Explaining Mental Illness Sociological Perspectives
By Baptiste Brossard and Amy Chandler
Most psychiatrists are aware of the effects of socioeconomic factors on mental health – such as the links between poverty and many mental problems – usually within the “stress paradigm”. Our knowledge of sociology itself is usually threadbare. This gem of a book is a concentrated and fascinating summary of the state-of-the-art sociological theories and knowledge on mental health.
It does not prove its claim that mental health is not about mental health. It does however demonstrate convincingly that we need to understand the conditions that lead to the emergence of what we describe as mental health conditions. As they are distributed unequally within societies, mental health conditions reflect the effects of social positioning (an individual’s position in their society) including intersectionality. Society produces stress and due to the nature of societal structures some have less resources to deal with this stress. The stress paradigm is conceptually and methodologically critiqued. Processes of categorisation of mental health conditions (most obviously the diagnostic classification system) are described with interesting discussion of labelling theory and Hacking’s looping theory. Social and political processes influencing classification are examined. Patients’ sociocultural contexts may be expressed in the form of distorted reactions to them that we describe as symptoms. Throughout the text the meaningfulness of experience and context specific to the individual is emphasised.
Some weaknesses of the book exist. The authors sometimes apply poor quality control to their choice of studies and their conclusions. Anorexia described in one paper as an attempt to ape upper class intellectual lifestyles is one such nadir. It is not a Foucault-obsessed psychiatry bashing exercise but there is some finger wagging at clinicians at times. These are minor criticisms for a concise yet broad in scope introduction to an essential branch of knowledge in mental health. Recommended for all psychiatrists from trainees to veteran consultants.
References
Brossard B, Chandler A. Explaining mental illness: sociological perspectives. Bristol University Press; 2022 Jun 24.
