Health and Illness

Mental Illness

Mental Illness and Social Policy

Social norms and values impact the definition and treatment of mental illness.

Definitions of mental illness and approaches to treating it are tied to social beliefs and values. As social norms change, so does a society's willingness or tendency to label certain behaviors as illnesses. In postindustrial, Western society, mental health refers to an individual's psychological and emotional well-being. Mental illness is generally treated in the United States with a combination of treatments, including medication and psychotherapy, that often focuses on early childhood experience and its effect in shaping adult patterns of behavior. Both therapy and medication for mental illness have become increasingly prevalent since the mid-20th century.

Mental illness that is deemed dangerous can lead to institutionalization, placing a patient in a restricted setting, under the supervision of mental health professionals. In the United States, institutionalization for mental illness declined sharply over the 20th century. Since the 1950s the number of patients housed in mental health facilities has decreased by 95 percent. Sociologists note a rise in the homeless population and in the number of people incarcerated during this same time period. Many researchers argue that these trends are linked and that the social and political approach to mental illness in the United States creates both homelessness and overincarceration. Many studies show that both homeless and incarcerated individuals have high rates of mental illness. For example, a 2014 report found that 54 percent of inmates in state prisons across the country have at least one mental health diagnosis. The percentage is higher in city and county jails, where 64 percent of inmates have some form of mental illness. A 2015 survey found that 25 percent of the national homeless population suffers from serious mental illness.

Growth of Mental Health Diagnoses

The number of identified mental illnesses has grown, along with an increase in medication and therapy and increased positive views about mental health treatment.

Since the mid-20th century, the number of conditions considered to be forms of mental illness has steadily increased. This increase is linked to advances in medicine, psychology, and technology, but it may also be a product of the growth of medicalization, the tendency to define conditions and behaviors as medical problems. In the United States, practitioners use the Diagnostic and Statistical Manual of Mental Disorders (DSM), a manual published by the American Psychiatric Association that lists and classifies all conditions considered to be mental disorders. This first edition of this manual was published in 1952. Six revisions have subsequently been produced, with the most recent edition published in 2013. Each revision has included more types of mental disorders. To some extent, this reflects new information gained from research. However, critics of medicalization argue that this steady increase in the number of conditions defined as mental illness is based on social and cultural trends.

Critics of medicalization argue that many conditions that are nonmedical and simply normal problems of human life are redefined as medical problems. Some point to how a profit motive can drive this tendency. With more conditions defined as medical problems, demand for providers to treat these problems grows, as does demand for medications. Others point to social stigma attached to mental illness. When issues such as anxiety or lack of social skills are defined as mental health problems, individuals with these traits may be stigmatized. On the other hand, the growth of mental health diagnoses and treatments is correlated to an increased awareness of mental illness and support for treating it. A 2014 study found a trend of increasing positive attitudes among Americans about seeking treatment for mental health problems.

Number of Mental Illness Diagnoses in Editions of the DSM

Each edition of the DSM, a manual listing types of mental illness, has included more kinds of mental disorders. This may be because of medicalization, the tendency to define people's experience in medical terms. Sociologists analyze the cultural, economic, and technological influences that encourage medicalization and demedicalization (when something is no longer defined as an illness or condition).

Social and Cultural Factors in Mental Illness

Factors of identity, including socioeconomic status, gender, sexual orientation, race, and ethnicity, are linked to issues of mental illness.
Social factors influence mental health to varying degrees. Poor people are more likely to suffer from mental health issues than wealthy people. This is particularly true for mental illnesses that result in visible socially deviant (less normal) behavior, such as schizophrenia or major depression. Stress is one contributing factor, but researchers are uncertain how much mental illness leads to poverty and how much poverty leads to mental illness. There is also a relationship between gender and mental illness, although researchers stress that this relationship is very complex. Men exhibit higher levels of mental illness resulting in violent behavior toward others. Women show much higher levels of serious depression. The disparity might be partly biological, but it might also be related to socialization, the process through which people learn social expectations for behavior. Men are socialized early on to keep feelings such as sadness and loneliness bottled up, while simultaneously being rewarded for aggressive behavior. Sexual orientation and gender identity can also impact mental health. LGBTQIA individuals (those who identify as lesbian, gay, bisexual, transgender, queer, intersex, or asexual) are at higher risk of suicide and have higher rates of substance abuse than the general population. Race and ethnicity can also play a role in mental illness and in beliefs about mental illness. Biracial and multiracial Americans have the highest reported rates of mental illness, followed by Native Americans. Asian Americans have the lowest reported rates. However, sociologists look carefully at how reported rates of mental illness correlate with reported attitudes and beliefs. For example, a 2016 survey found that Asian Americans report higher rates of self-stigma about mental illness than do members of other racial or ethnic groups. In other words, the Asian American respondents who had experienced a mental health issue reported higher rates of feeling inferior compared to people who had not experienced such an issue. Hispanic respondents in this survey differed according to whether they were surveyed in English or Spanish. Those who used English had higher levels of self-stigma than those who used Spanish. This type of data helps sociologists frame questions about mental illness and more deeply examine issues of mental illness within particular social groups.