The Sociology of Health

The socio-medical model of health focuses on the social factors which effect an individual’s health and well-being. They believe each person should be treated in accordance to their own personal circumstance and situation surrounding there illness, rather than be treated as a member of a group suffering from a particular illness, and should be treated the same as each person within that group.

The socio-medical model concentrates on social factors contributing to the standards of health. Social inequality and living standards are important influences on the standards of health. The socio-medical model suggests that the wealthy are more likely to have good health and suffer from less illness, and the poor are more likely to have bad health and suffer from more illnesses than the wealthy would.

Things which could be factors contributing to ill health within societies with poor living standards, according to the socio-medical model are; damp or cold houses, lack of exercise, poor diet, lack of education and health awareness etc.

The socio-medical model also suggests that the standards of health varies across different cultures, and that what is considered an illness in one society might be not be seen as an illness in another society. For example the contagious skin disease ‘yaws’ was so common in sub-Saharan Africa early this century that it was not considered a disease at all, it was considered normal because most of the population had the disease.

The socio-medical model thinks that some societies also treat people with an illness differently from other societies. For example Australia does not allow anyone with HIV into the country, which is seen by most other countries as morally wrong and contrasts with the way people with HIV are treated in the majority of societies around the world.

Time is another factor which the socio-medical model believes influences the standards of health. For instance cigarettes were promoted as being positive over 60years ago, whereas today smoking cigarettes is a well-known health threat. Socio-medical treatments for illnesses include looking at an individual’s personal situation, identifying the factors which have contributed to their illness or disorder, and removing these factors in order to correct or resolve the problem.

For example a young man who has gone bald, from a socio-medical point of view, would be assessed and factors in his life such as great stress at work would be identified, this stress would be seen as the cause of his premature baldness, and they would try to help the man find a health way to vent his stress – in order to improve his condition. The biomedical model would view this man in a different way, they would concentrate on genetic factors such as premature baldness in his father, and put this forward as the cause in contrast to the socio-medical model.

The biomedical model of healthThe biomedical model emerged after the industrialisation of the western world. New scientific discoveries and methods were being used to produce a new model of health which used new technologies and tests such as x-rays, biopsies and electroencephalographs in order to monitor people’s health. These tests aim to show ‘biological malfunction or irregularity’ in order to diagnose illnesses, which are then treated using biological methods such as drugs, operations, hospitalisation etc. (Ross Clarke, 2012).

According to the biomedical model the individual is not responsible for their illness or condition, and think that illness is caused by; a biological breakdown within the individual (this can be things such as infections, genetic malfunctions, broken bones and so on) or by external factors invading the body – such as virus’s and disease etc.

They believe every single illness has ‘one single observable cause’. (Mike Harris, 2008). The biomedical model believes that the cause for a certain illness in one person has the same cause of that illness in another person – so all people with that illness should be given the same treatments, no individual cases are usually taken into account. (Ross Clarke, 2012). The biomedical model refers to ‘good health’ as having no illness. If you have ‘bad health’ you are considered to be ill, or to have an illness.

Treatment is given with the aim of correcting a malfunction within the body and once this malfunction is corrected, you will be considered to be healthy again. (The Open University, 2012). The biomedical model is the dominant model of health in the modern western world. It treats illness and ‘malfunction’ with the use of medication, operations, radio and chemo therapy, transplants etc. Some socio-medical methods of treatment, however, are used alongside the biomedical model treatments, such as the use of therapy. (Unknown Author, 2012).

The different approaches to mental health and illnessMental health and illness can be defined and viewed in many different ways according to many different factors including; the models of disability, the culture, gender, social class, the time period, religion etc. (Ross Clarke B, 2012). The biomedical, or medical, model of health would describe mental illness in the same way they describe any other illness; that it is caused by one single physical/genetic cause.

This could be things such as genes passed down from your parents, a bump or bang to the head etc. They believe that symptoms are caused by a physical problem within the person or in the brain and they group these symptoms together in order to diagnose an illness or syndrome.

The medical model uses two classification systems of mental illness in order to diagnose a patient. These two systems are the DSM IV and the ICD-10. The DSM identifies the patient’s symptoms in order to give a diagnosis for their disorder, while the ICD-10 not only identifies the disorder and relevant symptoms, but it also tries to identify a cause. (Andrews, G., Slade, T., Peters, L. 1999).

The medical model of mental health describes people with mental illnesses as victims of their disorder, they see them as being unable to control their own actions and place no blame on the patient. The medical model uses drugs and therapies in order to treat people with mental illness, these could be things such as antipsychotic drugs, antidepressant drugs, mood stabilisers, sectioning, institutionalisation, ECT (Electro compulsive therapy), psychosurgery etc. (Saul McLeod, 2008).

The socio-medical model’s approach to mental health is a total contrast to that of the medical model. It believes that many of the treatments used by the biomedical model are inhumane and unnecessary, and that mental illness is a result of social and personal factors surrounding an individual, rather than as a result of a biological cause. The socio-medical model would use therapies such as CBT (cognitive behavioural therapy), client-centred therapy, family interventions, self-help groups, social and individual learning skills sessions and vocational training.

The therapies used by the socio-medical model aim to give insight into the patients personal problems which could be causing the mental illness, they aim to give the patient unconditional positive regard, boost self-esteem and confidence (which may be low due to the negative perceptions of mental illnesses in most societies) and try to promote an independent life for the patient so that they can live in society safely, whilst still getting the care and treatment they need from community carers etc. (Coppock and Dunn, 2009).

