Stigma and Discrimination: A Socio- Cultural Etiology of Mental Illness (original) (raw)

Editorial: Psychosocial interventions in psychotic illnesses

Frontiers in Psychiatry

Editorial on the Research Topic Psychosocial interventions in psychotic illnesses Evidence indicates that pharmacotherapy is the mainstay of treatment, both in early and chronic psychosis. Despite clinical improvement, many people with psychosis develop disabilities related to domains of negative, physical health and mood symptoms, cognitive dysfunction, and socioeconomic disadvantages, through all stages of psychoses. This implies a key need for psychosocial interventions. Initiation of combined drug and psychosocial treatments plays a significant part in the early phase of psychosis (1). Several meta-analyses have highlighted the need to address the complex health, social, and economic needs of those diagnosed with a chronic and highly disabling illness such as schizophrenia (2). A recent systematic review of recovery-oriented interventions delivered in pro-recovery and non-stigmatizing contexts has been reported to share several critical mechanisms, that propel service users toward recovery (3). This collection of articles aimed to bring together various psychosocial interventions across the course and chronicity of psychotic illnesses. The objective was to understand the innovations and adaptations of interventions both in the early phase as well as the chronic phase of the illness. It was also felt necessary to appreciate the application of these multi-module interventions in real-world settings. This volume brings together various interventions from different parts of the globe. Interventions that are well-established and have shown e ectiveness based on previous evidence Getting persons with psychoses back to work There is a noteworthy relationship between symptoms, cognition, social functions, and employment (4-7). Several social determinants such as income, daily life, housing, Frontiers in Psychiatry frontiersin.org

Severe and Persistent Mental Illness

40 Years of Academic Public Psychiatry, 2007

Individuals treated in public sector community mental health centers often have chronic or recurrent illnesses and diffi culties in housing, employment and social activities that compound one another. Understanding that this complex of clinical symptoms and functional compromise constitute the illnesses we treat, researchers at the Connecticut Mental Health Center (CMHC) described the variability in long-term course and experience of patients as they lived with their illnesses, engaged patients in their own treatment and that of others, and documented scientifi cally the value of an integrated network of clinical and community services. As part of an academic department of psychiatry, the CMHC has provided opportunities for translational research that brings basic neuroscience to bear on community care, and for training researchers and clinicians able to address the complexity of the illnesses and humanity of the patients.

Chapter 4 Welfarist Psychiatry Goes Global

Elsevier Academic Press eBooks, 2020

We begin by describing welfarist psychiatry before outlining the relevant challenges to improving global mental health and explaining how welfarist psychiatry meets those challenges. Welfarist psychiatry Welfarist psychiatry (Roache & Savulescu, 2017) is a theoretical framework for psychiatry intended to replace the current dominant paradigm based on the concept of mental disorder. 1 The American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5) defines a mental disorder as: A syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above (American Psychiatric Association, 2013, p. 20) In welfarist psychiatry, the concept of mental disorder is replaced with the much broader concept of psychological disadvantage (PD). A PD is a stable psychological trait that tends to worsen well-being given the social and environmental context. In contrast to mental disorders, PDs do not necessarily form part of a syndrome, involve no threshold between health and dysfunction, may include socially deviant behaviour, and are not wholly attributable to the individual's 'underlying mental functioning' because they involve a mismatch with the environment. In what follows, we elaborate on the attributes and implications of the concept of PD. PDs are always a matter of degree and involve no distinction between mental disorder and mental health. This entails that each of us has a variety of PDs, i.e. a range of psychological traits that, if enhanced or improved, would increase our well-being. For example, one might be nervous about public speaking, or overly risk averse, impulsive, stubborn, and so on. Most PDs don't undermine our well-being too seriously but, nevertheless, we could all benefit from enhancing our PDs up to the point that further adjustment no longer provided any improvement in well-being. For legal purposes, it may sometimes be necessary to draw sharp dividing lines: between the ill and the healthy, the guilty and the not guilty, those who must be punished by imprisonment and those not, and so on. However, adopting welfarism would help discourage the belief that such lines correspond to ethically or medically significant divisions. By abandoning a conception of 'normal' health, welfarist psychiatry doesn't distinguish between therapies (that aim to raise sub-normal health to normal health) and enhancements (that raise someone's well-being above normal levels). All effective psychiatric treatment of PDs can be considered enhancement in that all interventions aim to enhance well-being whatever the starting point. If we pair welfarist psychiatry with an egalitarian view of distributive justice (as is typical in healthcare), then we have reason to prioritise the treatment of more severe PDs that have a more serious impact on people's wellbeing. Therefore, psychiatric resources would still be weighted in favour of treating more severe PDs (including those that we currently recognise as 'mental disorders') but, where cost-effective, resources would still be channelled towards milder PDs that we may not presently count as disorders proper. PDs are context dependent. For example, the tendency to experience unusually high levels of social anxiety is a relatively severe PD for someone-like a politician-whose lifestyle involves many stressful social encounters but not for someone easily able to avoid such encounters, such as a forest worker. 2 Likewise, in some cases, having a diminished mental capacity can enhance well-being, for example, a decline in the specific recall of traumatic

