Sociology of mental health.
What is mental health? How do we classify different mental illness and disorder?
Takes different definitions.
World health organisation (2014) – ‘mental health is defined as a state of well-being
in which every individual realizes his or her own potential, can cope with the normal
stresses of life, van work productively and fruitfully, and is able to make a
contribution to her or his community’.
o Very aspirational, most of us don’t live up to this every day.
o Operationalising this is difficult, if we were measuring mental health.
o A prefix to ‘problems’ or ‘issues’.
o Sometimes seen as being more politically acceptable mid 20 th century, move
from psychiatric services to mental health services.
In social science, mental illness encompasses a wide range of conditions from
dementia to depression, anorexia, PTSD, personality disorders.
o It is an umbrella term. Just like physical health takes many forms.
o These are all conditions that come under the purview of medicine, or at least
clinical psychology, under a medical authority.
Biomedical vs. social models – how we react and respond to these conditions.
o What makes the sociological view important – we’re interested in the
collective, the social. Psychiatrists and psychologists are interested in the
individual case generally, we are interested in societal process which
produce mental illness, a production might be constructs, and the social
causation. What is it about social life that brings about mental illness?
Object of study in historical context.
To see how we responded to issues and illness over time and place, there is no one way of
doing things. What we do now Is partly a product of the past.
Foucault – PhD, written on and called ‘madness’. Interested in mental health,
worked in institutions, he himself suffered from depression.
o Interested in looking at a long-term history of archaeology to try and explore
how EU society responded to and constructed madness.
o In the middle ages, people who were ‘mad’ tended to roam around and live
alongside other people.
o Age of reason from the age of enlightenment – more rationalisation in
responses lead to a separation of those who are mad from the sane.
o Construction of large institutions where these people without reason, the
‘mad’ could be placed.
More to do with capitalism, it was unproductive people –
unemployed, old, lazy, had custodial care.
Foucault’s view is that it was a move towards disciplinary power.
o Either way, people classed as ‘insane’ were put into these places. They were
treated as animals; they were closer to nature. No need for blankets, clothes,
shoes, light, activity.
19th century reform of mental health institutions.
, William Tuke – The Retreat – York (1796). Key site for reform. Challenged these
inhumane ways of treating people who are mad.
o Argued for a moral treatment. Had a belief that people could be changed and
reformed, they needed to instil a morality and a set of values.
o If they were cared for, had good work such as gardening etc, if they had
kitchens to work, you could implicate these values in a humane way to have
reform.
But Foucault said his account of it is very different from saying it was a very bad
treatment, and now it is better (traditional history)
o It was a reconfiguration of the understanding of the insane. The insane were
those who were vulnerable, lacked moral virtue.
o From a moral discourse to a medical discourse. In these newly reformed
institutions, they got ran by and inspected by doctors.
o Doctors defined what constituted the insane. Came under the authoritative
voice of the psychiatrists.
These institutions were places where doctors could study patients, classify them into having
select disorders, etc.
These people became diagnosed.
A schema for defining mental disorders
Foucault’s thesis.
DSM.
List that contains virtually all medical conditions.
First developed in Britain after WW1, then USA – (DSM – 1) 1952. Revised, but still
used today.
Psychiatry had authority – defined what a mental disorder is.
Critiques of medical psychiatry and de-institutionalisation.
Psychiatrists could control that space.
Goffman’s Asylums (1961). Book – ethnography of an asylum.
One flew over the Cuckoo’s nest (Kesey, K 1963)
Strong hold of the psychiatrist was begging to be critiqued.
Psychiatry was losing authority.
Also within the profession, not just outside.
Anti-psychiatry movement
o Laing (1967) – a sane response to an insane world.
o Cooper – treatments (ETC, lobotomy, crude/abuse).
o On being sane in insane places – pseudo-patients (Rosenhan, 1973).
Anti-psychiatry movement.
Challenged what medicine was
Challenge meaning of madness
The problem of stigmatisation
The problem of social exclusion
Psychiatric preoccupation with physical treatments.
