at work it dealing with mental illness
→ lost tax revenues if people are unable to maintain employment - treatment issues
→ many remain untreated due to lack of services, belief that services are inadequate, stigmatization uncomfortable with self-disclosure
Controlling mental illness
- Stigmatization: assuming people with mental illness are unpredictable, unstable, and dangerous (damaging beliefs about mental illness and those who have them)
→ self-stigmatization: people with mental illness stigmatize themselves without having to experience external stigma (buying into harmful, inaccurate ideas) - medicalization: process by which more areas of human life get framed as medical issues (moral failing, criminal act, mental illness)
→ began with asylums but today it involves an extensive array of treatment options
→ issues of de institutionalizations: lack of treatment, worsening mental/physical health, lack of social support, stigmatization/discrimination, exploitation/abuse, transinstitutionalization (hospitals to prisons)
Resistance
- Disease paradigm: minimize symptoms (individual dimension of mental illness)
- discrimination paradigm: minimize stigmatization and its consequences (social dimension of mental illness)
Resisting stigmatization
Stigma management
- Trying to hide illness to appear “normal”
- dividing social works (only revealing illness to those who are close)
- deflecting (distancing from the label and stereotypes of mental illness)
- challenging (fighting back against stigma through direct confrontation or presenting themselves as capable and competent)
- legislation, institutional policies and programs
- self-help and advocacy groups
Resisting inadequate and insufficient care
- Advocacy and support groups: fighting for and lobbying the government to get more funding for mental health services, educate those affected about available options
- heath care community: producing research on mental illness, improved treatments, lobbying the government for increased support/funding for mental health programs
Resisting medicalization
- Physicians often push for medicalization believing it’s in the patient’s and society’s best interest (increases their authority, power, influence, and opportunity)
- consumers and consumer groups: believe that medical intervention is more beneficial than legal intervention (individuals also want validation for their condition)
- pharmaceutical industry:
→ disease mongering: pushing the idea that a particular disease exists and there is a treatment for it
→ branding a disease with a product: an ill for every pill - health insurance providers
Medicalization pros and cons
Pros:
→ legitimization/validation: provide answers about what’s going on and provide validation that their experiences are an illness
→ societal awareness and stigma reduction with certain conditions
→ development of beneficial therapies
Cons:
→ Empowerment of physicians and disempowerment of patients and limitation of options (if treatment plan is not followed they are considered irresponsible)
→ denial of social, economic, and political factors contributing to the illness
Critique of the DSM
- Many argue that its inclusion of certain disorders is a matter of debate
- it seems to be more political than a medical or scientific document (controlled by psychiatrists, insurance companies, and the pharmaceutical society; questions neutrality)
-tends to pathologize normal behaviours and ignore contextual issues (social, political, and economic factors)
Critique of Mental Health practitioners
- The influence of social factors on psychiatric diagnosis and the dehumanizing treatment of patients (gender, culture); Mental Health presents a Eurocentric bias
Critique of “mental illness” itself
- One end of the continuum: mental illness is a real thing but psychiatry has pathologized too much
- other end of the continuum: no such thing as mental illness, it’s pure fiction
