A Sociology of Mental Illness

by Tausig, Mark; Michello, Janet; Subedi, Sree

• ISBN13: 9780131114784
• ISBN10: 0131114786
• Edition: 2nd
• Format: Paperback
• Copyright: 2003-07-03
• Publisher: Pearson

Summary

Summarizing mental health research conducted by sociologists over the last 30 years,A Sociology of Mental Illness provides a consistent narrative that emphasizes how social statuses and social roles affect mental health. The mental health treatment system and the public's reaction to mental illness are also comprehensively discussed. Topics include social causes and consequences of mental illness; social statuses, such as gender, socioeconomic status, race/ethnicity, age, and community; deviant behavior; and the challenges of community mental health. For those in the fields of sociology, psychology, nursing, and social workers.

Table of Contents

PREFACE	xi
CHAPTER 1 INTRODUCTION: SOCIAL CAUSES AND CONSEQUENCES OF MENTAL ILLNESS	1	(10)
Biological and Psychological Perspectives	1	(2)
The Medical Model	2	(1)
The Sociological Perspective	3	(4)
The Origins of the Sociological Study of the Stress Process	4	(2)
The Current Sociological Study of the Stress Process	6	(1)
Statuses and Roles as Causes of Distress	7	(1)
Social Reactions to Mental Illness	8	(5)
The Labeling of Deviant Behavior as Mental Illness	9	(1)
The Relationship between Public Attitudes and Professional Labels	10	(1)
The Medicalization of Deviant Behavior as Mental Illness	11	(1)
Mental Hospitals and Community-Based Care	12	(1)
A Sociology of Mental Illness	13	(1)
A Note on Terminology	14	(1)
Distress, Deviance, and Mental Illness	14
PART I: SOCIAL CAUSES OF MENTAL ILLNESS
CHAPTER 2 THE STRESS PROCESS AND MENTAL ILLNESS	11	(14)
The Biological Basis of Stress	17	(3)
The Biosocial Basis of Stress	20	(1)
The Sociomedical Model	20	(1)
The Sociological Model	21	(2)
Linking Stress with Mental Illness	23	(1)
Summary	23	(2)
CHAPTER 3 SOCIAL STATUS: GENDER	25	(7)
How Gender Is Defined	25	(1)
The Relationship between Gender and Mental Health	26	(1)
Social Status Explanations of Distress	26	(2)
Social Role Explanations of Distress	28	(3)
Role Occupancy	28	(1)
Role Fulfillment	28	(1)
Multiple Roles	29	(1)
Role Strain	30	(1)
Summary	31	(1)
CHAPTER 4 SOCIAL STATUS: SOCIOECONOMIC STATUS AND RACE/ETHNICITY	32	(14)
Socioeconomic Status and Well-Being	33	(8)
Explaining the Relationship	34	(3)
The Socioeconomic Distribution of Stressors	37	(1)
The Socioeconomic Distribution of Resources	37	(4)
Race/Ethnicity and Distress	41	(5)
CHAPTER 5 SOCIAL STATUS: AGE	46	(12)
The Age Trajectory of Distress	46	(2)
Age, Resources, and Distress	48	(6)
Children and Adolescents	49	(2)
Young Adults	51	(1)
Middle-Aged Adults	52	(1)
Older Adults	53	(1)
The Cumulative Nature of Well-Being	54	(3)
Cumulative Advantage	55	(1)
Cumulative Adversity	56	(1)
Summary	57	(1)
CHAPTER 6 SOCIAL STATUS: COMMUNITY	58	(10)
Community-Wide Trauma: 9/11 and Other Tragedies	59	(5)
The Impact of Trauma	59	(2)
Evidence of Historical Linkages	61	(1)
The Aftermath of 9/11	62	(2)
The Neighborhood Context: Chronic Stressors	64	(4)
CHAPTER 7 SOCIAL ROLES: SPOUSE, PARENT	68	(12)
Marriage, Marital Roles, and Emotional Well-Being	69	(2)
Aggregate Changes in Family Structure as a Source of Distress	71	(1)
Marital Status Transitions	72	(2)
The Impact of Parental Roles on Emotional Well-Being	74	(2)
Gender Differences	76	(2)
Summary	78	(2)
CHAPTER 8 SOCIAL ROLES: WORKER	80	(11)
The Economy, Labor Markets, and Distress	81	(5)
The Effects of Unemployment	82	(1)
Economic Cycles and Unemployment	83	(1)
Downsizing	83	(1)
Shifts in the Economic Distribution of Jobs	83	(2)
The Deskilling of Jobs	85	(1)
Temporary and Contingent Jobs	85	(1)
Job Conditions and Distress	86	(4)
Job Demands and Decision Latitude	87	(2)
Job Complexity, Coworker Support, and Job Security	89	(1)
The Effects of the General Economy on Job Conditions	90	(1)
Gender, Socioeconomic Status, Race, and Job Conditions	90	(5)
Gender Effects	91	(2)
Effects of Socioeconomic Status	93	(1)
