HLTHAGE 2G03 Lecture Notes - Lecture 7: Deinstitutionalisation, Neoliberalism, Moral Treatment

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Lecture 7: Place, Space, and Mental Health
March 5, 2018
Case Study: Halpern’s Housing Estate (1995)
- Great Britain social housing
- Initially, ppl living in these housing estates did not do well on numerous mental
health qualities
o From high suspiciousness, isolation, depression, and anxiety to increased
trust, optimism, hope for future, neighbourhood identification
- They then went in and cleaned up the housing estate and these scores increased
o Depression and anxiety rates in these estates dropped as well
- These changes increased interaction between neighbours
o Settings were not as negative, spent more time outside
- Tells us something about how mental health can be determined and shaped by
environment
o And how environment shapes social behaviour
Mental Health, Mental Illness
- In day to day life we tend to follow a categorical model when discussing mental
health
o Ex: “I have depression”
o Vs. the dimensional model that acknowledges that numerous aspects
impact mental health specific to the individual creates a spectrum of
disorder
Varying degrees of emotional and behaviours
- Example research study: is depression linked with poverty
o Assumes that everyone who does not have depression is mentally healthy
(ie. if they don’t meet the criteria for depression, they are “healthy”)
o Should we/how do we describe someone as mentally healthy
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Wellbeing
- Feeling good, positive emotions
o Happiness, security, sense of control over destiny
o Assumes that negative emotions are not wanted and that we do not
want/need them… which is problematic
- Functioning well (inherently social)
o Connecting to others, meeting needs
- Social support as a protective factor in mental health
o When a person’s community or social network offers instrumental or
expressive support
o Instrumental support (ex: financial support)
- How do space and place impact mental health/wellbeing?
Space, Place, and Mental Health
- Is mental health a reflection of internal characteristics or the broader external
social environmental factors?
- Both physical environment and theorized place
o Space = physical area
o Place = theoretical area (meaning that we have ascribed to an area)
- Space/place particularly important when thinking beyond strict notion of MH as
an individual concern
- Researchers: we underestimate extent to which MH is affected by surrounding
o Ex: moral treatment
Urban Environment
- Rise of urbanization (19th, 20th c.) comes hand in hand with the rise of psychiatry
and MI
- Why?
o Density: more ppl sharing the same space more tense, sharing of
resources, too many interactions, etc.
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o Surveillance: more ppl to notice if someone’s behaviour is acting off (i.e.
more reporting
In a smaller pop. there tends to be more tolerance
o Economic stratification: only the rich can afford to live in certain housing
areas divide of economic classes
o Development of “social problems” (ex: homelessness, drugs, violence)
Frequency far greater in urban environments
o “Concrete jungle”: instead of being surrounded by green spaces, we are
surrounded by concrete
- Mid-late 20th c. shift towards sub-urbanization
o In response to problems associated with urbanization
o More nature, less stratification, more space, etc.
- These shifts have reverberated through mental health, subject to intense debate
Economic Stratification
- Class is not only associated with income
o Also associated with education, behaviours, ideas, goals, culture, etc.
- Class is inversely related to almost every type of major mental disorder
o i.e. low classes have higher rates of MI
o exception: eating disorders
- Class impacts MH in both acute (e.g. violence) and chronic (e.g. stress) fashion
o Lower class open to more stress and around more violence
- Individuals with schizophrenia are far more likely to be found in city centres (even
more in low income areas) than in rural areas
o Rates of depression higher in neighbourhoods of social and material
disadvantage
- Beyond official disorders, several mental health effects noted through urban
living…
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Document Summary

Initially, ppl living in these housing estates did not do well on numerous mental health qualities: from high suspiciousness, isolation, depression, and anxiety to increased trust, optimism, hope for future, neighbourhood identification. They then went in and cleaned up the housing estate and these scores increased: depression and anxiety rates in these estates dropped as well. These changes increased interaction between neighbours: settings were not as negative, spent more time outside. Tells us something about how mental health can be determined and shaped by environment: and how environment shapes social behaviour. Feeling good, positive emotions: happiness, security, sense of control over destiny, assumes that negative emotions are not wanted and that we do not want/need them which is problematic. Functioning well (inherently social: connecting to others, meeting needs. Social support as a protective factor in mental health: when a person"s community or social network offers instrumental or expressive support.

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