The Biological Basis Of Mental Illness: To What Degree Is Mental Illness A Social Phenomenon?
Some people, including professional psychiatrists, have argued that mental illness is not real but a myth. While sociologists may find such a standpoint in line with the sociological way of thinking, recently, psychiatrists and neurologists have tried to demonstrate the biological nature of mental illness. So, in what sense is mental illness a SOCIAL phenomenon?
In the current discourse surrounding mental health, the nature and conceptualisation of mental illnesses emerge as a highly debate topic. This essay intends to explore the complex dynamics of mental illnesses, particularly scrutinising the perspective that these illnesses are influenced not solely by biological elements like genetics and brain chemistry, but also significantly shaped by social factors, positioning them as a social phenomenon. The debate probes whether mental illness is inherently shaped by the cultural and social contexts, thereby mirroring the values, beliefs, and norms of a society. This essay will contend that although the positivistic biomedical model, which emphasises the biological bases of mental illnesses, holds merit, it is essential to underscore that mental illnesses are profoundly influenced by social and cultural factors too. This includes the variation in how different societies perceive, classify, and address mental health conditions and the influence of societal norms, values, and structures on the experience and expression of mental illness. Further, the essay will look into the environmental impact on mental health, drawing on theories such as Merton's "Strain Theory" and "Stress Theory" to demonstrate how mental illnesses extend beyond simple biological explanations and underscore the significant role of social and environmental factors.
The initial argument in this discussion asserts that societal influence plays a significant role in shaping mental illnesses. This view challenges the traditional perspective that mental illness is purely a biological phenomenon, highlighting its nature as a social construct. According to this stance, the cultural context in which an individual exists greatly influences how mental illnesses are perceived, labelled, and consequently manifested (McCann, 2016). This approach diverges from the model established by the World Health Organisation (1992), which suggested that the diagnosis and experience of illnesses were consistent within specific cultures. This perspective overlooks the impact of unique social constructs inherent to each culture, which substantially shapes an individual's understanding, labelling, and experience of mental illnesses, thereby affecting their behaviours (Hassim, Wagner, 2013). Consequently, people from differing cultural backgrounds may exhibit similar behaviours but manifest them in ways consistent with their culture's perceptions and understanding of a particular illness, regardless of the illness's biological origin or cause (Hassim, Wagner, 2013).
Elaborating on this concept, the study of mental illnesses, notably in this case schizophrenia, through cultural comparisons provides strong evidence that mental illnesses can broadly be understood as a social phenomenon. This was strongly evidenced as noted in the paper, “Is Mental Illness Socially Constructed” by McCann (2016), which underscored initial World Health Organisation findings, revealing notable variations in mental illness manifestations across differing cultures, despite standardised diagnostic criteria. The study indicated that patients in developing countries, namely Columbia, India, and Nigeria, exhibited less severe symptoms compared to those in developed countries (World Health Organisation, 1979). The differences in mental illness symptoms between developed and developing countries suggest that more than just biological or clinical factors are at play in the experience and expression of mental illnesses (McCann, 2016). This disparity arguably points to the influence of varied societal beliefs and attitudes towards mental illnesses in different countries, indicating a strong cultural component in how these conditions are perceived, managed, and thus manifested. In developed nations, schizophrenia is often seen as a chronic condition with a biological basis, whereas in developing countries, it is viewed as a condition with external causes and potential for a cure (Waxier, 1979; Eisenberg, 1988). This difference in perception highlights the role of societal attitudes in influencing the labelling of mental illnesses and the expectations for recovery, which can ultimately affect patient outcomes (McCann, 2016). Expanding on this, the Western perception of mental illnesses often suggests that these conditions are intrinsic and incurable flaws within the individual rather than external, treatable issues (Waxier, 1979; Eisenberg, 1988). This specific cultural understanding can lead to feelings of hopelessness or resignation among patients.
Consequently, individuals labelled with mental illnesses in developed countries may start to conform to this “deviant” label, reinforcing the societal stigma associated with their condition (Becker, 1973). Therefore, this phenomenon can perpetuate negative behaviours and create a self-fulfilling prophecy, where the individuals embody the expectations associated with their label. In contrast, in developed countries where schizophrenia is viewed as a curable, external issue, there is often a more optimistic and proactive stance towards treatment and recovery. The consequence of this latter definition and social perception around mental illnesses in developing nations means that there is less stigmatisation around mental illnesses. Individuals may be more likely to seek help without fear of social ostracism, and communities might be more supportive, understanding mental illness as a condition influenced by a variety of external factors rather than a personal failing. This more holistic understanding can lead to more community-based and culturally sensitive approaches to illnesses, emphasising the importance of social support and environmental factors in both the onset and recovery process of mental health conditions. Hence why, in developing countries, specifically within the context of schizophrenia, the manifestation of this mental disorder is less severe.
