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Mental disorders are common and associated with substantial levels of work disability. Relative to persons with most types of physical impairments, persons with mental disorders have lower employment rates and lower mean wages, and experience greater discrimination in the workplace (Baldwin, 1999, 2000; Baldwin & Johnson, 1995, 2000). Persons with mental disorders have lower socioeconomic status, on average, and greater risk of living in poverty, than persons with physical disorders (Dohrenwend et al., 1992). By 1999, mental disorders had supplanted back cases as the health condition most frequently cited in employment discrimination charges filed under the Americans with Disabilities Act of 1990 (Moss et al., 1999).

Work-life challenges experienced by employees navigating pregnancy, maternity, and parenting young children are well documented in the literature. Correspondingly, work-life balance policies and provisions aimed at supporting affected staff are well established in many modern organizations. Within this agenda however, complications within maternity journeys, and specifically the intersection with mental health has been neglected. In this chapter, we consider the work-life issues associated with perinatal (pregnancy and post-birth) mental illness. After introducing perinatal mental illness, and its impact on individuals and families, we consider the two-way relationship between illness and work: how employment factors influence the development of perinatal mental illness and recovery trajectories, with implications for family life; and how such illnesses impact work and employment. We offer key insights from our empirical research on this topic in the context of UK policing, highlighting challenges linked to the nature of police work and organization culture, and issues that are more broadly applicable to how maternity and mental illness are treated in the workplace. The chapter offers recommendations for people management practice aimed at reducing or mitigating occupational factors that exacerbate illness and maximizing those facilitating recovery in the perinatal period and beyond, thus advancing work-life inclusion.

While deinstitutionalization has changed how and where those with serious mental illness receive mental health treatment, the high rate of homelessness among those with mental illness, the number of mentally ill incarcerated, and the general inadequacy and underfunded nature of public psychiatric resources suggest an inadequate social reaction to their needs. While United States (US) policies have appeared to deemphasize long-term confinement in hospitals, the author contends that various ideologies maintain a process of social control whereby those with serious mental illness continue to be minimized and disempowered within American society.

The author presents three different ideologies for examination: the “otherness” of mental illness, stigma and social exclusion, and perspectives of dangerousness. These ideologies are hypothesized to limit the social capital and power of those with serious mental illness. Considering Antonio Gramsci’s definition of hegemony and “common sense,” this chapter urges a challenge to these hardened ideologies if those with serious mental illness are to have greater inclusion in US society.

This chapter responds to calls to “reclaim” the work of Erving Goffman, and specifically his conceptualization of stigma, arguing that Goffman’s ideas can inform a critical social theory of mental illness in sport. The analysis pays particular attention to the challenges to social identity for those experiencing mental illness stigma, the role of personal identity in negotiating mental illness stigma, and strategies for stigma reduction including the adoption of stigma symbols.

The first section of the chapter revisits the concept of stigma, before proceeding to relate this to mental illness stigma as applied to sport. The second section overviews several high-profile cases of mental illness stigma of elite athletes, before presenting some examples of campaigns to address the perceived stigma related to mental health issues in sport.

The chapter proposes that Goffman’s work maintains relevance when related to social contexts other than those directly observed by him, and that the conceptualization of stigma helps understanding of, and challenges to, mental illness stigma in sport.

While sport continues to be proposed as an arena for positive character development, analysis informed by the work of Erving Goffman demonstrates that the culture of sport provides a context within which athletes experiencing mental health issues may be stigmatized. This, in turn, undermines the potential for them to secure the health care that they need, with participation and performance often taking precedence over well-being, even in the campaigns ostensibly designed to address mental illness stigma.

This chapter outlines the paucity of media research attending to mental health and mental illness in sport. As such, the purpose of this chapter is to encourage critical reflection and further research on the mass mediation of mental illness in sport.

In the first part of the chapter, we review the extensive literature addressing the mass mediation of mental illness and mental health in order to provide key reference points for future scholarship. We then suggest to potential avenues for sociological study of this topic: Talcott Parson’s sick role and Guy Debord’s spectacle.

The authors find that the notion of the sick role provides insight into the assumptions underpinning athlete disclosure of mental illness as well as encouragement of help seeking behavior in relation to mental illness specifically. From a broader perspective on mental health, the authors identify a central challenge of the spectacular presentation of mental health and well-being and the lived experience.

