What Social Factors Can Contribute To Mental Illness?

A mental illness is a psychological abnormality of an individual, and significantly affects the individuals emotional stability. There are different types of mental illnesses with different degrees of severity such as; depression, anxiety, eating disorders, schizophrenia, bipolar mood disorder and personality disorder. When a person develops a mental illness, emotions can be so overwhelming that they develop an inability to cope with everyday activities such as: work, socialising, and maintaining a relationship. In extremity, people who suffer from depression may find it difficult to physically care for themselves, or leave their home. The less common mental illnesses may involve psychosis; these include bipolar mood disorder and schizophrenia. People experiencing these types of psychosis lose their sense of reality, feelings and the world surrounding them. A psychotic episode may involve delusions and/or hallucinations which can confuse or threaten the individual’s peers. (Sciencemuseum.2012) This essay will explore the social factors that can contribute to mental disorders, it will analyse the three dominant theories: the stress theory, social structure theory and the labelling theory. It will explore each theory in turn and look at the research, assumptions and criticisms.

The sociological approach looks at the environmental or social factors, which are external to an individual. It suggests that, these factors can cause an overwhelming stress; leading to a breakdown in mental health. (Horwitz & Scheid 1999:121) The stress theory is derived from the notion that when social stressors are accumulated, mental health problems are more likely to occur. The term “stress” or “stressors” was introduced in the mid 1930’s by a physiological researcher, Hans Selye. When using these terms it is meant that stress is anything that causes the body wear and tear. Selye used laboratory animals to experiment; the stressors he used were extreme hot and cold temperatures, overcrowding of the animals in cages, and electric shocks. (Horwitz & Scheid 1999:122). This experiment showed that when animals are exposed to such stimuli, they show three stages of reactions known as general adaptation syndrome (G.A.S). The first stage of reaction was ‘flight or fight’, the animal becomes aggressive and ready to fight or retreat from the threat. In the second stage, the animal reacts with resistance; regaining equilibrium, it continues to combat the effects caused by the stress. The final stage is exhaustion; the body’s ability to defend itself becomes depleted leaving the individual more susceptible to infection or disease. Selye’ experiment proved a link between prolonged exposure to stress and illness. In the years to follow the research began to focus on the effects of stress in humans and social stressors (mainly major life events) (Horwitz & Scheid 1999:122)

Researches regarding major life events were carried out by Thomas Holmes and Richard Rahe. They defined major life events as: external changes which occur in people’s lives and require them to make major psychological adjustments. They proposed that increased amounts of readjustments could cause exhaustion of the ability to cope; this would cause the person to be at a higher risk of illness. Holmes and Rahe devised a life events checklist with 43 life stresses that may cause a person to make adjustments. The checklist was named the Social Readjustment Rating Scale (SRRS) Each event on the checklist was called a Life Change Unit (LCU), with a different ‘weight’ for each type of stress. The more events the patient added up, the higher the score became. The higher the score meant the larger the weight of each event; this made the individual more likely to become ill. (McLean & Link 1994:162) The checklist allowed social researchers to determine whether being exposed to social stressors could cause a breakdown in a person’s health. The problems with Holmes and Rahe’s SRRS are that there were many major life events missing from the list, such as: exposing one’s homosexuality and losing custody of a child. It also assumes that both positive and negative life events cause behavioural adjustments, leading to overtaxing one’s ability to cope. Later research found that negative life events had a more severe impact on individual’s psychological health than positive life events. (Ayers.S 2007:131).

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After years of research into the mental health effects of stressors, considerable variations have been found. There are three dominant approaches to explain these variations. The first approach looks at the stressor itself and examines its characteristics. When looking at the characteristics of the stressor and familiarising with Holmes and Rahe’s SRRS, there is a clear indication of the difference in the severity of affect for negative life events. Each event can vary in how stressful it is or how it affects a person emotionally; this is because of the differences in their desirability, predictability, controllability or their magnitude. (Thoits 1983:33-103) Research shows that the undesirable or uncontrollable events are the ones which have a greater detrimental effect. (Ibid). Although the first approach was originally designed to categorize the different ways that stressful situations effect people psychologically, what it actually helped to do was establish that different types of stress manifest in different ways. For example, work or family based issues, effect people differently to financial problems or illness. Furthermore, the different characteristics of each instance in life alter how it affects the mind. So, the timing and circumstances surrounding a life event make a difference to how a person copes and any long term effects it will have.(Ibid).