Race/Ethnicity Effects	94	(1)
Summary	95
CHAPTER 9 THE INTERSECTION OF STATUSES AND ROLES	91	(23)
The Intersection of Gender, Work, and Family	99	(3)
Some Non-Normative Cases	102	(6)
Single Mothers	103	(2)
Caregivers	105	(3)
Combining Statuses and Roles to Predict Distress	108	(4)
A Note on the Limitations of This Discussion	112	(2)
PART II: SOCIAL REACTIONS TO MENTAL ILLNESS
CHAPTER 10 LABELING DEVIANT BEHAVIOR AS MENTAL ILLNESS	114	(17)
Deviant Behavior as Mental Illness	114	(2)
Societal Reactions to Deviant Behavior: Social Control	115	(1)
The Labeling of Deviant Behavior and Deviants	116	(7)
Critique and Modifications	120	(3)
Family Reactions to Deviant Behavior	123	(3)
Non-Family Reactions to Deviant Behavior	126	(1)
Social Status and Labeling	127	(2)
Summary	129	(2)
CHAPTER 11 THE RELATIONSHIP BETWEEN PUBLIC ATTITUDES AND PROFESSIONAL LABELS	131
Public Attitudes	132	(5)
Reactions to Being Labeled	135	(1)
Why a Negative Stereotype Develops	136	(1)
Professional Labels	137	(7)
The Classification of Mental Disorders	138	(3)
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence	141	(1)
Delirium, Dementia, and Amnestic and Other Cognitive Disorders	142	(1)
Substance-Related Disorders	142	(1)
Schizophrenic Disorders	142	(1)
Mood Disorders	143	(1)
Anxiety Disorders	143	(1)
Sexual and Gender Disorders, Eating Disorders, Sleep Disorders, Impulse-Control Disorders, Adjustment Disorders, and Personality Disorders	143	(1)
How Changes Are Made in the DSM	144	(2)
The Objectivity of Diagnosis	146	(1)
Summary	147
CHAPTER 12 THE MEDICALIZATION OF DEVIANT BEHAVIOR AND MENTAL ILLNESS	14	(154)
Deviant Behavior and Its Control	151	(2)
Illness as Deviant Behavior	152	(1)
The Medicalization of Deviant Behavior	153	(5)
The Medicalization Process	154	(3)
Benefits of Medicalization	157	(1)
Costs of Medicalization	157	(1)
The Medicalization of Madness	158	(1)
The Prevalence of Mental Illness in the General Population	159	(3)
The Social Distribution of Mental Illness	162	(1)
Deviant Behavior or Biological Dysfunction?	163	(3)
Summary	166	(2)
CHAPTER 13 THE HISTORY OF SOCIETAL REACTIONS TO MENTAL ILLNESS	168	(16)
Definitions of Deviance and Societal Responses across Cultures	168	(4)
Common Explanations	169	(1)
Non-Western Definitions and Societal Responses	170	(2)
Definitions and Societal Responses in Western Culture	172	(6)
Ancient Greece and Rome	172	(1)
The Middle Ages	173	(2)
Industrialization, Enlightenment, and the Need for Order	175	(2)
The Growth of Large: Public Hospitals	177	(1)
Modern Medical and Psychological Explanations	178	(5)
The End of the Hospital Era	180	(1)
The Shift to Community-Based Care	181	(2)
Summary	183	(1)
CHAPTER 14 THE CHALLENGE OF COMMUNITY MENTAL HEALTH	184	(25)
The Roots of Community Care	185	(3)
The State of Public Mental Hospitals	185	(1)
The Availability of Psychotropic Drugs	185	(1)
The Economics of Custodial Care	186	(1)
Mental Illness in the General Community	186	(1)
Legal Requirements	187	(1)
New Philosophical Orientations to Treatment	187	(1)
Deinstitutionalization	188	(1)
The Community Ideal	188	(2)
Characteristics of Community Mental Health Services	190	(4)
The Implementation of Community Mental Health Services	191	(1)
Refocusing on the Chronic Patient	192	(2)
Deinstitutionalization and Community Mental Health; Persistent Problems	194	(5)
The Financing of Mental Health Services and the Growth of Managed Care	199	(3)
Current Trends in Community Mental Health	202	(7)
The Family and Community Mental Health Care	203	(1)
Family Reactions to Mental illness	204	(1)
Family Burden	205	(1)
Alternative Forms of Community-Based Care	206	(3)
CHAPTER 15 THE CONTRIBUTION OF SOCIOLOGY	209	(14)
Other Explanations	210	(6)
The Biological Basis of Psychological Disorder	211	(2)
The Psychological Basis of Psychological Disorder	213	(2)
The Social Base of Psychological Disorder	215	(1)
The Place of Sociological Explanations	216	(3)
Social Causes of Psychological Distress	219	(1)
Societal Reactions to Mental Illness	220	(3)
BIBLIOGRAPHY	223	(23)
INDEX	246