The central limitation of the field currently is the dearth of research. Similarly, in providing a broad overview of key considerations, this chapter does not undertake primary media analysis of mental illness in sport. Nonetheless, the authors outline key considerations and lines of inquiry for the field.

Mental disorders collectively account for 4 of the 10 leading causes of disability and represent more than 15% of the overall burden of disease in the United States (SAMHSA, 1999). The first Surgeon General’s Report on Mental Health reported that in 1999 nearly 20 million American adults (9.5% of the population) were clinically depressed and that, at any one time, 1 in every 20 employees is experiencing depression (SAMHSA, 1999). The indirect costs of mental disorders to the American economy amounted to an estimated $79 billion in 1990, with loss of productivity because of illness accounting for about 80% of these costs ($63 billion) (Rice & Miller, 1996). Additionally, significant costs may accrue from decreased productivity due to symptoms that sap energy, affect work habits, and cause problems with concentration, memory, and decision-making (SAMHSA, 1999).

The purpose of this chapter is to apply structural functional theory and the concept of “unbundling” to an analysis of the deinstitutionalization and community mental health efforts that have shaped the current mental health services environment.

We examine the original goals of the institutional movement, the arguments supporting it, and the functions of the institutions that were created. We then examine the criticisms of that approach and the success of the subsequent deinstitutionalization process, which attempted to undo this process by recreating the hospitals’ functions in community settings. Finally, we address the question of whether the critical functions of psychiatric institutions have indeed been adequately recreated.

Our overview of outcomes from this process suggests that the unbundling of state hospital functions did not yield an adequate system of care and support, and that the functions of state hospitals, including social control and incapacitation with respect to public displays of deviance were not sufficiently recreated in the community-based settings.

The arguments for the construction of state hospitals, the critiques of those settings, and the current criticism of efforts to replace their functions are eerily similar. Actors involved in the design of mental health services should take into account the functions of existing services and the gaps between them. Consideration of the history of efforts at functional change might also serve this process well.

Purpose – The DSM-III reflected American psychiatry's shift from a dynamic approach to a descriptive diagnostic approach. This chapter seeks to elucidate the implications of this shift for the diagnosis and treatment of mental illness.

Methodology/approach – To shed light on this issue I analyze the diagnosis and treatment implications of this shift for Attention Deficit Disorder (ADD).

Findings – The transition to the diagnostic approach has had three consequences for the handling of ADD, and later Attention Deficit/Hyperactivity Disorder (ADHD): first, it increased the number of children diagnosed with the disorder; second, it encouraged clinicians to treat the disorder with psychostimulants; and third, it expanded the pool of clinicians who could prescribe stimulants.

Contribution to the field – Beyond illuminating the specific cases of ADD and ADHD, this analysis contributes to the medicalization literature by demonstrating that there is more to be studied than merely the expansion or contraction of diagnostic categories. Researchers also have to analyze the implicit assumptions within the diagnostic definitions, which have implications for the prevalence and treatment of illness.

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

This chapter examines the effects of mental health services and stigma on changes in self-concept and well-being for individuals with SPMI.

Data for this chapter come from structured interviews and service data for 140 individuals with severe and persistent mental illnesses. We use structural equation modeling to examine the relationship between perceived and internalized stigma, as well as the relationships among stigma, self-concept (self-esteem and mastery), and well-being (quality of life and functioning).

We find that case management is negatively related to quality of life and psychiatric services are positively related to functioning. Crisis services and assessment are associated with mastery in opposite directions. Internalized stigma is positively associated with self-esteem and mastery, and negatively associated with functioning. We do not find a relationship between services and stigma.

A limitation to this chapter is the sample size, which prohibits us from examining a full range of services and outcomes. Nonetheless, our findings provide information about how services and stigma impact well-being, and may be used as a starting point for considering strategies for improving services and reducing stigma. Future work should consider pairing outcomes with services to determine their effectiveness.

This chapter builds on previous research that examines the relative effects of services and stigma among individuals in community health care by extending measures of both services and stigma, and by examining the relationship between them, in order to better determine their implications for self-concept and well-being.