In contrast, the second theoretical approach focuses on the characteristics of the person who is experiencing the stressor. Variations in the effects of stressors, is a function of variations of a person’s vulnerability or how they react to stressors. There has been a lot of research on coping and social support. When a person is dealing with negative stressors they rely upon social and personal characteristics, also known as ‘coping resources’. (Perlin & Schooler 1978:2-21) The social and personal characteristics can be found in an individual’s social network, this is where the individual will seek emotional or practical support. Such support systems can raise a person’s self esteem, and help them to stay in control. Research examines to what extent individuals or groups vary in how much personal or social resources they possess e.g. self esteem, mastery and social support.(Ibid) The research indicates that the more of these resources people have, the greater the negative impact of stressful life events are buffered. Overall, the studies carried out for this approach signify that people who have strong coping resources and have access to functional, structural and emotional support have the advantage of being able to tackle the psychological consequences of stressors, easier than those whom do not have personal or social resources.(Ibid)

Lastly, the third theoretical approach attributes variations in psychological harm caused by stressful life events to variations in the larger social context surrounding stressors. Advocates of this approach argue that when an event or strain occurs, the social circumstances are important for explaining variations of their psychological effects. This is because they form the personal meanings and emotional significance of the stressors. Blair Wheaton (1990:209) shows that; a role loss such as divorce is often less distressing to individuals who have experienced a lot of marital stress, than for those who have a less stressful marriage. A similar study by Deborah Umberson (1987:306) indicates that widowhood brings more depression to people who suffer from household and financial strain than those who do not experience these stressors.

The stress theory is well suited for the purpose of explaining why lower class people are more likely to have a mental illness than middle or upper class people. (Horwitz & Scheid 1999:128) However, the theory is non – specific for example, it does not explain how some groups are more susceptible to certain disorders than other groups such as: depression and anxiety are mostly experienced by women, and men are more susceptible to anti – social disorders. (Ibid) Furthermore, this theory does not apply to all mental disorders such as psychoses: a very complex and serious disorder, which is better explained by biological explanations or ones childhood socialization. Price et al (1988) show experiments which indicate that interventions which alter an individual’s coping strategy and offer social support and encouragement, do reduce negative emotional reactions to major life events. Therefore, the stress theory is a promising tool for administering mental health interventions. (Horwitz & Scheid 1999:129)

A blanket term used to describe more specific sociological theories regarding mental illness etiology is ‘structural strain theory’; which looks at the broader organizations of society and finds the basis of distress, and where some groups are at a disadvantage when compared to others. (Ibid) A useful example of structural strain theory is Merton’s (1938) anomie theory; this theory attempts to explain criminal behaviour, rebellious behaviour, addictive behaviour, as well as mental illness. Merton uses the American society to explain his theory, he argues that the American culture highly emphasize how wealth and success are the most important values an individual can posses. They are taught that the highest goal in life is to strive for success, with education being the key means to achieve economic success. Merton’s assumption is that most people agree that education is the most legitimate route to achieving success. There is a majority of the society who unfortunately have their means to success blocked. (Horwitz & Scheid 1999:130)These groups live in neighbourhoods which are poor and lack school facilities and competent teachers. Thus, they lack encouragement, preparation and funding for progression onto higher education. This causes class and race based discrimination within the schools and the workforce, leading to a defeat in efforts made to succeed when attempting to follow the legitimate paths.(Ibid)

Merton’s use of the term anomie describes a gap between the desire to be financially successful and the means of entry to acceptable education or employment. He argues that individuals who experience the gap will adapt by changing their goals or looking for alternative means. Merton described 5 adaptive responses, which are; conformity, ritualism, innovation, retreatism and rebellion (Morine.N:2009). The people who conform follow rules shared by the cultures goals, and carry out legitimate means to achieve them. Even if they are doubtful that their efforts will pay off. Ritualists give up on achieving success. However, they continue to behave in a socially acceptable manner; for instance working steadily in a job with low income and low prospects. The conformist’ and ritualist’ do not cause society many problems. Whereas, the innovator’, retreatists’ and rebels cause major problems for society. (Ibid)This is because: innovators give up on success, but they still desire wealth and use illegitimate means to achieve it such as; committing fraud or tax evasions. Retreatists also give up on success and retreat from the world surrounding them into substance abuse or become mentally ill.(Ibid) Rebels use threatening behaviour to achieve success, they reject socially acceptable goals and create new goals with new ways of achieving them such as; being involved in riots or social movements (Ibid). The main point of this analysis is to show how mental illness is a reaction to environmental demands and the result of an individual’s legitimate pathways being blocked; due to the hierarchical or structure of society causing a disadvantage for some social groups. (Ibid)

Most structural strain ideology of mental illness suggest that, macro strains in social and economic systems can cause increased rates of mental illness for certain groups. (Horwitz & Scheid,1999:131) Emile Durkheim (1897) analyzed the social factors which can cause suicide; he found that the distributions of suicide within and across societies were unequal. Durkheim argued that the social integration of groups and societies differ. People are bound together by the balance of shared norms. These norms regulate a person’s passion and maintain the ties to one another; in order to prevent unreasonable behaviour from acts of passion or emotional impulses. If a society is too weakly, or too strongly integrated, or are subjected to rapid changes it can cause conditions of structural strain.

