To What Extent Does Medicine Act As A Social Control Mechanism? Please Refer T o Social Class And Mental Illness In Your Response. There are a number of theories about medicine as a social control mechanism. The medical profession is the recognised authority in the UK on illness and treatment and also has established a monopoly on the official identification of sickness and on the legitimate practise of healing. It also shapes ideas, expectations of how those who are pronounced sick may behave and believe the public have to be protected from unscrupulous practise.
For example Functionalism sees doctors as gate-keepers to the sick role thereby limiting abuse because they have the skills and knowledge to maintain a healthy population. Marxists believe that it is a mechanism to get people back to work as quickly as possible so they can make more money for the capitalists. The Feminists argue that drugs ‘treatment’ of depression in women is based on gender stereotypes. Although these theories put forward strong arguments in favour of medicine as social control there are however criticisms that suggest that medicine is not always a form of social control.
Medically dealing with deviance justifies certain intrusive procedures to be performed on individuals not only in the name of “treatment” but also in the interests of the common good. When health professionals attempt to eradicate a disease or a bothersome social behaviour, we all supposedly benefit. Mental illness is ‘a state of mind which affects the persons thinking, perceiving, emotion or judgement to the extent that she or he requires care or medical treatment in her or his interest or in the interest of other persons’. Mental Illness is common. 1% of the population develop schizophrenia.
One in ten are admitted to a mental hospital and a much higher proportion receives psychoactive medication. The biomedical approach sees mental illness as a medical problem and treatment involves the use of drugs or other medical or surgical treatments in clinical environments. In the past mentally ill were treated in long – stay psychiatric hospitals but now, accept for the most serious cases they are likely to be cared for in the community. Community care involves those who are mentally ill living as much as possible within a ‘normal’ community, alongside members of the public who are not mentally ill.
The move to care in the community was prompted by the desire to reduce spending on large-scale hospital care and the desire to avoid negative effects that long-stay psychiatric hospitals had on the patients. The underfunding of community care led to a series of scandals arising from inadequate care and supervision by welfare agencies, and lack of liaison between local authorities and health authorities. On the other hand care in the community provides an important means for people with mental health problems to receive support and treatment in conditions as near normal as possible.
The World Health Organisation estimates one in six people suffer from some form of mental illness. . The working class are diagnosed as suffering more mental illness than the middle class and working class mothers report more depression than middle class mothers. This may reflect higher levels of poverty and family stress. Class differences in the treatment given, such as admittance to NHS psychiatric hospitals (where they become a health statistic) rather than unrecorded private psychotherapy or psychiatric treatments at home or in private clinics may also explain this difference in the pattern shown in statistics on mental illness.
Scheff and Szasz argues that mental illness is not really an illness at all but a label used by powerful or influential people to control those who are seen as socially disruptive or who challenge existing society or the dominant ideas in some way. Scheff also argues that most people at some time go through stages of stress, anxiety or depression or show signs of odd or bizarre behaviour. In the majority of cases other people do not label this as evidence of mental illness and it is dealt with by the normal sick role.
A few days off work, a change in social circumstances or a holiday is often enough to deal with these problems. It is only when people with power such as doctors, politicians, mass media etc label this behaviour as evidence of mental illness. Psychiatrists confirm the ‘insane’ label, psychiatric treatment begins and the deviant label of mentally ill is firmly established. Goffman suggests that once the person is labelled as mentally ill and chooses or is forced to enter a psychiatric hospital as a patient the insanity role is confirmed and the career of the psychiatric patient begins.
Goffman argues once a person attains ’Master Status’ and a ‘Self Fulfilling Prophecy’ then the insanity role is confirmed and this reduces the chance of release and makes it difficult for them to re-enter ‘normal’ society successfully. Entering a mental hospital involves what Goffman calls ‘Mortification’. The patient then withdraws, rebels, or accepts institutionalisation and accepts their new role and keeps their head down, don’t break rules so they can hang on to what’s left of their own identity. On being discharged Goffman also argues that the ‘mentally ill’ carry a stigma of ‘ex-mental’ patient.
This may make it difficult to find work and develop completely normal relations with others hence the patient might relapse. Rosenham’s research confirmed the views of Scheff, Szasz and Goffman that mental illness is basically a label placed on behaviour by others. Rosenham in 1972 with eight other people prepared themselves by not washing, shaving or cleaning their teeth for 5 days and faked symptoms of schizophrenia by claiming to hear a voice saying ’thud’. All were diagnosed as schizophrenics and admitted to the different hospitals.
Once admitted they behaved normally and said the voice was not bothering them anymore but were still kept in hospital for many days and aspects of their normal lives befor being admitted to hospital were reinterpreted as signs of their apparent illness. Rosenham took many notes while in hospital, and this was also interpreted by staff as part of his illness, labelled as ‘writing behaviour’. Rosenhan then made an even more serious challenge to the bio-medical model and institutionalisation in particular when he reversed the experiment and told hospital staff to expect people trying to gain entrance by faking illness.
The staff eventually thought they had identified forty-one patients, but all those they identified were actually genuine patients who wanted help and Rosenhan had in fact not sent any fake patients at all. Rosenhan’s work illustrated very clearly that the attachment of the label ‘mentally ill’ is fairly arbitrary and an inaccurate process. The work of Scheff, Szasz,Goffman and Rosenhan have been criticised for the small scale of their studies which may therefore not be representative of all institutions involved with mental health.
Further more mental illness is not just a social constraint but a very real condition that affects an increasing number of people. In the olden days mentally ill used to be sectioned and put away and even forgotten about. Now a days because of the work of Scheff, Szasz, Goffman and Rosenhan institutional care of the mentally ill has become increasingly replaced by a focus on care in the community so patients are treated at home or in day centres so they can live a normal life as possible.