What is mental health? How do we classify different mental illness and disorder?
Takes different definitions.
World health organisation (2014) – ‘mental health is defined as a state of well-being
in which every individual realizes his or her own potential, can cope with the normal
stresses of life, van work productively and fruitfully, and is able to make a
contribution to her or his community’.
o Very aspirational, most of us don’t live up to this every day.
o Operationalising this is difficult, if we were measuring mental health.
o A prefix to ‘problems’ or ‘issues’.
o Sometimes seen as being more politically acceptable mid 20 th century, move
from psychiatric services to mental health services.
In social science, mental illness encompasses a wide range of conditions from
dementia to depression, anorexia, PTSD, personality disorders.
o It is an umbrella term. Just like physical health takes many forms.
o These are all conditions that come under the purview of medicine, or at least
clinical psychology, under a medical authority.
Biomedical vs. social models – how we react and respond to these conditions.
o What makes the sociological view important – we’re interested in the
collective, the social. Psychiatrists and psychologists are interested in the
individual case generally, we are interested in societal process which
produce mental illness, a production might be constructs, and the social
causation. What is it about social life that brings about mental illness?
Object of study in historical context.
To see how we responded to issues and illness over time and place, there is no one way of
doing things. What we do now Is partly a product of the past.
Foucault – PhD, written on and called ‘madness’. Interested in mental health,
worked in institutions, he himself suffered from depression.
o Interested in looking at a long-term history of archaeology to try and explore
how EU society responded to and constructed madness.
o In the middle ages, people who were ‘mad’ tended to roam around and live
alongside other people.
o Age of reason from the age of enlightenment – more rationalisation in
responses lead to a separation of those who are mad from the sane.
o Construction of large institutions where these people without reason, the
‘mad’ could be placed.
More to do with capitalism, it was unproductive people –
unemployed, old, lazy, had custodial care.
Foucault’s view is that it was a move towards disciplinary power.
o Either way, people classed as ‘insane’ were put into these places. They were
treated as animals; they were closer to nature. No need for blankets, clothes,
shoes, light, activity.
19th century reform of mental health institutions.
, William Tuke – The Retreat – York (1796). Key site for reform. Challenged these
inhumane ways of treating people who are mad.
o Argued for a moral treatment. Had a belief that people could be changed and
reformed, they needed to instil a morality and a set of values.
o If they were cared for, had good work such as gardening etc, if they had
kitchens to work, you could implicate these values in a humane way to have
reform.
But Foucault said his account of it is very different from saying it was a very bad
treatment, and now it is better (traditional history)
o It was a reconfiguration of the understanding of the insane. The insane were
those who were vulnerable, lacked moral virtue.
o From a moral discourse to a medical discourse. In these newly reformed
institutions, they got ran by and inspected by doctors.
o Doctors defined what constituted the insane. Came under the authoritative
voice of the psychiatrists.
These institutions were places where doctors could study patients, classify them into having
select disorders, etc.
These people became diagnosed.
A schema for defining mental disorders
Foucault’s thesis.
DSM.
List that contains virtually all medical conditions.
First developed in Britain after WW1, then USA – (DSM – 1) 1952. Revised, but still
used today.
Psychiatry had authority – defined what a mental disorder is.
Critiques of medical psychiatry and de-institutionalisation.
Psychiatrists could control that space.
Goffman’s Asylums (1961). Book – ethnography of an asylum.
One flew over the Cuckoo’s nest (Kesey, K 1963)
Strong hold of the psychiatrist was begging to be critiqued.
Psychiatry was losing authority.
Also within the profession, not just outside.
Anti-psychiatry movement
o Laing (1967) – a sane response to an insane world.
o Cooper – treatments (ETC, lobotomy, crude/abuse).
o On being sane in insane places – pseudo-patients (Rosenhan, 1973).
Anti-psychiatry movement.
Challenged what medicine was
Challenge meaning of madness
The problem of stigmatisation
The problem of social exclusion
Psychiatric preoccupation with physical treatments.
