Week 11

Psych 470

You tell your parents that your college dormitory is making you sick because the rooms are so small and noisy. Your parents tell you to stop complaining and that the problem is "all in your head." Do you agree or disagree with your parents? Is it true that the physical environment cannot impair your health? Why or why not?

Many people feel that there are no disadvantages to receiving social support. Why is this belief false?

Is mental illness more acceptable today than in previous periods? Think of examples of openness to mental illness and of still existing stigma.

Some would argue that we have created a society in which mental disorders are normative (e.g., more services, more media representation of positive images). Do you think this is the case? What are the implications of such a change?

Why would community psychologists be interested in the Rosenhan pseudo-patient study?

Are formerly institutionalized patients better off today then in the era of large institutions? Where might we find such individuals now?

• In the area of mental health/illness, there are two major competing explanations: social causation and social selection
• Either social or cultural factors cause the individual phenomenon (social causation) or the individual phenomenon (or tendency for it) is responsible for differences in social or cultural factors (social selection)
• Example: Early researchers (e.g., Faris and Dunham, 1939) studying mental illness urban Chicago assumed that poverty and disorganization were responsible for producing high rates of schizophrenia. Later, they stated it also was plausible that people with schizophrenia may tend to become poor or disorganized.
• These two explanations have stirred much controversy when attempting to explain the high negative correlation between rates of mental illness and socioeconomic status.
• Social selection hypothesis has taken different forms
• Social drift explanations
• Social stagnation
• Recently, there has been a greater move towards social selection explanations
• Example, schizophrenic individuals in New York (Link, Dohrenwend, and Skodol, 1986)
• Community psychologists would argue transactional causality in examining mental illness

• For example, in the case of social class and mental illness, Allen and Britt (1983) provide evidence for a transactional process

• Stress-vulnerablity
• Stress of marital disruption
• Stress of unemployment
• Inequalities in physical health

• Primary and secondary deviance
• Primary deviance may originate from four sources: organic deficit, psychological dynamics, external stress, or volitional acts in defiance of social rules
• Depending on class of rules broken, individuals are referred to a specialized agency of social control
• Special education system
• Criminal justice system
• Psychiatric facilities and service providers
• Persons processed through psychiatric systems often have broken "residual rules" (Scheff, 1984), or assumed norms regarding proper and decent conduct

• There is disagreement by researchers as to the nature of stereotypes of mental illness held by the public and whether societal and individual reactions to acts of deviance are in keeping with cultural stereotypes of mental illness
• One issue is that today, a large range of behaviors other than serious mental illness have fallen under the domain of mental health professions
• Increasing voluntary treatment suggests that public images of mental health are more broad and people are more accepting of seeking treatment across social, ethnic, and gender classes
• However, consequences of labeling may still differ

Scheff outlines a number of conditions in which behavior may result in labeling

1. The degree, amount, and visibility of rule breaking determine reactions and efforts at control/intervention
2. If power differentials favor the rule breaker, he or she, may not be readily subject to social control
3. Persons who occupy more central roles in families (with presumably, greater social power) are hospitalized sooner than those in more peripheral roles
4. Level of tolerance for deviance within a community determines responses to deviant behaviors
5. The availability of alternative non-deviant roles that allow behavior to be expressed in a positive context determines reactions and labeling

• Can we depend on the validity of the diagnostic process to identify and label only those in need of care?
• Parham v. J. and J.R. (1979); strong implications for consequences of labeling process
• Over-commitment and overload of mental health systems
• Risk of liability