These divergent perspectives underscore the significance of societal reactions to "deviance". They suggest that societal reactions and labelling play a crucial role in shaping an individual's behaviour and identity, thereby influencing the varying degrees of severity observed in mental illnesses. In the context of schizophrenia, the rigid stance of developed nations that view mental illnesses as a chronic, biological impairment creates a feedback loop (Becker, 1973). This cultural labelling can escalate emotions and feelings of alienation in individuals, leading them to internalise this label. Thus, this internalisation can exacerbate initial emotions, causing further detachment and possibly leading to a more chaotic or suppressed emotional state. This may drive these individuals to withdraw socially, creating a self-fulfilling prophecy that deepens their alignment with behaviours or symptoms associated with the label, further perpetuating societal views of them as mentally ill or deviant (Becker, 1973). This labelling process indicates the differing ways as to how labels – in which vary culturally – can influence the manifestations and outcomes of a specific illness, regardless of the underlying biological cause, thereby revealing the nature of mental illnesses as a social phenomenon.
These interpretations challenge the notion that mental illness is solely a biological or neurological issue, highlighting the importance of social and cultural contexts in defining and labelling mental health conditions, which have tangible impacts on the outcomes and manifestations of these mental illnesses, thus revealing the nature of mental illnesses as a social phenomenon.
To add to the prior points, the ensuing discourse endeavours to substantiate the assertation that mental illnesses transcend mere biological determinism, asserting instead a profound influence exerted by social dimensions, with a particular emphasis on environmental determinants. This perspective elucidates an intricate interplay between an individual’s genetic constitution and their socio-cultural context. Such a standpoint underscores the notion that mental illnesses are, in substantial measure, deeply rooted in societal contexts, thus reinforcing the notion of mental illnesses as a social phenomenon.
Environmental factors, as showcased by Marsella and Yamada (2010), serve as critical frameworks, shaping our perception and interaction with reality. While the biological underpinnings of mental illnesses are incontrovertible, an exclusive focus on neurological pathology fails to acknowledge the paramount influence of environmental contexts. These contexts not only mould our cognitive experiences but also extend their reach to the neurological level, influencing synaptic processes and functions, thus reflecting the complex interplay (Marsella, Yamada, 2010; Heinrichs, 1993). It is evident that phenomena such as social turmoil, acts of violence, and the ravages of war, along with a myriad of life stressors, undoubtedly imprint themselves upon the human brain (Marsella, Yamada, 2010; Heinrichs, 1993). Central to this argument is the notion that the influence of environmental factors is paramount in sculpting our comprehension and engagement with the world around us. Further, this process of socialisation establishes mental frameworks that are instrumental in guiding individuals in the interpretation and navigation of their surroundings, thereby shaping their cognitive and emotional landscapes. Importantly, however, these templates are not merely static but are continuously influenced and modified by the cultural contexts in which an individual lives (Marsella, Yamada, 2010). The central point here is that whilst it is clear that mental illnesses often have a strong biological underpinning, the focus solely on brain pathologies can overlook the significant impact of one's environment and experiences. The context in which individuals live can profoundly impact the brain's development and functioning. This influence extends to how the brain processes and responds to various life stressors and events. Moreover, this evidence suggests that the brain's structure and functioning are not only determined by biological factors but are also shaped by the experiences and stresses encountered in one's life.
Expanding on this point further, it becomes imperative to expand upon the question as to why mental illnesses are not solely the progeny of biological determinants, but are also substantially moulded by social factors. In this context, the theory of “Stress”, intricately connected with “Strain Theory”, emerges as a pivotal concept which specifically addresses the ramifications of social stressors, including significant life alteration. Such stressors, when encountered persistently or repeatedly, markedly increase an individual's susceptibility to both physical and mental ailments, as posited by Thoits (2012). Moreover, other research on stressors revealed a profound link: namely, sustained exposure to stressors can profoundly overburden an individual's capacity for adaptation and coping (Holmes, Rahe, 1967 ). This, in turn, heightens their vulnerability not only to mental disorders but also to various physical health issues, thereby underscoring the interplay between mental health and social stress factors.
