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The purpose of this paper is to discuss a social constructionist point of view about mental health in contrast to the medical model.

This is a discussion paper bringing together two systems of thought concerning mental health and its origins.

It is not clear that there is any substantive evidence to support the medical model of mental illness.

Researchers may be helped to consider a qualitative approach to knowledge rather than the traditional positivist approach.

This paper will help people to think about mental health in a way that is not orthodox.

It will bring an understanding that even though mental illness is not an illness in the traditional sense, there is still no blame or shame associated with it.

The author is an active operational senior manager at a user-led community mental health organisation with over 20 years’ experience in the field. The organisation and its services track a social constructionist philosophy.

This chapter examines whether the European Union or the United States set the parameters in the field of consumer protection and environmental regulations. The analysis points out that there is no straightforward answer because leadership rotates or fluctuates depending on the extent to which societies and decision makers feel strongly about a particular issue. Examples are tobacco control and regulations with regards to genetically modified crops and food. The US identified the risks related to the wide availability of cigarettes before the EU, while the EU highlighted the risks related to the introduction of GM crops/products in the absence of similar American concerns. Both cultural and institutional developments account for this divergence. A unique combination of factors heightened the salience of anti-smoking measures in the US, while an equally distinctive matrix of developments highlighted the social, economic, health, and safety challenges of genetically modified organism (GMO). However, in spite of different constellations of institutional and cultural factors, the EU has embraced tobacco control and the American private sector is slightly more cautious about pushing GM crops onto the market.

Purpose – To explore the ideological effects and social control potential of diagnostic biopsychiatry and encourage the sociology of diagnosis to retain key insights of early medicalization scholarship.

Methodology – As the sociology of diagnosis emerges from medicalization, it is imperative that the new sub-specialty retains the critical edge of the early scholarship. With this in mind the paper reviews key aspects of the medicalization thesis, emphasizing the links between medical definitions and social control processes (e.g. Conrad, 1992; Conrad & Schneider, 1992; Zola, 1972). Based on this review scholars are urged to be mindful of the “diagnostic imaginary” -- a way of thinking that conceals the presence of the social in diagnoses, and which closes off critical analysis of the existential-connectedness and political nature of diagnoses.

Findings – The paradigm shift from dynamic to diagnostic psychiatry in DSM-III opened the door to a new biomedical model that has enhanced American psychiatry's scientific aura and prestige. With the increased presence and ordinariness of diagnoses in everyday life, an illusory view of diagnoses as scientific entities free of cultural ties has emerged, intensifying the dangers of medical social control.

Social implications – By illustrating that diagnoses are cultural objects imbued with political meaning, the ideological effects and social control potential of diagnostic biopsychiatry may be mitigated.

Purpose: This report analyzes relationships between chronic inflammation and quality of life (QoL). It assesses the potential role of intimate relationships in associations between inflammation, medical sequelae such as pain and disability, and QoL.

Design/Methodology/Approach: Limited longitudinal data from the National Social Life, Health, and Aging Project (NSHAP) were analyzed. Inflammation was assessed via the biomarker C-reactive protein (CRP). The authors examined pathwise associations between CRP levels and general happiness. The authors used ordinal logistic regression with companion OLS models, and conducted a variety of sensitivity analyses.

Findings: Intimate partnerships – especially marriage – appear to impact associations between inflammation and QoL. When QoL is measured using general happiness, intimate relationships appear to shape directional associations between inflammation and QoL along with medical consequences of inflammation.

Research Limitations/Implications: Inflammation and its clinical consequences may substantially alter intimate relationship involvement and quality that in turn impact QoL. These relationships should not be viewed as unilateral explanations of the tremendous variability observed in QoL among people with inflammatory conditions, but rather as possible elements of complex causal frameworks. Further investigation using advanced methods for longitudinal modeling from limited waves of data can help to shed additional light on the nuances of happiness and QoL among people living with chronic inflammation.

Originality/Value: This chapter provides an overview of possible causal relationships between chronic inflammation, associated clinical and social experiences, and QoL. Researchers interested in advanced causal modeling of relationships between chronic inflammation and QoL can build on this work using novel methods and data sources.

Purpose: This chapter examines the implementation of lesbian, gay, bisexual, transgender, and queer (LGBTQ) health curricula in medical education, focusing on how this content is presented to students to understand if these curricula can fulfill goals of achieving healthcare equity for LGBTQ populations.

Methodology: This research draws on data from six months of participant observation of an academic medical center and school and 28 interviews with medical faculty, students, community members, administrators, and LGBTQ Health Center employees.