Welfarist psychiatry goes global

Elsevier eBooks, 2020

PERCEIVED CAUSES AND TREATMENTS OF MENTAL ILLNESS: A HISTORICAL REVIEW

IJRAR | www.ijrar.org | E-ISSN 2348-1269, P- ISSN 2349-5138, 2019

The reviewers conducted a historical review using books and articles published in different databases like PubMed/MEDLINE, PsycINFO, Google Scholar, Scopus(Elsevier), ScienceDirect, JSTOR and so forth. The objectives of the review were to describe the perceptions of the societies towards mental illness and person with mental illness, and to compare and contrast the understanding of the causes of mental illness and the way persons with mental illness are treated and cared at different periods in a different context (country). Mental illness believed to exist throughout the existence of humankind. Throughout history, there have been radical changes in the attribution of the cause of mental illness and the way persons with mental illness are treated and cared. Most of these changes are due to the changing of societal views and knowledge about mental illness. In ancient time, (500BCE), since mystical views dominate the social and natural phenomena of the world mental illness with name of abnormal behavior, mad, crazy, witches, evildoers, lunatics believed to be caused by supernatural phenomena such as spiritual or demonic possessions, sorcery, the evil eye and an angry deity (God or gods) for the wrong act of the person. In the same way, the treatments were mystical and sometimes brutal which included spells cast by Shamans, incantations, exorcisms, and perhaps trepanning. The Middle age did not bring positive developments regarding the understanding of mental illness and its treatments. There was no science and/or reason, only religion explains phenomena. Accordingly, all illness including mental illness was ascribed to the works of devils, witches, and possession by demons as a curse from God or other supernatural power. In modern times, new ideas about the causes and the treatment of mental illness were introduced. It was in modern times, the causes of mental illness began to be viewed from both biological and psychosocial perspectives. Alike, different modern treatments including psychotherapy, asylums, good diet, purges, bleeding, baths/showers, horticulture, emetic for vomiting, gyrator, tranquilizing chair, Dover's powder, modern medicines, and so forth were introduced.

Anthropology of mental illness

Andrew Scull (ed.), Cultural Sociology of Mental Illness : an A-to-Z Guide , Sage, 2014, pp. 31-32, 2014

Madness is a major disorder of social ties and a universal problem for all societies. The formation and transformation of local treatments of madness are therefore a major area of study within social and cultural anthropology. In this perspective, “treatment” should be understood on three different levels. First, as treatment of the problem that madness poses to social order; Second, as treatment of an ailment on the basis of a therapeutic system that can call upon specialist knowledge or not (e.g. a classification, an etiology, a pharmacopoeia, etc.) in order to identify the disorder or to determine its nature and to then provide the appropriate intervention; Finally, as moral treatment of people experiencing madness and trying to find a solution to their state of disorder.

Changes in Mental Illness Understanding and Treatment Throughout Time in the United States

The Review: A Journal of Undergraduate Student Research, 2021

Healthcare professionals have been overlooking mental health for centuries resulting in inadequate care. This paper reviews the progression of mental health care from the 13th century to the present day in order to understand why we are seeing a gap in healthcare. Mental illness is a growing health condition in the United States with nearly one in every five adults experiencing some form of mental illness a year (Parekh, 2018). In order to understand what mental illness is and why it is so common despite the majority of cases being treatable, one must understand the social and historical progression and stigma associated with it. A literature review on the history of mental illness in American was conducted, using the context of social history to understand the general progression of mental illness treatment and care, as well as the impact of medicalization and the stigma individuals have experienced. The current understanding of mental illness and the field of psychiatry is a relatively recent phenomenon. Developments in neuroscience and behavioral and cognitive psychology have led to improvements in the quality of care and treatment methods for those with mental illnesses. However, stigma still persists and clouds society's and healthcare professionals' judgements, preventing the opportunity for the best possible care. In addition to more research, awareness and education on mental health and illness are needed.

On The Liberation of Mental Illness, Or The Revenge of Freud

2021

The mental health system is exactly where the ruling class wants it. A neoliberal political system needed a neoliberal form of therapy for the elites of capitalist society to continue their ideological subjection of the lowest strata of the working class, unemployed and lumpenproletariat. This imposed behaviorist worldview takes the form of an intra-personal therapeutics rather than a social, political, or historical analysis of the conditions which lead to the alienation of the individual in their unique social context. The institutionalization of cognitive-behavioral therapy within psychotherapy is directly opposed to any sort of political program for the liberation of the mentally ill, has no political basis whatsoever, and can hardly be called a “social science” by any stretch of the imagination.

Stigma and Discrimination: A Socio- Cultural Etiology of Mental Illness (original) (raw)

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