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Running head: SOCIAL CONSTRUCTION OF MENTAL ILLNESS 1

The Social Construction of Mental Illness

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

resulting from compromised psychological functioning. However, the appearance of this

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.
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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

perceived as normal or abnormal, such as mental illness, is a social construct— a

theory/phenomenon that the perception of an individual, group, or idea is constructed by culture

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

on the behavior spectrum for younger ages.

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

attitude, based on prejudice/misinformation, that is triggered by an illness marker, like unusual

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

stigma, more ignorance, and results in a vicious cycle.

However, it is imperative to acknowledge that societal trends have a tendency to shift

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,

previously conventional behaviors might lean to be viewed as irregular, and be attributed to

mental illness. This is even evident within the DSM-5, the standard classification of mental

disorders used by mental health professionals throughout the United States.

The DSM is a “socially constructed guidebook to clinically significant distressed

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

including drug therapy.

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

are able to get treatment.


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When considering the implications from being mentally ill, it is important to

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

a psychological disorder is either in, or changing to be in respect to culture. As such, it is

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

American Psychiatric Association. (2013). Highlights of Changes From DSM-IV to DSM-

5. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

doi:10.1176/appi.books.9780890425596.388591

Carnevale, F. A., Alexander, E., Davis, M., Rennick, J., & Troini, R. (2006). Daily living with

distress and enrichment: The moral experience of families with ventilator-assisted

children at home. Pediatrics, 117(1), e48-E60. doi:10.1542/peds.2005-0789

Conrad, P., & Barker, K. K. (2010). The social construction of illness: Key insights and policy

implications. Journal of Health and Social Behavior, 51(1_suppl), S67-S79.

doi:10.1177/0022146510383495

McCann, Joseph (2016) Is mental illness socially constructed? Journal of Applied Psychology

and Social Science, 2 (1). pp. 1-11.

Miller, R., & Prosek, E. A. (2013). Trends and implications of proposed changes to the DSM‐5

for vulnerable populations. Journal of Counseling & Development, 91(3), 359-366.

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

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