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Chapter 21

HLTA02H3 Chapter Notes - Chapter 21: Labeling Theory, Medicalization, Psychoactive Drug


Department
Health Studies
Course Code
HLTA02H3
Professor
Michelle Silver
Chapter
21

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Health, Illness, and Health Care in Canada
Chapter 21: Mental Health Policy in Canada: What’s the Problem?
INTRODUCTION
An illness care system in Canada is a weakness in the health
care system
Illness care system in Canada is more or less of an effective
means to deal with acute injuries and illnesses but less adequate
in terms of providing solutions for chronic and degenerative
health problems that currently predominate in Canada
20% of the Canadian population suffers from health problems,
and 2% of these suffer from severe mental illnesses; both the
number of cases and those who receive treatment have been
increasing over time
The CIHI have recently reported a decrease in the number of
mental health services utilized in hospitals; could be due to the
refinement of psychiatric mediations and the development of
community-based services which have contributed to the
decrease in the numbers that receive psychiatric care in
hospitals
Many people are not admitted to the hospital for treatment of
their mental health problems
More than half of all psychiatric patients are treated in primary
settings; family physicians are most often the source of help
manage roughly 80% of all mental health problems
50-75% of people do not seek help for their mental health
problems; those who seek help often do so from non-medical
health professionals
Total costs of mental health problems are difficult to measure:
indirect/direct costs, non-institutional treatments; hospital costs
for mental health disorders have increased
Mental health care system seems to be overwhelmed and
incapable of effectively dealing with these problems
THE SOCIOLOGY OF MENTAL ILLNESS AND MENTAL HEALTH
In Western societies, the solution to the problem of what to do

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with individuals labeled deviant has evolved through a series of
steps from religious, to legal, to medical forms of management
and control
Medicalization of social control is thought to taken place between
the 18th and 19th centuries
The confinement of the mentally ill in mental hospitals remained
the dominant solution to the problem until the 1960s
Psychiatry had undergone major changes during this time, but
little agreement is present concerning wither the causes or
consequences of those changes
oAdvances in modern medical science resulted in the
discovery of new and true knowledge about the nature
and causes of mental illness; scientific understanding
replaced ignorance, superstition, and myths and led to
new forms of medical treatment to replace ineffective and
inhumane methods previously used
Mental hospitals were more like prisons rather than hospitals
Transition from mental hospital to community psychiatry was a
triumph of science and humanitarian concern, the final
realization of which was made possible by the discovery of
powerful psychotropic drugs
The demise of the mental hospital and rise of community
psychiatry is best understood as the substitution of one form of
social control for another which is neither more humane or
scientifically justified from what preceded it
oBest described using politics and economics, to reduce
costs
Szaz proclaimed that mental illness was a myth and that
psychiatric treatment (especially involuntary treatment) was a
form of torture; anti-psychiatry
Anti-psychiatry has the belief that the primary function of
psychiatric diagnosis and treatment is the social identification,
classification, and control of deviance; anti-psychiatrists agree
that person diagnosed and treated as mentally ill have problems,
but disagree about the nature of the problems
Szaz argues that problems that are currently being diagnosed
and treated as medical problems by psychiatry and really
psycho-social problems and that these problems should be
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solved in living by those suited to doing so (social workers,
psychologists, non-medical psychotherapists)
In another branch of anti-psychiatry, Laing and Esterson believe
that people labeled as mentally ill are neither ill nor are their
putative problems in living the primary problem; they are
reacting to the maddening social reality in a sane and rational
fashion; the problem is not the individuals who refuse to conform
to social demands and expectations, but rather the health-
destroying and soul-deforming demands of modern social
institutions, particularly the bourgeois family and the capitalist
economy
The mental patient’s/consumer’s right movement emerged
alongside the rise of psychiatry; efforts to medicalize psychiatry
resulted in many of the mentally ill being given the same rights
as other patients (right to informed consent, right to receive
treatment in least restrictive environment, right to refuse
treatment, etc)
Extension of rights alter doctor-patient relationships; patients
became consumers of treatment with their rights
Mental patient’s liberation movement/psychiatric survivor’s
movement maintains that professionally provided mental health
services, whether medical in nature or not, are oppressive forms
of social control; movement is not homogenous in memberships
and ideologies; common commitment is the development of self-
help alternatives to professional provided treatment, and the
securing of full citizenship rights for individuals labeled mentally
ill (supported to anti-psychiatrists)
Women are more likely to be diagnosed with a mental disorder
compared to men
Low class position is a consequence of mental disorder, not a
cause; downward drift hypothesis suggests that people with
mental disorders are unable to function effectively in
occupational and other social roles downward drift into the
lower classes; mental disorder limit their ability to achieve
upward social mobility
Theorists understand mental disorders in terms of various
psycho-social problems with living
Suggested that marginalized groups experience greater stress in
their lives; higher levels of stress are related to a general
condition of social powerlessness
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