There are two main assumptions of this theory; the first is that, minority groups, women, the poor, unmarried people and the elderly are all at a socioeconomic disadvantage.(ibid) The second assumption is that high rates of mental health breakdowns are caused by the socioeconomic disadvantage. In comparison to the stress theory, the structural strain theory is better suited for explaining that mental illness is not distributed randomly in society, rather it is closely linked to socially or economically disadvantaged groups of society.(Ibid) It conveys that, the structure of society itself could contribute to the epidemiology of mental illness. The stress theory does not fully capture this idea and biological and psychological theories bypass it altogether. The disadvantages of the structural strain theory are that, structural theorists do not present how the broad social structures and socioeconomic trends are actualized in individual’s lives. They also tend to give priority to economic factors and disregard other large scale changes such as, poor quality family relationships (absentee fathers, increased divorce rate and child or spouse abuse) which could affect mental health. (Horwitz & Scheid 1999:132) Therefore, it is unclear of how the macro social trends cause psychological distress. It is not only socioeconomic disadvantage that are sources of stress, but interpersonal relationships can also be a contributing factor. It is interesting to note that, the structural strain theory has the same basis as the stress theory. The concept that the stress theory is essential to support the structural strain theory makes this theory weak.(Ibid)

The societal reaction theory (labelling theory) is similar to the structural strain theory in the sense that they both offer a unique sociological explanation for the cause of mental illnesses; it is often referred to as the radical sociological explanation. The fundamental idea of the labelling theory is how the identity and behaviour of an individual can be influenced by how they are described and categorized by others in the society. (Pilgrim & Rogers 1999:13) The theory looks at the linguistic tendency of a majority to negatively label those perceived as deviant from the shared norms, and is connected with the idea of a stereotyping and self-fulfilling prophecy. As a use of phenomenology, the theory speculates that the labels which can be applied to an individual can influence their behaviour. In particular, the application of stigmatizing or negative labels such as: ‘criminal’ can promote deviant behaviour and therefore becomes a self-fulfilling prophecy. Consequently, the labeling theory assumes that social deviance can be prevented by using a social shaming reaction and replacing moral anger with tolerance.(Ibid)

The labeling theory has been closely linked to the mentally ill. In 1966, Thomas Scheff published his writings: Being Mentally Ill. Scheff questioned the common perceptions of psychological disorders by declaring that mental illness is exhibited entirely as a result of societal influence. Scheff disputed that society perceives certain behaviour as deviant, and certain expectations are then placed on the individuals. Over a period of time this will unconsciously alter the individual’s behaviour; in order to fulfil the expectations. The criteria given for different mental disorders are not always filled by the people who are diagnosed with them just because they all suffer from the same disorder. Scheff believed they are simply fulfilled due to the ‘mentally ill’ being led to presume they are supposed to conform and act in a certain manner and eventually they do. (Pilgrim & Rogers 1999:14)

Scheff received multiple criticisms for his theory; the most notable critic is Walter Gove. (Pilgrim & Rogers 1999:15) Gove has frequently argued an almost opposite of his theory; he feels strongly that society has very little influence on mental illness. Instead, he argues that any societal perceptions of people who are mentally ill are derived as a result of the individual’s behaviour. Gove’s ideology is that, the mentally ill behave uncommonly due to their disorders, so they come to be treated as being ‘different’. Most of the sociology theorists view labeling and mental illness between the extremes of Scheff and Gove. It is difficult to deny, given both research findings and common sense; that perception society gives to ‘crazy” people has had a detrimental effect on them. Realistically, it seems that labeling can accentuate and perpetuate a mental illness. However, it is rare that it is the complete cause of the symptoms. (Ibid)

Each of the sociological theories can be integrated. For example, structural strain theories have indicated that risks for certain social groups are created by the way in which societies are organized. (Horwitz & Scheid 1999:137) The stress theory can assist in helping to bridge the gap between micro and macro structure, by giving an explanation of how structured risks are actualized as stressful events in people’s lives(Ibid) Also, the stress theory suggests that accumulation of strains and life events can overwhelm an individual’s psychosocial resources and their ability to cope; thus leading to mental illness. This is similar to primary deviance in the labelling theory’s terms. (Ibid)

In conclusion, there has been a lot of research to prove a link between sociological ideology and mental illness. The stress theory proves how the more an individual is subjected to major negative stressors; the higher risk they have of psychological breakdown (flight or fight). Also, it indicates how an individual’s coping resources can assist with overcoming psychological breakdowns (resistance) and lastly, how overwhelming exposure to stressors can cause exhaustion and a breakdown of an individual’s mental state (exhaustion). (Horwitz & Scheid 1999:122). The structural strain theory focuses more on society as a whole and determines which groups are more susceptible to mental illness. Groups of low social status, living in poor and disadvantaged areas are more susceptible to unemployment, being victims of crime etc and are more likely to become involved in illegitimate means to success or mental illness. (Horwitz & Scheid 1999:130) The labelling theory then explains how the individuals who suffer from mental illness as a reaction to overwhelming stressors and/or being disadvantaged due to hierarchical or society’s structure are then stigmatized and unfairly stereotyped. (Pilgrim & Rogers 1999:13) It also shows a link that those who receive the label find it difficult to remove the label and often causing the individual to become entrapped with no other choice but to act in the way that they are ‘meant to’. (Ibid)