Introduction: Rethinking the sociology of mental health

Abstract

Recent advances in genetics, the neurosciences and pharmacology currently appear to be confirming the ascendancy of the natural sciences in contributing to the understanding of body and behaviour and, more particularly,to the explanation and treatment of both mental and physical ills. And in so doing they seem to be pushing aside the importance of social processes and any contribution from sociology to the understanding of mental health and disorder, a contribution that has been highly diverse and multi-faceted.There are a number of reasons for the current predominance of genetic and biochemical understandings of mental disorder. First, and most obviously,the significant advances in these sciences during recent years, not least the progress in decoding the human genome, have drawn professional and media attention to the role of genetic factors in mental health and illness. Second, doctors still tend to be powerful, if not always the most powerful professionals within the mental health field, and, since medical training is still largely oriented towards the natural sciences, doctors usually give primacy to ideas and understandings based on the natural sciences over those from the human and social sciences. And third, explanations and understandings of mental disorder in terms of physical processes often have a number of attractions for other actors, including those with mental health problems, the lay public and politicians: they fit with medicine's widespread use of drugs in the treatment of mental disorder; they suggest a simple causal account of the condition ± a faulty gene (see Conrad 1999); they seem to take away responsibility for being ill from the individual (the problem lies in the body rather than the mind or social relations); and they focus on what is going on within the body rather than on any deficiencies in society. But it is important to recognise that the situation is not entirely monolithic. In Britain, for instance, whilst researchers and media reports announce the discovery of new genes for different mental disorders (Conrad 1997), the Labour Government has given a new emphasis to health inequalities, including inequalities in mental health (Secretary of State for Health 1998), as well as the role of environmental factors, in generating these inequalities. It has also announced new Health Improvement Programmes. Whilst it is too early to assess the impact of these developments and there are grounds for caution, they do suggest some space for assertion by sociologists and others of the importance of the social.