Holmes & Rahe (1967) embarked on an investigation by examining medical records of Navy personnel to pinpoint significant life changes that led to hospitalisation and medical consultations. This exploration culminated in the identification of 43 “Major Life Changes” or stressors, offering a practical instrument to access the implications of social stressors on human health. Subsequent research further cemented a clear correlation: namely, the greater the quantity and severity of life events – known as stressors – experienced by individuals over a specific period, along with their corresponding readjustment scores, the higher the likelihood of them suffering from injuries, illnesses, or even experiencing increased mortality rates (Cooper, 2005). The central point relevant to the following essay is that building upon these studies, hundreds of subsequent researchers have consistently demonstrated the significant relationship between the extent of life changes a person undergoes and various illnesses. This, too, is applicable to mental health, confirming the notion that major life changes, known as stressors, have been substantially linked to the emergence of psychological distress (Thoits, 1983). Therefore, it can be inferred that an accumulation of social stressors may act as a catalyst, precipitating mental health issues.
Subsequent investigations further reinforce this perspective. A notable example is the study by Brown & Harris (1978), who conducted comprehensive interviews with 460 women from Camberwell, a suburb in London. Their object was to ascertain whether these women met the criteria for major depression and to pinpoint the onset month of this condition. The study revealed that about 15% of these women were clinically depressed at the time of research. Brown and Harris (1978) categorised "severe" life events as substantial, long-lasting negative experiences that are universally recognised as detrimental to personal well-being. Their findings showed that these severe events had a higher predictive value for the onset of major depression compared to "non-severe" events, which encompassed minor negative or positive incidents. Furthermore, they noted that ongoing difficulties or chronic strains, such as living in overcrowded conditions, enduring continuous family conflicts, and facing financial challenges for basic needs, were almost as predictive of depression as severe negative events. The implications of their research were striking: 89% of the women diagnosed with depression had encountered one or both types of stressors in the preceding nine months. In contrast, only 30% of the women who were not depressed experienced such stressors. This stark difference highlights the profound impact of both severe and chronic stressors on mental health, particularly in precipitating conditions like depression (Thoits, 1983).
Consequently, Brown and Harris (1978) deduced that both acute negative events and long-term challenges significantly increase the risk of developing major depression. This suggests that both acute incidents and chronic strains, necessitating continuous or daily behavioural adjustments over prolonged durations, are instrumental in triggering a spectrum of mental illnesses ranging from mild to severe. According to stress theory, the relatively modest correlation between stress exposure and symptomatology is attributable to the fact that many individuals possess robust coping resources and implement efficacious strategies for stress management, thus attenuating its detrimental psychological impacts (Pearlin, Schooler, 1978). "Coping resources" are defined as the social and personal assets that individuals draw upon in the face of stressors, a concept elaborated by Pearlin and Schooler (1978). Importantly to this argument, a pivotal social coping resource identified in this context is social support, encompassing emotional, informational, or practical assistance provided by key relationships, such as family and friends, in navigating stressors. The critical element here is the variance in individual susceptibility to mental health issues, influenced by factors such as the absence of social support, limited control over their life circumstances, or the lack of effective coping mechanisms (Pearlin, Schooler, 1978). These variations underscore the complex interplay between external stressors and individual resilience or vulnerability in the face of mental health challenges.
Sociologists of mental health have noted that life events, chronic strains, and coping resources like social support, self-esteem, and mastery are unevenly distributed across the population. This uneven distribution makes certain groups (such as women, the elderly, the young, the unmarried, and those with low socioeconomic status) more susceptible to experiencing stressors and their effects (Thoits, 2012). These findings emphasise the significant role of social factors in the development of mental illnesses and psychological distress, thereby disputing the fact that mental illnesses are just a product of biological factors (such as genetics or brain chemistry) but instead arguing that it is also significantly influenced by social factors. This also helps explain why lower-status, disadvantaged groups experience higher rates of mental disorders and psychological distress, as these groups are more likely to encounter stressors and lack essential coping resources.
In conclusion, the discourse on mental illness as a social phenomenon uncovers the inseparable relationship between societal factors and mental health, an area which is overlooked by the biomedical model. This essay has rigorously established that while the biological underpinnings of mental illnesses are undeniable, the role of social and environmental factors in shaping the perception, labelling, and, thus, by extension, manifestation of these conditions is equally crucial. Further, the exploration of diverse cultural contexts reveals how societal beliefs, values, and norms can significantly influence the way mental illnesses are understood and expressed. Moreover, to add to this argument, the significance of environmental stressors points to the undeniable influence of life events and chronic strains on mental health. These findings challenge the reductionist view of mental illnesses as mere products of biological determinism. In summary, the aforementioned arguments compellingly demonstrate that mental illnesses transcend mere biological impairments, highlighting their profound character deeply rooted in social and cultural contexts, thus evidencing the notion that mental illnesses are a social phenomenon to a large degree.
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