State University of New York College at Buffalo

Department of Sociology

Professor Zhang Jie, Ph.D.

Soc 393: Sociology of Mental Illness

Study Guide Number 3

Chapter 10: Helping Seeking Behavior

General Issues

• The Decision to Seek Treatment

• Family Disruption

• Family Alienation

• Public Disruption

Aware of Mental Illness

• Behaviors or thoughts different from others

• Behaviors or thoughts different from the past

The Decision to Seek Treatment

• Self choice

• Coercion by others

• Muddling through by others

– Neither active nor resisting

The Un-coerced Situation

• Female

• More educated

• Non-religious (except for Jewish)

• High SES people

– are more like to seek help.

Help Seeking Route

• Family and friends

• Physicians

• Psychiatrists/psychologists

The Coerced Situation

• Loving and gentle (through persuasion)

• Brutal (threats, force, arrests, fired, etc.)

Mental Illness and Disruption

• Family disruption

• Public disruption

Power, Politics, and Forced Asylum

• Family (out of marriage issues)

• State (out of political dissident issues)

• Mental disorder is largely socially defined

• The concept of mental disorder can be used for political gains by the powerful.

Chapter 11: Acting Mentally Disordered

General Issues

• Schizophrenia

• Anxiety

• Depression

Schizophrenia Symptoms

1. Loss of reality
2. Hallucinations (most reported are hearing voices)
3. Delusions (often bizarre in nature)
4. Disorganized thinking and speech (loss of train of thought, to sentences only loosely connected in meaning)
5. Social withdrawal (sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia)
6. Lack of responsiveness.
7. Impairment in social cognition
8. Social isolation
9. Difficulties in working and long-term memory, attention, executive functioning
10. Mute, remain motionless in bizarre postures(uncommon)
11. Exhibit purposeless agitation

Anxiety

• Phobia

• Social anxiety

• Obsessive-compulsive (OCD)

• Post-traumatic stress (PTSD)

Phobia -- Three Categories:

• Social phobia

• Fear of seeing and meeting people

• Social isolation

• Specific phobias: Fear of a single specific panic trigger

• spiders

• snakes

• dogs

• water

• height

• flying

• catching a specific illness

• Agoraphobia: A generalized fear of leaving home or a small familiar “safe” area

• Open space

• Social embarrassment

• Fear of contamination (germs)

Trait and State Anxiety

• Trait – long term and stable

• State – short term and unstable

Measure of State Anxiety: Speilberger STAI State Anxiety

Depression: Definition

Possible Feelings of Depress

• Sad

• Anxious

• Empty

• Hopeless

• Worried

• Helpless

• Worthless

• Guilty

• Irritable

• Hurt or restless

Measures of Depression

• Beck’s Depression Scale

• CES-D

• HAM-D

Depression and Suicide

Chapter 12: The Mental Hospital

General Situation of the Mental Hospital in the United States

• 558,922 residents in 1955

• 54,015 residents in 1997

Problems of Hospitalization

• Depersonalization

• Institutionalization

The Issue of Coerced Hospitalization

Defining Mental Illness: Medical Model

• Objectively measurable

• From within the individual

• Treatable

• No harms from treatment

Defining Mental Illness: Sociological Model

• Subjectively defined

• From social settings as well as biology

• May improve without treatment

• Harms may be from treatment

Subjective Diagnoses: David Rosenhan (1973) Study

• Seven assistants and Rosenhan

• Pseudo-patients in 12 mental hospitals

• Complaining of hearing voices

• They were all diagnosed as mentally ill

• 30% of other patients identify them as false

• Conclusion: mental health workers cannot always tell whether someone needs psychiatric care

Moral Treatment

• Treating mentally ill persons through kindness and through giving them opportunities for both work and play

• Now, custodial care has largely replaced moral treatment

Criticizing Psychiatry

• Erving Goffman (1961)

• Symbolic interactionism

– Being labeled as mentally ill affects individuals’ view of themselves

• Self-fulfilling prophecy

• Total institutions

– Military

– Prisons

– Monasteries

– Mental hospitals (mortification or depersonalization)

Deinstitutionalization: average number of days in confinement

• 1970 41

• 1980 23

• 1992 15

Remedicalization of Mental Illness:Treatment

• Three major categories of medication

– Anti-psychotics

– Mood-stabililizers

– Anti-depressants

• Most psychiatrists now primarily use drug therapies