definitions in the field of mental health

what are the 4 definitions of mental illness?

• Deviation from ideal mental health

• Deviation from social/cultural norms

• Failure to function adequately

• Statistical infrequency

what is the deviation from ideal mental health def?

• Jahoda - physical illness = absence of physical health so same for mental

• review of what ‘good’ mental health characteristics to behave competently and be happy

6 categories:

• Self-attitudes

• Personal growth and self-actualisation

• Integration

• Autonomy

• accurate perception of reality

• Mastery of the environment

• proposes absence of criteria may be sign of mental illness

what are the 6 criteria of ideal mental health (meaning)?

• Self-attitudes: having high self-esteem and strong sense of identity

• Personal growth and self-actualisation: extent to which an individual develops their full capabilities

• Integration: such as being able to cope with stressful situations

• Autonomy: being independent and self-regulating

• Having an accurate perception of reality

• Mastery of the environment: including the ability to love, function at work and in interpersonal relationships, adjust to new situations and solve problems

what are 3 evaluation points of deviation from ideal mental health as a definition for mental illness? (3)

Unrealistic criteria:

• According to criteria most people = identified as having mental illness

• Jahoda presented the ideal criteria - unrealistic for people to have them all

• criteria also quite hard to measure

• Not useful when trying to identify a mental illness

Positive approach so reduces stigma:

• As criteria is unrealistic and means most people would have a mental illness

• This could reduce the stigma as it isn't usual to fulfil the criteria all the time

Cultural relativism:

• Criteria is culture bound

• For example, goal of self-actualising is relevant to members of individualist cultures but not collectivist cultures

• If criteria is applied to those in a collectivist culture there would be a higher level of mental illness 

what is deviation from social/cultural norms def?

• soc/cultural norms = shared beliefs of what is deemed acceptable behaviour in spec group or culture

• Anyone who behaves diff from socially created norms = behaviour could be seen as sign of mental illness

• Standards are often in place for good reason for example politeness, people who aren't polite are considered socially deviant because people find it difficult to interact with them

• Can be implicit or explicit norms

what are some examples of implicit and explicit social norms?

Implicit	Explicit
Politeness Unwritten/spoken Queuing	Laws Legal/illegal Fines Criminal convictions

what are some evaluation points of deviation from social/cultural norms as a def of mental illness? (3)

Susceptible to abuse:

• In past gay or bi relationships were included in the sexual and gender disorders

• Also 50 years ago in Russia, anyone who disagreed with how the state was run was labelled with a mental illness and placed in a mental institution

• Therefore, if mental illness is defined in terms of deviation from social/cultural norms, there is a danger of discrimination or loss of free speech

Deviance is related to context and degree:

• Someone dressed up on Halloween is not seen as breaking social/cultural norms, but if they wore an outfit to a job interview they would be

• Breaking social/cultural norms in itself is not necessarily an indication of mental illness, but the degree to which they do it could be

•  for example, someone who momentarily loses their temper and shouts at someone, but then apologises and returns to being rational, is different to someone who is excessively and persistently shouting loudly in all situations 

• This shows social deviance on its own cannot offer a complete definition of mental illness, because it is inevitably related to both context and degree

Cultural relativism:

• Hearing voices of ancestors is viewed as a spiritual gift in some indigenous cultures but may be flagged as symptoms of psychosis in Western psychiatry 

• This shows how that including cultural differences in diagnostic systems is necessary

• Ignoring these cultural differences can cause misdiagnosis

what is the failure to function def?

• Mental illness can be judged in terms of not being able to cope with everyday living

• Functioning refers to day to day activities (e.g. going out, communicating with people)

• Not functioning adequately can cause distress and suffering for the individual and/or others too

what are some evaluation points of failure to function as def for mental illness? (2)

Failure to consider alternative lifestyles:

• A limitation = doesn’t consider people who live unconventional lives

• Always been people who don’t engage within mainstream society and choose to love a life that better fits their values

• e.g. hippies in the 1960s, digital nomads now

• Not having a home is usually an indication of not coping but this is not the case for those who choose an alternative lifestyle - labelling these people as mentally ill is inappropriate

Subjective experience recognised:

• Positive side: this definition of mental illness does recognise the subjective experience of the patient

• Allows us to view mental illness from the point of view of the person experiencing it

• Also, failure to function is also relatively easy to judge objectively because we can list behaviours (self-dress, prepare meals etc.) and thus judge failure to function objectively

• This definition therefore has a certain sensitivity and practicality

what is statistical infrequency as a def of mental illness?

• Mental illness defined as those behaviours that are extremely rare e.g. any behaviour found in very few people is regarded as a mental illness

• The mean, mode and median are descriptive statistics used to represent the typical value in any data set

• If we can define what is most common than we can also define what is not common or rare

• In statistics, scores that are rare fall into the groups that are over 2 standard deviations from the mean in a normally distributed population and represent about 5% of the population

what is some evaluation points of statistical infrequency as a def of mental illness? (3)

Some rare behaviours are desirable:

• Many statistical infrequent behaviours = desirable

• e.g. very few people have an IQ over 150 but this rare characteristic is desirable not undesirable

• Equally, some 'common' behaviours are undesirable

• e.g. experiencing depression is relatively common

• Therefore, the statistical infrequency definition is limited in its ability to define mental illness because it fails to distinguish between desirable and undesirable behaviours

Cut off point is subjective:

• Fact that cut off points are subjectively determined is a limitation

• Mental illness is defined in terms of infrequency - a decision needs to be made about what constitutes common and rare behaviours

• e.g. one symptom of depression is insomnia or hypersomnia - however, where do we draw the line on how much is too much or too little sleep. Some people may think less than 6 hours a night is rare, others may think cut off should be 5 hours

• Such disagreements mean it is difficult to define mental illness in terms of statistical infrequency

Cultural relativism:

• An issue is that behaviours that are statistically infrequent in one culture may be statistically more frequent in another

• e.g. one symptom of schizophrenia is claiming to hear voices. However, this is an experience that is common in some cultures

• What this means in practice is that there are no universal standards or rules for labelling a behaviour as rare or as a sign of mental illness