Sociology of mental health and illness

Question 1

Describe the social causation/social determinants model

Answer 1

The key assumptions of the social causation model are as follows:

• Mental illness is an objective, measurable ‘social fact’.
• The aetiology of mental illness can be explained largely in social epidemiological terms.
• There are identifiable social factors correlated with a predicable incidence of mental illness; depression in particular.
• Social class is identified as key correlate of `social-stress’.

The stresses associated with social deprivation such as social isolation and material deprivation are seen to ‘push’ already vulnerable individuals into mental illness.

Inequalities also create a sense of social unfairness which can lead to a breakdown in social cohesion.

Lack of ‘social support’ is also recognised as being related to vulnerability to illness - with high social support being ‘protective’ or acting as a ‘buffer’ against the psychological impact of stressful ‘life events’.

With a combination of circumstances and perceptions leading to: debt, overwork, ‘unhealthy’ coping behaviours and ‘demoralisation’.

Question 2

What 3 areas does the NHS England mental health strategy encompass?

Answer 2

Recommendations to achieve parity of esteem between mental and physical health.

Recommendations for wider cross-government intervention in areas such as employment, housing and social inclusion.

Recommendations to tackle social mental health inequalities among people who are unemployed and those who experience discrimination.

Question 3

what is the social constructionist perspective

Answer 3

Social constructionism is the philosophical position that everyday knowledge of the world is `creatively produced‘.
So that what constitutes a ‘social fact’ is established through social interactions and interpretations alone.
As applied to the conceptualisation of mental illness, this approach would not draw any hierarchical distinction between psychiatric and social explanations.
One strand of social constructionism you will be familiar with is known as ‘Labelling theory’.

Question 4

describe the impact of neuroscience in mental health

Answer 4

If the brain is perceived to be a material and self-contained physiological system that can be known and therefore predicted, then (in theory) it opens up mental illness to effective interventions.

One of the attractions of this changing discourse of mental illness as brain disorder, is that the former would no longer be equated with personal (or parental) responsibility, so making it difficult to sustain social stigma and blame.

The actuality of neuropsychiatric approaches to the identification and treatment of mental ill-health has though been questioned.
In part this is because the process of establishing phenotypes of mental disorder is problematic given that similar symptoms can result from different combinations of genetic risk factors.
At the same time, the same genetic variant may be associated with multiple DSM diagnoses.
Additionally, there are many environmental and other random events that contribute to mental illness not predicated on whole genomic make-up.