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Natalia Martens
University of Florida
SOCIAL CONSTRUCTION OF MENTAL ILLNESS 2
Abstract
Behaviors considered normal or abnormal are labeled as such relative to society, and thus, the
factors that contribute to it. Mental illness is used to define the a spectrum of abnormal behaviors
abnormal behavior varies greatly from culture to culture, and must therefore be assessed as such.
It is imperative that mental illness be acknowledged as socially constructed, since this would
increase the validity and cultural sensitivity of diagnoses and, therefore, health policies and
treatment. With growing regard for the factors that contribute to the social construction of mental
illness, the DSM (Diagnostic Statistical Manual) is constantly being updated to accommodate for
any new elements that impact the presentation of any psychological issues.
SOCIAL CONSTRUCTION OF MENTAL ILLNESS 3
The term “normal” can be loosely defined ass “conforming to the standard, usual, typical,
or expected”. From this, it can be concluded that the spectrum on which individuals are
categorized as normal and abnormal is relative to society. This means that anything that is
or social practice—and that normal behavior is relative to a variety of factors including age,
culture, and gender. As a result, a variety of mental illnesses are founded on an individual’s
inability to meet the expectations of their character. For instance, one of the criteria for specific
learning disorder states that the academic skills of the individual must be below the expected for
their chronological age. In addition, intermittent explosive disorder can only be diagnosed in
individuals who are legal adults, since this behavior might be considered to be closer to normal
There are several factors that lead to the social construction of mental illness. One of the
greatest contributors to this is ignorance. For instance, in one study, a father with two sons that
had relatively major physical impairments (i.e. muscular disorders and difficulty breathing,
requiring a wheelchair and respirator) described casual public outings as intensely stressful
experiences due to other peoples’ reactions of disbelief and shock to his sons’ appearances
(Carnevale, e56). The assumptions made by others that these boys were mentally ill contribute to
the idea that individuals who suffer from psychiatric disorders are and look a certain way. Lack
of knowledge pertaining to mental illness also leads to the development of stigma—a negative
behavior, or awareness of one’s psychiatric treatment (Sartorius 810). Harboring stigma leads
individuals to draw definite lines between what is regular in society and what is irregular, despite
SOCIAL CONSTRUCTION OF MENTAL ILLNESS 4
all other elements, contexts, and causes for (ir)regularities. As such, stigma shapes what is
classified as being mentally ill. This social construction of mental illness, in turn, breeds more
over time. This implies that the standards for what is considered to be in-line with society also
changes, so any ignorance leading to stigma is relative to circumstance. This is what maintains
the social construction of mental illness; as people change their internal definitions of normality,
mental illness. This is even evident within the DSM-5, the standard classification of mental
functioning that greatly influences individuals, groups, and institutions across the world” (Miller,
359). It has undergone several changes over time, in order to account for new knowledge and the
influence of socially-distinguished time periods. For instance, changes in the criteria for
agoraphobia, specific phobia, and social anxiety disorder (social phobia) includes the removal of
the pre-requisite that individuals over 18 recognize that their anxiety is excessive or
unreasonable. Instead, their anxiety must be considered to be out of proportion to the actual
danger/threat of the situation, and cultural context must be recognized (American Psychiatric
Association, 6). By doing this, the criteria to diagnose individuals with agoraphobia etc., is made
independent of the patient’s personal perception, which itself may be influenced by the condition
they suffer from. In addition, by taking into account the cultural factors in play, the validity of
the DSM is increased, and possibility of misdiagnosis due to cultural insensitivity is significantly
decreased. Furthermore, it is clear that the social construction of mental disorders has certain
SOCIAL CONSTRUCTION OF MENTAL ILLNESS 5
implications on diagnosis, treatment, and policies. For instance, when society determines what
behaviors are normal and which are not, universal rules are made for everyone and anyone
belonging to that society. As such, when someone is deemed as portraying abnormal behavior,
they may be labeled as “mentally ill” (McCann, 4) . This may also occur in the context of
seeking treatment—if the individual in question is part of a different culture with different
customs and regularities, and the mental healthcare profession does not take this into
consideration when assessing a diagnosis, they may in fact be misdiagnosed. This, consequently,
would lead to unnecessary treatment options that might even be potentially dangerous if
Moreover, the social construction of mental illness also affects whether or not those that
suffer from psychological distress are able to get treatment. One study demonstrated that since
individual’s symptoms are not directly associated with a physical origin, it is often difficult for
those symptoms to be acknowledged or treated, and many begin to suspect that what they are
experiencing is “all in their heads”. Because of this, physicians sometimes refuse to treat patients
with mental illnesses, and some insurance companies have policies in which they refrain from
reimbursing patients for appropriate treatment. Also, lack of validation of individuals’ mental
illnesses often pushes them to seek a medical diagnosis as verification that their symptoms are, in
fact, real. This leads to the demand of unwarranted and expensive diagnostic procedures, which
prompts health organizations to diagnose patients and provide inexpensive palliative care in
order to manage costs (Conrad, S70). It is clear that the social construction of mental illness
leads some healthcare providers to employ policies determine whether or not mentally ill patients
acknowledge the social origins and outcomes of it. Mental illness is subjective, and as such, the
very lines that separate the mentally ill from those who are not, are drawn by society. The social
standards that exists across the globe vary according to culture, historical background, time
period, and physical location. This is why the criteria in the DSM for being diagnosed as having
imperative that mental illness be regarded as a social construct, since failing to do so could have
drastic effects on the diagnosis, health policies, and therefore treatment, of the mentally ill.
SOCIAL CONSTRUCTION OF MENTAL ILLNESS 7
References
doi:10.1176/appi.books.9780890425596.388591
Carnevale, F. A., Alexander, E., Davis, M., Rennick, J., & Troini, R. (2006). Daily living with
Conrad, P., & Barker, K. K. (2010). The social construction of illness: Key insights and policy
doi:10.1177/0022146510383495
McCann, Joseph (2016) Is mental illness socially constructed? Journal of Applied Psychology
Miller, R., & Prosek, E. A. (2013). Trends and implications of proposed changes to the DSM‐5
doi:10.1002/j.1556-6676.2013.00106.x
Sartorius, N. (2007). Stigma and mental health. The Lancet, 370(9590), 810-811.
doi:10.1016/S0140-6736(07)61245-8