They believe the society you live in, your quality of life and your social class has a great influence on an individual’s mental health. They would say that due to the financial stresses and low life quality of the lower classes, this would make them more likely to suffer from mental illness. They will use the client centred therapy to identify the personal problems in an individual’s life such as marital problems, financial problems, problems in the work place etc.

The socio-medical model believes that the medical model stigmatizes patients by treating all patients suffering from a particular mental illness the same. They believe that society has a negative perception of mentally ill people and that they should not be labelled as it is not their fault they are suffering from that condition. (Ross Clarke B, 2012).

Besides the different medical models, there are also other approaches to the study of mental health. Sigmund Freud, and others who follow the psychodynamic theory, would say that mental illness is due to an unsuccessful completion of a psychosexual stage or due to a trauma in a person’s childhood, and that bringing their unconscious thoughts to the surface of the conscious mind (using psychotherapy) will eliminate the problem. (Unknown Author B, 2011).

Different time periods have also had different approaches to the study of mental illness. Early this century, for example, people suffering from mental illness were seen as being inadequate to the rest of society, a danger to their-selves and others and unable to live ‘normally’ within society.

They treated these people inhumanely, carrying out horrendous treatments which often resulted in patients becoming emotionless and ‘zombified’. Before the 1950’s ECT was carried out without the use of anaesthetic, which was very painful and uncomfortable for the patient.

Around this time people with mental illnesses were being institutionalised on a regular basis, and by the mid 1950’s there was a total of around 150,000 people across the UK in mental institutions. (BBC, 2010). People were institutionalised for a variety of different reasons, ranging from sufferers of depression, to violent outbursts (mostly among women) and then extreme things such as murder or suicide attempts.

These institutions at the time thought they were providing the best form of treatment for their patients, but people in more recent times think that the institutions had an unpleasant ‘prison-like atmosphere’ and that they totally took away people’s rights, freedom, independence, social skills and self-esteem and confidence and that the treatments they used were unnecessary and inhumane. (BBC, 2010). In the late 1950’s – early 1960’s a more humane approach started to be taken to the study of mental health.

The start of the NHS in 1948 meant that mental health would now have a more modern and humane view from society, the NHS started to introduce new treatments and therapies in the asylums/institutions such as ‘programmes of activity’ including craft and sewing classes ect, and also introduced an ‘open-door policy’, aiming to give the patients more independence and freedom.

This new approach recognised that asylums were not necessary for all mentally ill patients and in 1961, a man named Enoch Powell tried to change societies vision of mental ill health and, as the health minister of the time, he vowed to close all mental asylums/institutions and to instead, release patients into society, providing treatment and care for them at home and in the community via community carers. (Adam McCulloch, Michael Fitzpatrick, 2011).

It wasn’t until the 1970’s however that people stopped being admitted into the asylums and still took until the 1980’s for the first asylum to close. By 1990 100,000 patients had been released into society and mental hospitals started to become extinct. This was the start of care in the community for the mentally ill, as we know it today. (BBC, 2010).

The modern approach to mental illness is that there could be a number of causes, whether that be genetic, organic, personal, social or a combination of either, and that sufferers should not be labelled, should not be considered ‘abnormal’ and that they should be treated just like any other ‘normal’ member of society. (Ross Clarke B, 2012).

They should receive sufficient care via GP/hospital appointments, care in the community and by alternative therapies such as family interventions, self-help groups etc. ‘User movements’ have also quite recently been introduced, this is a system which encourages the patient to work with a professional such as a doctor/psychiatrist to help choose the treatments they receive in order to make them feel more in control of their illness or disorder and to help them feel more confidence that the chosen treatment will work. (BBC, 2010).

People with mental illnesses are no longer stigmatised or labelled and a majority of the western world have now accepted mental illness as a genuine problem which needs to be solved, rather than seeing it as a condition which needs to be locked away from society like in the early 50’s.

References

Mike Harris. (2008). Sociology of health and illness. Available: http://www.slideshare.net/Bias22/sociology-of-health-and-illness-presentation#btnNext Last Accessed: 06/12/2012

Unknown Author. (2012). What is the biomedical model? Available: http://www.wisegeek.com/what-is-the-biomedical-model.htm Last Accessed: 06/12/2012

Ross Clarke. (2012). Booklet 3 – the different constructions of health and illness. The Manchester College, 2012

The Open university. (2012). Models of healthcare: the biomedical model. Available: http://openlearn.open.ac.uk/mod/oucontent/view.php?id=398060&section=1.6 Last Accessed: 06/12/2012

Andrews, G., Slade, T., Peters, L. (1999). Classification in psychiatry: ICD-10 versus DSM-IV. The British Journal of Psychiatry. v. 174. no. 1. p. 3 – 4

Ross Clarke B. (2012). Booklet 4 – approaches to the study of mental health and illness. The Manchester College, 2012.

Saul McLeod. (2008). The medical model. Available: http://www.simplypsychology.org/medical-model.html Last Accessed: 06/12/2012.

Coppock and Dunn. (2009). Understanding mental health and mental distress. Available: http://www.sagepub.com/upm-data/30675_02_Coppock_&_Dunn_Ch_01.pdf LastAccessed: 06/12/2012.

Unknown Author B. (2011). Psychology 101. Available: http://allpsych.com/psychology101/personality.html Last Accessed: 06/12/2012.

BBC (2010). BBC4 video – mental history of the mad house. Last Accessed 27/11/2012.

Adam McCulloch, Michael Fitzpatrick. (2011). Mental institutions, Enoch Powell and community care. Available: http://www.communitycare.co.uk/blogs/social-care-the-big-picture/2011/09/mental-institutions-enoch-powell-and-community-care.html Last Accessed: 06/12/2012.