Table Of ContentSixth
“This classic textbook provides the definitive sociological lens with which to Edition
understand the range of conceptual approaches to understanding mental ‘illness’
in the historical journey from madness to emotional health and the complex
A
interdisciplinary challenges of providing appropriate care or treatment to human
S
distress and suffering. This updated edition continues to provide illuminating O
insights and clarifications not only for students but for academic researchers and C
I
scholars at all levels.” O
Gillian Bendelow, Professor in Sociology of Health and Medicine, University of Brighton, L
O
UK.
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Y
“This sixth edition of Rogers and Pilgrim’s classic text is very welcome in these
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neoliberal times of profound uncertainty and increasing societal mental distress.
F
We absolutely need books such as this one which offer sophisticated
M
but eminently readable treatment of relevant theory and inquiry. Mental health
E
care is arguably best grounded in social understandings and A Sociology of
N
Mental Health and Illness deserves the acclaim it has received for serving these T
ends. It should be required reading on any mental health course.” A
Mick McKeown, Professor of Democratic Mental Health, University of Central Lancashire, UK. L
H
E
A
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T
How do we understand mental health problems in their social context? H
A former BMA Medical Book of the Year award winner, this book provides a sociological analysis of major A
areas of mental health and illness. The book considers contemporary and historical aspects of sociology, N
social psychiatry, policy and therapeutic law to help students develop an in-depth and critical approach D
to this complex subject. New developments for the sixth edition include:
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• Brand new chapter on aging and older people
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• Updated material on social class, ethnicity, user involvement, young people and adolescence
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• New coverage on prisons, legalism and the rise of digital mental health management and delivery
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A classic in its field, this well-established textbook offers a rich, contemporary and well-crafted overview of
mental health and illness unrivalled by competitors and is essential reading for students and professionals
Sixth
studying a range of medical sociology and health-related courses. It is also highly suitable for trainee
mental health workers in the fields of social work, nursing, clinical psychology and psychiatry. Edition
A SOCIOLOGY OF
Anne Rogers is Professor of Medical Sociology and Health Systems Implementation at the
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University of Southampton, UK.
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MENTAL HEALTH
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David Pilgrim is Visiting Professor of Clinical Psychology at the r
University of Southampton, UK. s
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Anne Rogers and David Pilgrim
A Sociology of Mental Health and Illness
A Sociology of
Mental Health
and Illness
Sixth edition
Anne Rogers and David Pilgrim
Open University Press
McGraw Hill
8th Floor, 338 Euston Road
London
England
NW1 3BH
email: [email protected]
world wide web: www.openup.co.uk
and Two Penn Plaza, New York, NY 10121-2289, USA
First edition published 2021
Copyright © Open International Publishing Limited, 2021
All rights reserved. Except for the quotation of short passages for the purposes of criticism and
review, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in
any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without
the prior written permission of the publisher or a licence from the Copyright Licensing Agency
Limited. Details of such licences (for reprographic reproduction) may be obtained from the
Copyright Licensing Agency Ltd of Saffron House, 6–10 Kirby Street, London EC1N 8TS.
A catalogue record of this book is available from the British Library
ISBN-13: 9780335248483
ISBN-10: 0335248489
eISBN: 9780335248490
Library of Congress Cataloging-in-Publication Data
CIP data applied for
Typeset by Transforma Pvt. Ltd., Chennai, India
Fictitious names of companies, products, people, characters and/or data that may be used herein
(in case studies or in examples) are not intended to represent any real individual, company, product
or event.
Praise page
A Sociology of Mental Health and Illness is a sociological classic – for three decades now it
has been essential reading for all sociologists (and other social scientists) wishing to
learn more about mental (ill-)health and society, be they students or professional teachers
and researchers. It has also long been a beacon, and will continue to guide, mental health
practitioners keen to better understand and engage with the social dimensions of their
work. A Sociology of Mental Health and Illness is an incomparable resource.
Professor Martyn Pickersgill, University of Edinburgh, UK
The relationship between sociology and mental health has been well documented over the
years. Social factors such as poverty, social stress, socioeconomic disadvantages, inequality,
social exclusion have been implicated for increased rates of mental health problems.
Unfortunately, psychiatry has not engaged sufficiently with sociology. “A Sociology of
Mental Health and Illness” has covered this disparity. The sixth edition is a most welcome
addition updating social trends and new sociological material relevant to mental health,
more emphasis on service users’ participation and the emerged evidence base. It is a clas-
sic which should be essential reading for all mental health professionals.
Nick Bouras, Emeritus Professor of Psychiatry,
King’s College London, Institute of Psychiatry,
Psychology and Neuroscience
This sixth edition of Rogers and Pilgrim’s classic text is very welcome in these neoliberal
times of profound uncertainty and increasing societal mental distress. In the decades
since the first edition, despite some notable pockets of resistance, a bio-psychiatric ortho-
doxy has been consolidated within services. Curricula for practitioner education have
increasingly become competency focused at the expense of teaching theoretical insights
and by virtue of this, regardless of much pedagogical rhetoric, implicitly neglect the
encouragement of critical thinking. We absolutely need books such as this one which offer
sophisticated but eminently readable treatment of relevant theory and inquiry. Mental
health care is arguably best grounded in social understandings and A Sociology of Mental
Health and Illness deserves the acclaim it has received for serving these ends. It should be
required reading on any mental health course.
