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Sociologists who study mental disorder work from a number of assumptions that define and distinguish their approach. They view mental disorder as a normal consequence of social life caused by structured inequality. They regard mental disorder as the outcome of social processes that include the labeling of deviant behavior and stigmatic societal reactions to those labels. They often define the object of study as general psychological distress rather than as specific psychiatric disorders. They may view the mental health treatment system as an institution for the social control of deviant behavior. Finally, the sociological perspective is concerned with properties of groups and populations and it is less informative regarding individual and clinical concerns.
Sociologists argue that disorder or distress arises from a stress process in which eventful, chronic, and traumatic stressors represent risks to well-being. Individuals can also mobilize resources to offset the effects of stressors. Both exposure to risk and the ability to mobilize protective resources are a function of social status. Race, class and gender, in particular, are related to risk exposure and access to protective resources. This accounts for differences in the rates of distress/disorder by race, class and gender. Over the life course individuals are exposed to stressors and have access to resources that consistently affect well-being as a direct function of socially structured access to resources and exposure to risk factors. Hence, both risk and protective resources that predict mental disorder arise in the normal day-to-day lives of persons as a function of social status.
Sociologists also view mental disorder as the outcome of a social process in which others evaluate and label deviant behavior. The labeling perspective represents an external causal explanation for disorder in which others confer a label on certain forms of deviant behavior. When an individual behaves in ways that others find deviant and unexplainable, that individual can be diagnosed (labeled) as having a mental disorder as a way of explaining the deviant behavior. The label has powerful effects for both those who encounter the labeled individual and the labeled individual. The mental illness label is stigmatic and it is associated among the general public with negative attributes of dangerousness, unpredictability, and lack of personal responsibility. Finally, labeling is a form of social control because it can be used to constrain behavior and because it reflects power relations in social systems.
Sociologists are not sure that psychiatric labels refer to real entities or diseases. There are strong theoretical and empirical grounds for believing that diagnostic categories of disorder can be arbitrary, value-laden, and normative. A review of official diagnostic categories suggests that many of the disorders described could also easily be labeled simply as non-normative behavior. The medicalization of deviance argument describes a social process that turns deviant behavior into illness symptoms.
The treatment of mental disorders can be understood as the social control of deviance. In this regard, sociologists view the mental health treatment system as a social control institution and they are interested in race and class patterns of mental health treatment including: differences between public and private treatment modalities, the goals of treatment, and differential access to mental health services in general.
The sociological study of mental disorder focuses on the mental health status of social groups and populations. Sociologists do not attempt to explain why a particular individual feels depressed but why persons with low socioeconomic status, for example, are more likely to feel depressed compared to persons with high socioeconomic status. The perspective has limited application to clinical concerns and is not especially useful for explaining individual cases of disorder.
- Aneshensel, C. S. & Phelan, J. C. (eds.) (1999) Handbook of the Sociology of Mental Health. Kluwer Academic/ Plenum, New York.
- Horwitz, A.V. (2002) Creating Mental Illness. University of Chicago Press, Chicago, IL.
- Kutchins, H. & Kirk, S. A. (1997) Making Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders. Free Press, New York.
- Scheff, T. J. (1984) Being Mentally Ill. Aldine, New York.