lecture 2 - Mental Health Examined through the Social Sciences

chapter 3

psychoanalysis

• Developed by Sigmund Freud

• Human behaviour understood by looking into the unconscious mind

• Constant conflict between two aspects of the mind:

  • The id

    • Instinct, passed on by evolutionary heritage

  • The superego

    • Inner representation of societal norms and cultural conventions, shaped by social and family environment

• Conflict resolved by repressing unacceptable drive

  • Unaware of this repression because it occurs in unconscious mind

inferiority complex

• Alfred Adler, 1956

• Ways that social structures may cause humans to feel helpless or powerless (self-ideal is so unrealistic ex. Wealth, power)

• Human striving is an attempt to overcome inferiority complex

collective unconscious

• Carl Jung, 1981

• We all share deep level of our mind (Jung, 1981)

• Understood human personality in terms of archetypes

  • E.g., puer aeternus: the perpetual child

behaviourism

• Straightforward framework aimed to understand how behaviour is shaped by application of various stimuli, rewards and punishments (Skinner, 1938; Watson, 1924)

• Used animal research in early phases

  • E.g., dogs (Pavlov, 1927)

behaviour therapy

• Aims to identify how people with mental health problems learned maladaptive responses to their environment

• Classical conditioning

• Operant conditioning

operant conditioning

• Skinner, 1953

• One has been rewarded and punished for particular kind of behaviour

• Increase or decrease the frequency of the behaviour

classical conditioning

• Learning response that involves associations between environmental stimulus and naturally occurring stimulus

cognitive behaviour therapy

• Replaced behaviour therapy over recent years (Rachman, 1997)

herd behaviour

• Behaviour changes when people are in large groups or crowds

Developmental Trajectories and Mental Health

• Childhood a critical period that establishes lifelong patterns of personality and behaviour

• Erik Erikson

• Kohlberg’s theory of moral development

erik erikson

• Identity development proceeds through a series of stages across the lifespan

• Failure to navigate each stage can result in mental health challenges

Kohlberg’s theory of moral development

• Six stages by which individuals develop the ability to reason out the moral aspects of a situation and make an appropriate ethical decision

• Most adults do not progress beyond third or fourth stage

stages of moral development in order

• Level 1 (Pre-Conventional)

  • 1. Obedience and punishment orientation

  • (How can I avoid punishment?)

  • 2. Self-interest orientation

  • (What's in it for me?)

  • (Paying for a benefit)

• Level 2 (Conventional)

  • 3. Interpersonal accord and conformity

  • (Social norms)

  • (The good boy/girl attitude)

  • 4. Authority and social-order maintaining orientation

  • (Law and order morality)

• Level 3 (Post-Conventional)

  • 5. Social contract orientation

  • 6. Universal ethical principles

  • (Principled conscience)

Society and Mental Health

• Emile Durkheim argued that people living in societies undergoing a high degree of turbulence experience anomie

• Anomie is a condition in which social and/or mental norms are confused, unclear, or not present

• Recent research indicates that individuals with low levels of connections to social networks have relatively poor mental health and higher mortality rates (Holt-Lunstad & Smith, 2015)

social constructionism

• Argues that “scientific concepts” and “facts” are based upon social norms, rather than a bedrock of absolute reality (Burr, 2015)

politics, economics, mental health

• Political or economic instability can have detrimental impact on a population

  • E.g., suicide rate increased during economic crisis in Asia in 1997–98 (Chang et al., 2009)

• Global populations have experienced mental health consequences related to job loss, economic uncertainty, and political unrest during COVID-19 pandemic

• Indigenous communities have experienced terrible losses as a result of colonization

  • (ex. Residential schools)

social determinants of health

• Sociopolitical and economic factors that influence the health of individuals and broad populations

• Have greater influence on health than behavioural risk factors (Donkin et al., 2018)

• Many are correlated and interact on multiple levels (intersectionality) (Hankivsky & Jordan-Zachery, 2019)

• Patterns of oppression are often tied together and influenced by the intersectional systems of society (Hill Collins, 2000)

• Income and its distribution

• Housing

• Education

• Early childhood development

• Gender

• Employment and working conditions

• Unemployment and employment security

• Indigenous status

• Social exclusion

• Social safety net

• Food security

• Health services

• Race/racism

• Disability

poverty

• Strongly correlated with poor health

• Impact through stress of obtaining material necessities and sustaining oneself or one’s family

• Also increases likelihood that one will live in unsafe environment and be exposed to criminal activity, violence, and problematic/harmful substance use

statistics - who is experiencing homelessness? info from 2018

• age

  • 8% under 25

  • 70% between 25-54

  • 21% over 55

• gender

  • 75% male

  • 24% female

  • 1% transgender

• income

  • 39% income assistance/welfare

  • 30% disability benefit

  • 20% employed

• health

  • 65% problematic substance use

  • 39% mental health challenges

  • 34% physical disability

• noted subpopulations

  • 40% indigenous

  • 23% new to vancouver

  • 8% veterans