Excerpts

If Alice, caught in Wonderland, ran as fast as she could just to stay in the same place, then many of us feel we are losing ground in our own fast-paced wonderland. Stress is everywhere. No one has enough time. No one has enough money. No one is sure if they will keep their job. There are drugs, crime, AIDS, divorce, suicide, pollution, threats of war, and now threats of terrorist acts. We worry for ourselves and our children. It is no wonder, in our wonderland, that being "stressed out" and "burned out" are commonly understood expressions and commonly observed reactions to modern life. Life can drive us crazy. Reliable estimates suggest that an adult has a fifty-fifty chance of experiencing a mental illness in his or her lifetime. But everyone''s chance is not the same. Rather the frequency of mental illness varies by such factors as gender, socioeconomic status, marital status, neighborhood context, and work status. While some would explain these differences as being due to biological predispositions, sociologists wonder if these social factors themselves might cause people to feel distressed or to become mentally ill. Sociologists have long recognized that the organization of society affects the life chances of its members. The sociology of mental illness suggests that the organization of society also affects the mental health of its members. Economic hardship arising from membership in the lower class, for example, can be demoralizing, and it doesn''t take much imagination to conclude that poverty might cause distress. This perspective often implicates as direct causes of disorder the day-to-day experiences of individuals that are related to their membership in one social stratum or another. In the past thirty years, a distinctive sociological perspective on the meaning, origins, and treatment of mental illness has emerged to address these concerns. The perspective is intended to explain how we get stressed out by considering how the organization of social life affects our psychological states. This impressive body of knowledge adds important insights into human behavior and into collective responses to certain forms of social behavior. Each of the authors has taught courses in our respective college or university utilizing a sociological approach for understanding mental illness, and we felt it was time to create a new summary of this research. We do not claim that our book represents a complete summary of such research, nor that all scholars would agree with our interpretation and organization of the material. Hence this book is asociology of mental illness, not thesociology of mental illness. The modern world (our wonderland) is a vastly complex place. It is also full of contradictions stemming from that complexity. For instance, contemporary societies create opportunities for people to realize their dreams. There seems to be no end to the things people can do to make a living and to the chances for people to be who they want to be. But this limitless freedom is an illusion. Complex systems require high degrees of control in order to function well; they put limits, therefore, on what people can actually do. Norms of acceptable behavior serve important limiting functions; hence the contradiction that we sometimes experience between personal autonomy and social constraint. This is what Sigmund Freud called "civilization and its discontents." Whatever its origins, mental illness can be described as behavior and thought patterns that are not normative and that require control or constraint because of their potential to disrupt individual and collective arrangements. We would mostly agree that mental illness can have negative effects on individual life chances, disrupt families, and, in some instances, threaten the general community and the continuity of social systems. One means for constraining undesirable behavior is to punish it. Another option is to "treat" it. A casual review of the listing of official diagnostic categories currently used by professional mental health practitioners to treat mental illness is enough to suggest that much of what is considered to be mental illness also represents violations of social norms of behavior. Hence sociologists view mental illness as a way to categorize forms of behavioral deviance for the purpose of controlling them. This perspective emphasizes the idea that mental illness is a social construction or idea, and from there we regard mental illness and its treatment from a sociological perspective as part of a system for the social control of deviance. Our teaching experience has also made us realize that students do not easily accept the notion that mental illness can have social causes. Although we agree with some of our colleagues that social causes may actually be more important for explaining mental illness than other factors such as genetics and cognitive impairments, we will not make this claim. Rather, our intent is to demonstrate the basis for such a claim and let the readers decide (if they feel the need to do so). If one in two adults will experience symptoms of mental illness during their lifetime (and this proportion goes up every time the definitions of mental illness expand), then it seems important to understand how this situation arises and how we deal with it. Alice, after all, was threatened with beheading. In our wonderland we may keep our heads but lose our minds. Mark Tausig Janet Michello Sree Subeda