12.1.1 Learning Objectives

After reading this chapter, you will be able to:

1. Compare and contrast the concepts of mental health, mental illness, and mental well-being.
2. Explain how mental health can be understood as a social problem.
3. Explain why people from different social locations, like gender, race, and class, experience different levels of mental health systems, diagnosis, and treatment.
4. Analyze how the socially constructed identity of mixed race impacts mixed-race people’s experiences of mental health, mental illness, and mental well-being.
5. Explain how mental health and mental illness relate to race and class, particularly in relationship to exacerbating other social problems.
6. Explain how the social structure and behaviors of patriarchy impact the experience of social problems for women and non-binary people, particularly related to mental health and mental illness.
7. Compare and contrast the multiple medical, psychological, and sociological models of mental health and mental illness.
8. Evaluate interdependent solutions using collective action and individual agency to provide effective mental health solutions that expand social justice.

12.1.2 Chapter Overview

I am grateful to my husband Jon who has taught me a new way to live with a severe mental illness.
—Kathryn Burrows

Figure 12.1. Rosalind’s Story: Living with Serious Mental Illness and Alcoholism [YouTube Video]. Please watch this 5:58-minute video. As you watch, please consider how mental illness might complicate other social problems. Transcript

In this chapter, we examine the social problem of mental health, mental illness, and mental well-being. Our human lives contain sadness, loss, excitement, joy, and, especially in the United States, feeling like you are not enough. But what are the boundaries between having a tough week and mental illness? To begin, we’ll read my story about my interactions in a mental hospital.

Kate’s Story

I have a SPMI (severe and persistent mental illness), and needed to be hospitalized because I couldn’t differentiate between reality and fantasy. This excerpt tells part of my story. This story illustrates some of the challenges that people with mental health issues experience while they are in the hospital. Many people* appear in the excerpt:

• Holland is a man in his 30s who has schizoaffective disorder. He was experiencing psychosis and mania.
• Lise is a woman in her 50s who has been addicted to alcohol and other drugs since her teens. She is in the hospital for detox, after which she will go to a residential addiction treatment program.
• Music is a man in his 40s who has schizophrenia. He often forgets his name, and as a result, he changes his name frequently.
• Jim is a man in his 20s who has depression. He is in the hospital because of a suicide attempt.
• Liz is a woman in her 20s who has anxiety and depression. She is in the hospital because of a suicide attempt.

(*All of the names are changed to protect the anonymity of the people.)

Personal Experiences of Stigma and Out-grouping in the Psychiatric Hospital

Encounter 1: “Do you believe in UFOs?”

From my diary: Monday, Day 1, South Unit

Holland and I were standing in line for dinner, and we started talking about our delusions. They are almost exactly the same! We got so excited because finally, for once, we were talking to somebody who believed us and who understood! Holland GETS me. He knows about the things that come over the radio. I know about the signs he gets from church. I am so excited to meet somebody who is like me!

Lise was overhearing us and said, “What do you mean?” Holland explained that there were things going on in the universe that she doesn’t know about, and only special people can know about them. Then Christian broke in and said, “How do you know about this?” I told him I heard it on the radio. Then Jim said, in a totally rude and demeaning voice, “Do you believe in ghosts? Do you believe in UFOs? You can’t believe everything you hear on the radio!” First of all, Jim thought I was talking about FM radio, but you can’t hear anything over FM. I get the messages from Andy’s ham radio at home.

I felt like they were calling me crazy—calling me nuts. Like Lise has been sober for three days, and those other guys are all depressed and Bipolar. Like they have something over us.

Encounter 2: “I can’t believe he’s schizo!”

From my diary: Tuesday, Day 2, South Unit

Today, while I was waiting for our music group to start, Lise and Liz were talking about a conversation they had with Music last night. Lise said, “He was like a normal person! It was amazing!” Liz added, “I can’t believe he’s schizo! I mean, he talked to me totally normally. Do you know he has been married twice and has kids?” “You’d never know he had schizophrenia,” Lise said. “Until he forgets his name!” Liz said, and then they both laughed.

I didn’t know what to do to stand up for Music. I should have. I feel guilty for just letting them sit there and talk about him like that, but I didn’t know what to do. They’ve obviously never met a person with schizophrenia before. They acted like he was a freak. It was horrible.

In this story, you might notice all the things you have in common with the people who are patients. In the hospital, we had to figure out how to talk to people and how to get along. Just like high school, we formed our own groups. Some people were in the in-crowd, and others weren’t.

In this chapter, we use the models of social problems and social location that we have been using all along. We add some new sociological vocabulary — stigma, and total institutions – to understand why “who feels OK?” is a sociological issue.

You may have experienced your own challenge with mental health during COVID-19. Many of us are feeling stressed, lonely, or depressed. We may have even needed to see a counselor for the first time, or we may have found that the ways we usually cope with life didn’t work. But why would we consider this a social problem?

At first blush, mental health appears to be a uniquely personal phenomenon: mental health, mental well-being, and mental illness seem to be intensely private experiences outside the realm of sociological analysis. After all, who but psychologists and psychiatrists are truly equipped to understand mental health and illness? In this chapter, we aim not only to understand the role of sociology in the study of mental health but to gain a deeper understanding of the effects of social life on our mental well-being. You will be introduced to the major concepts and techniques of understanding mental health and illness from a sociological perspective.

This chapter is interdisciplinary. It includes material from many fields. But there is a coherent organizing theme: the need to understand mental illness in a broad social context. Too often, scientists and psychologists study people who have diseases of the mind without regard to their social origins and to the institutions of social control involved in mental illness.

This chapter critically examines how history, institutions, and culture shape our conceptions of mental illness and people with mental health challenges. Mental health and mental illness become a social problem because of the conflict in how people disagree about these ideas. We will consider the social factors contributing to the rates and the experiences of mental illness. By this point in our exploration, you will not find it surprising that social location impacts the social problem of “Who is OK?”

12.1.3 Focusing Questions

In this chapter, we examine the epidemiology of mental health and mental illness to discover how race, class, gender, and other social locations impact how people are diagnosed and treated. We explore how sociologists explain this difference, using concepts such as stigma. Finally, we consider the interdependent nature of mental health and mental illness. These conditions impact individuals, but they also affect families and society. The questions that focus our curiosity are:

1. What is the difference between mental health, mental illness, and mental well-being?
2. How can we understand mental health as a social problem?
3. Why do people experience different mental health issues, diagnoses, and treatments based on gender, race, class, and other social locations?
4. How does the social construction of the mixed-race identity explain social inequality, particularly in relation to mental health?
5. How are mental health and mental illness underlying factors in other social problems?
6. How does the structural oppression of patriarchy impact social problems, particularly related to women, queer, transgender, and non-binary people?
7. How do sociological explanations of mental health and mental illness differ from primarily medical or psychological models?
8. What creative solutions to providing mental health services combine individual agency and collective action to expand social justice?

Let’s find out who feels OK!

12.1.4 Licenses and Attributions for Chapter Overview and Learning Objectives

Open Content, Original

“Chapter Overview” by Kathryn Burrows is licensed under CC BY 4.0.

All Rights Reserved Content

Figure 12.1. “Rosalind’s Story: Living with Serious Mental Illness and Alcoholism ” by California Health Care Foundation is licensed under the Standard YouTube License.

“Kate’s Story” © Kathryn Burrows, 2022 is all rights reserved.