Findings: This research has three findings: (1) this medical school has variable definitions for LGBTQ health, making it a hybrid form of knowledge based in (a) understanding the unique health needs of; (b) being culturally competent to; and (c) being a (structural) advocate for LGBTQ patients; (2) LGBTQ health is integrated into multiple courses in the curriculum; and (3) LGBTQ health is becoming a medical specialty frequently delivered to students by LGBTQ health experts.

Research limitations and implications: This research used snowball sampling to recruit participants engaged in LGBTQ health at the institution; it therefore risks self-selection bias. Findings from this study are not generalizable.

Originality: This research argues that LGBTQ health experts engage in a new kind of diversity and inclusion work because (1) these health experts are not always LGBTQ identified; (2) this work is not necessarily unpaid or involuntary; and (3) it involves a hybrid knowledge requiring an understanding of LGBTQ identity, medical knowledge, and social science. Because these LGBTQ health experts opt into this work, and broadly define it, a message available to other physicians and students is that LGBTQ health remains elective.

This article examines US official and public responses to the COVID-19 pandemic for insights into future policy and pubic responses to global climate change.

This article compares two contemporary global threats to human health and well-being: the COVID-19 pandemic and climate change. We identify several similarities and differences between the two environmental phenomena and explore their implications for public and policy responses to future climate-related disasters and disruptions.

Our review of research on environmental and public health crises reveals that though these two crises appear quite distinct, some useful comparisons can be made. We analyze several features of the pandemic for their implications for possible future responses to global climate change: elasticity of public responses to crises; recognition of environmental, health, racial, and social injustice; demand for effective governance; and resilience of the natural world.

This paper examines public and policy responses to the coronavirus pandemic for their implications for mitigating and adapting to future climate crises.

The purpose of this paper is to investigate the effect of social dynamics on the performance of mutual health organisations (MHOs) exploring the influence of community wealth and community leadership on policy implementation.

Four operating district mutual health insurance schemes were selected using geographical locations, among other criteria, as case studies. Data were gathered through interviews and documentary review. The findings were analysed using community field and social capital theories.

Traditional leaders like the Chiefs serve as the pivot around which social and human capital of the communities revolve in the developmental process of the country.

Lack of exhaustive examination of the financial and institutional viability issues of the MHOs. Future studies could assess the interplay between financial, institutional and social viability models when measuring the financial and overall sustainability of MHOs.

Health policy makers need to involve traditional leaders in the formulation and implementation of national policies since their acceptance or rejection of central government policy could have negative consequences.

Ghana is a dynamic country and there is the need to utilise existing social networks: inter-family and inter-tribal relationships to ensure the viability of MHOs.

There is and can be a successful interplay between public sector funding and community sector revenue mobilisation for financing the health sector in Ghana. This justifies the complementarity between government funding and community’s resource mobilisation efforts in the health sector.

Purpose – This chapter explores the pharmaceutical industry's strategic utilization of empowerment discourse in two realms: direct-to-consumer advertising (DTCA) and clinical drug development.

Methodology – It draws upon two research projects that examine the role of the pharmaceutical industry in the political economy of healthcare in the United States: Ronald's policy analysis and participant observation of DTCA policy hearings and Fisher's participant observation and interviewing of the clinical trials industry.

Findings – Empowerment rhetoric is mobilized by the pharmaceutical industry to create specific expectations about patient-consumer behavior, particularly the responsibilities associated with the consumption of drugs.

Research implications – The social and economic implications of DTCA and drug trials must be understood within their broader historical and contemporary contexts of health advocacy, consumerism, and medical neoliberalism.

Practical implications – The chapter offers alternative constructions of healthcare subjects and pharmaceutical practices that can mitigate the power of the pharmaceutical industry and bring about better pharmaceutical governance.

Originality/value of chapter – By analyzing findings from two empirical projects, this chapter is able to shed light on trends in the pharmaceutical industry's discourse about empowerment and consumption from the clinical testing to marketing of new drugs.

Medical uncertainty is recognized as a critical issue in the sociology of diagnosis and medical sociology more generally, but a neglected focus of this concern is the question of patient decision making. Using a mixed methods approach that draws upon autoethnographic accounts and third-party interviews, we aim to illuminate the dilemmas of patient decision making in the face of uncertainty. How do patients and supportive caregivers go about navigating this state of affairs? What types of patient–doctor/healthcare professional relationships hinder or enhance effective patient decision making? These are the themes we explore in this study by following patients through the sequence of experiencing symptoms, seeking a diagnosis, evaluating treatment protocols, and receiving treatments. In general, three genres of culturally available narratives are revealed in the data: strategic, technoluxe, and unbearable health narratives.