By Anne Rogers, David Pilgrim
A former BMA scientific e-book of the 12 months award winner, this publication offers a sociological research of significant parts of psychological healthiness and illness.
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Additional resources for A sociology of mental health and illness
An understanding of mental health in society implicates the interaction of social structure and personal agency: it is a both/and not an either/or form of analysis. It requires notions of social capital, personal identity and the situated actions and decisions made by individuals, when exploring health inequalities in the structural context of a material gradient of wealth and power, associated with class membership. A lack of ‘social capital’ refers to ‘features of social life-networks, norms and trust that enable participants to act together more effectively to pursue shared objectives’ (Putnam, cited in Wilkinson 1996: 221) It implies that the quality of social relationships and, most importantly, our perceptions of where we are relative to others in the social structure, are likely to be important psycho-social mediators in the cause of inequalities in health (Wilkinson 1996).
The interdisciplinary project of ‘social psychiatry’ describes this convergence of disciplinary interests. We also mentioned the tendency for some critical psychiatrists and other professional groups to embrace social constructivism. Some sociologists have gone some way to legitimize the core business of psychiatry by accepting that the psychoses are ‘true’ illnesses, while designating ‘common mental disorders’ as being forms of social deviance (not illnesses). Horwitz argues that ‘a valid definition of mental disorder should be narrow and should not encompass many of the presumed mental disorders of diagnostic psychiatry, especially appropriate reactions to stressful social condition and many culturally patterned forms of deviant behaviour’ (2002: 15).
With an incoming health (Labour) administration in 1997, there was a reversal to the previous terminology, and a Green Paper with the aim of tackling inequalities and unmet need (Department of Health 1998). This point about terminology also reminds us of the vulnerability of only conducting debates about health within a framework of constructivism – there is a risk that these debates are only about what we call the world rather than about the reality of that world. Over time there have been elaborations of this fourfold typology and the introduction of new variables and factors.