Sociology Flashcards
What is the social causation model in the sociology of mental illness?
Assumes that mental illness is an objective social fact
Aetiology of mental illness is identifiable with social factors
Postulates people of lower social class have a higher chance of encountering negative factors like adversity and stress making them vulnerable to psychiatric illness
Stresses associated with social deprivation (e.g. stress, poor coping resources, social isolation, poverty) seen to push vulnerable individuals into mental illness
What is the social constructionism model in the sociology of mental illness?
Assumes all knowledge is socially constructed
Psychiatric knowledge seen as just one explanation of behaviours seen to be outside the norm albeit an influential one
Labelling theory
Looks at the ways labels are attached to behaviour outside social norm
The more visible the “deviant” behaviour greater the chance of being labelled with a mental health problem
Clinical iceberg - only small minority diagnosed as mentally ill
How has neuroscience impacted on the sociology of mental illness?
Increasing influence in providing explanations for mental illness = “neuropsychiatry”
One of the attractions is that mental illness no longer equated with personal responsibility making it difficult to sustain social stigma and blame
However is complex - for example neurotransmitter chemistry cannot alone precipitate depression
How has the DSM related to sociology of mental illness?
DSM (diagnostic and statistical manual of mental disorders):
Standardised classification of mental illness first published 1952
Intention to stabilise psychiatric nomenclature
And to clarify description of mental syndromes by officially approving diagnostic terms
Attempts to draw on diagnostic methodology of physical illness (as found in ICD)
What are health inequalities?
Systematic differences in the health of groups of people according to
Social position
Place of residence
Ethnicity
Gender
Other characteristics but age not usually considered one
What did the black report 1980 show? (inequalities in health)
Black report (1980):
Rates of morbidity and mortality not randomly dispersed throughout the population
Argued it was material factors which were the main cause of social inequalities in health
Identified number of possible explanations
Artefact (health results as a result of individual behaviour)
Social/health selection (those with poor health downwardly mobile)
Behavioural/cultural factors; class differences in health beliefs and behaviour, those of a low class more likely to smoke, drink and have poorer nutrition
Material circumstances e.g. income, housing, education
Report found material circumstances that were the main cause of social inequalities in health
What did the acheson report 1998 show?
Report showed that since the introduction of the welfare state there was a fall in mortality but the greatest fall in mortality was in upper classes
Recommended interventions to reduce health inequalities
Medical care
At level of morbidity to prevent early death
Improve access to healthcare
Preventative approaches
To change individual risk
In workplace
To improve psychological conditions, reduce unemployment
In social structure
Reduce social and economic inequalities, provide good food at cheaper prices, provide better housing
What did the marmot review [strategic review of health inequalities in england 2010] reveal?
The marmot review looked at 5 main sections and if they had improved since the Acheson review
- Employment (unemployment leads to worse health outcomes)
- Housing (poor housing = poor health)
- Educational achievement (those with low levels of educational attainment have poor adult health), attainment in secondary education and those who went to uni increased
- Crime – generally has decreased
- Child poverty (discussed in more detail below), HAS INCREASED!
Social inequality has a massive impact on child development (cognitive, social aspects etc.), marmot recommended to increase proportion of expenditure allocated to early years. To support families more. Reduce inequalities in education outcomes, prioritise inequalities in life skills, increase access and use of quality lifelong learning (e.g. 16-25 support, work based learning, non-vocational courses).
Obesity is far more prevalent in those who are of lower socioeconomic status Young people of a lower socioeconomic class are more likely to use drugs of abuse
What are the trends in social inequalities in health
Life expectancy in the UK is rising
but inequality between the highest and lowest social class is rising
Gap in inequality has been reduced in terms of absolute number of deaths involved however gap in relative terms has become larger
What is the impact of social dependency and aging?
Recurring theme of old age as a social problem remains
Message conveyed is that the elderly are an ever increasing burden on health and social care
Sociologically “problematising” of the elderly operates at two levels
Structurally constructed
- Social and political consequences of changing demographics
Socially constructed
- Ageist assumptions about capabilities and contribution of older people
What is dependency as a social construction?
If old age socially constructed as period of dependency can act as a barrier against “active ageing” and become “self fulfilling prophecy”
Universal retirement age - removes older people from the workplace
Biological ageing constructed as pathological
What are the economic issues regarding dependency and ageing?
Debate regarding funding of long term care
Needs consideration of 4 areas
1. What proportion of old people will require care = unknown
2. Introduction of economic incentives
- Encouraging individuals to save for older age
- Encourage families to take on role of informal carer
- Encouraging growth of private long term care insurance schemes
3. Intergenerational equity = possibility of redistribution from those with low to those with high care needs
4. Public sector fiscal sustainability - by 2060 25% of GDP in UK will be on elderly care how long can spending be sustained
What are the long term care services?
Three types
1. Social care
- Statutory responsibility of local authority
• FACS gave local authorities right to refuse care for people if they could not afford it
• Attempting to standardise way decisions for care were made and move away from post code lottery
- Means tested service that places people in four bands of need
2. Institutional care
- Nursing or residential homes
- Public funding is means tested
3. Informal care
The future:
Personalised policies in health/social care
Personal budget that people can spend as they wish
- Greater independence
- But can be daunting and people may lack online skills of personalisation
What are the gender issues in older age?
Women have higher life expectancy than men but save less for their pensions
Occupy less remunerated positions than men or more often than men interrupt employment for child care or elderly relatives
Leads to higher risk of poverty for women in old age
What is the third age critique for social dependency in old age?
Majority of elderly have benefited from pensions that enable them to pursue lifestyle unthinkable a few years back
If social identity is based on your consumption then the idea of social dependency in old age is untrue
What is the initial reaction to chronic illness?
Shock - Depends on suddenness of diagnosis - Feeling stunned/bewildered - Feeling detached - Behaving automatically Common emotions - Anxiety and fear = response to threat - Depression = response to loss/failure/helplessness Retreat and denial - Controls the emotional response - In short term faster initial recovery e.g. from heart attacks and less side effects - In the long term causes less concordance, less self management and knowledge
What are the seven areas of adjustment to chronic illness?
- Adjust to symptoms and incapacities of illness
- Adjust to treatment procedures and hospital environment
- Develop and maintain relationship with health care providers
- Preserve a reasonable emotional balance
- Preserve satisfactory self image and a sense of competence and mastery (positive thinking)
- Sustain positive relationships with family and friends
- Prepare for an uncertain future
What is the crisis model of chronic illness?
after being diagnosed with a chronic illness, individual loses their social status (you can’t work etc)
Leading to either biographical disruption (bad) or negotiation (good)
Biographical disruption
Diminishes patient self esteem and cause stigma leading to isolation and withdrawal which eventually causes a lack of confidence
Negotiation
Person has difficulty in maintaining normality with time
But they refuse to accept labelling and stigmatization, preserve identity
Many factors affecting adjustment
Illness related factors
- Threat level
- Visible conditions e.g. seizures
- Pain
Background and personal factors
- Financial position (can afford private care, treatments not under NHS etc)
- Support
- Gender (men find it more difficult to adapt)
- Age
- Personality
Physical and social environmental factors
- Practical support
- Hospital/home care can be depressing (social support can enhance coping)
- Financial support may provide relief
What are psychological interventions for chronic illness etc?
CBT
Stress management
Social support
Treat depression