Mick McKeown, Professor of Democratic Mental Health,
University of Central Lancashire
This classic text book has for many years provided the definitive sociological lens with which
to understand the range of conceptual approaches to understanding mental ‘illness’ in the
historical journey from madness to emotional health and the complex interdisciplinary
challenges of providing appropriate care or treatment to human distress and suffering.
This updated edition continues to provide illuminating insights and clarifications not
only for students, but for academic researchers and scholars at all levels.
Gillian Bendelow, Professor in Sociology of Health
and Medicine, School of Applied Social Science,
University of Brighton
Contents
Preface to the sixth edition xi
1 Perspectives on mental health and illness 1
Clinical perspectives 1
Psychiatry 1
Psychoanalysis 3
Psychology 4
The statistical notion 5
The ideal notion 5
The presence of specific behaviours 6
Distorted cognitions 7
Perspectives within sociology 9
Social causation 10
Interpretive sociology 11
Social constructivism 14
Sociological and clinical perspectives compared 15
Discussion 21
2 People with mental health problems and users of services 23
The diffuse concept of service use 24
Relatives or ‘significant others’ 25
Users as patients 27
Privileging professional over user views in research 27
The assumption that psychiatric patients are continually irrational 28
Patients and relatives are assumed to share the same perspective 28
Framing patient views to suit those of professionals 29
Coopting users and user research? 29
Users as consumers 32
Users as survivors and activists 35
The phenomenology of surviving the psychiatric system 35
Survivors as a new social movement 36
Users as providers 41
viii C ONTENTS
The tension between advising, providing and campaigning 45
Discussion 46
3 Social stratification and mental health 49
The relationship between social class and diagnosed mental illness 50
Social capital and mental health 57
The relationship between poverty and mental health 60
Labour market disadvantage 61
Housing 62
Social class and mental health professionalism 63
Lay views about mental health and social class 64
Discussion 65
4 Sex, gender and mental health 69
The over-representation of women in psychiatric diagnosis 69
Does society cause excessive female mental illness? 71
Is female over-representation a measurement artefact? 72
Sex differences in help-seeking behaviour 74
Are women labelled as mentally ill more often than men? 76
Women, minor tranquillizers and antidepressants 79
Men, distress, dangerousness and mental health services 80
Gender and sexuality 82
The psychiatric response to gender non-conformity 85
Discussion 86
5 Race, ethnicity and mental health 89
Theoretical presuppositions about race 90
Race and health 91
The epidemiology of mental health, race and ethnicity 92
Methodological cautions about findings 96
Type of service contact 97
Disproportionate coercion 99
Black people’s conduct and attributions of madness: some summary points 100
Labelling reflects actual incidence 100
Misdiagnosis 100
Racialized psychiatric constructs 101
South Asian women and the somatization thesis 102
Migration and mental health 104
Discussion 106
6 Birth, childhood and adolescence 109
The life course and mental health 109
Birth: mental health challenges at the start of life 110
Childhood and mental health 111
Adversity in childhood 116
Childhood sexual abuse 118
Adolescence, social media and mental health 121
The challenges of entering adulthood 123
CONTENTS ix
Discussion 125
Conclusion 126
7 Ageing and older people 127
The ‘Third Age’: retirement and mental well-being 128
Help-seeking and service provision for older people 130
The ‘Fourth Age’: dementia, depression and suicide 131
Dementia 132
Depression and suicide 136
A ‘Fifth Age’?: making a hundred 137
Discussion 138
8 The organization of mental health work 140
The rise of the asylum and its legacy 141
The ‘pharmacological revolution’ and its critics 146
The role of economic determinism 148
Changes in the organization and place of provision 148
Digital interventions and mutual support 154
Discussion 156
9 Mental health work and its professions 158
Sociological perspectives on mental health work 159
The neo-Durkheimian framework 159
The neo-Weberian framework 160
The neo-Marxian framework 163
Sociological eclecticism 164
Relevant sociological contributions about deviance and knowledge 168
Legal governance and inter-professional relationships 171
Discussion 172
Conclusion 174
10 The treatment of people with mental health problems 176
A brief social history of psychiatric treatment 177
Can ‘personality disorder’ be treated? 178
A critical appraisal of psychiatric treatment 181
Why have physical treatments predominated? 182
Antipsychotics 183
Antidepressants 185
‘Big Pharma’: its role and critics 187
Psychological therapies 188
Disputes about ECT 190
Alternative and complementary therapies 191
Precarious treatment authority 194
The moral sense of ‘treatment’ 195
Moral ambiguities: informed consent and other matters for practitioners 196
The social distribution of treatment 199
Discussion 200
