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The Sociological Study of Mental Illness: A Historical Perspective by Andrew Scull

Mental illness, as the eminent historian of psychiatry Michael MacDonald once aptly remarked, “is the most solitary of afflictions to the people who experience it; but it is the most social of maladies to those who observe its effects” (MacDonald 1981: 1).  It is precisely the many social and cultural dimensions of mental illness, of course, that have made the subject of such compelling interest to sociologists.  They have responded in a huge variety of ways to the enormously wide social ramifications of mental illness, and the inextricable ways in which the cultural and the social are implicated in what some might view as a purely intrapsychic phenomenon.  If psychiatry has typically, though far from always, focused on the individual who suffers from various forms of mental disorder, for the sociologist, it is naturally the social aspects and implications of mental disturbance for the individual, for his or her immediate interactional circle, for the surrounding community, and for society as a whole, that have been the primary intellectual puzzles that have drawn attention.Mental illness has profoundly disruptive effects on individual lives and on the social order we all take for granted.  Erving Goffman, whose mid-twentieth century writings still constitute some of the most provocative and profound sociological meditations on the subject is perhaps best-known for his searing critique of mental hospitals as total institutions, engines of degradation and destruction that falsely put on a medical gloss (Goffman 1961).  But he also spoke eloquently of “the social significance of the confusion [the mental patient] creates,” arguing that it “may be as profound and basic as social existence can get.”  He insisted, rightly in my view, that “Mental symptoms are not, by and large, incidentally a social infraction.  By and large, they are specifically and pointedly offensive…It follows that if the patient persists in his [sic] symptomatic behavior, then must create organizational havoc and havoc in the minds of members [of society].”  Characteristically, Goffman then proceeded to critique the response of our contemporary credentialed experts in the treatment of mental illness” “It is this havoc that psychiatrists have dismally failed to examine.”  But he was equally scathing about many of his contemporaries in the sociological profession, who then sought to dismiss mental illness as a purely socially constructed category, a mere matter of labels.  For sociologists who adopted this romantic view were equally guilty of playing down or ignoring the profoundly disruptive effects of madness on the individual and on society. https://www.madinamerica.com/2016/07/the-sociological-study-of-mental-illness-a-historical-perspective/