Help Seeking in Mental Distress: the Role of Institutional and Sociocultural Contexts in Spain
University of Oviedo, Spain
Social, economic and health costs of persistent mental distress that takes forms of depression or anxiety disorders are increasingly burdening individuals and societies in Europe. This has been particularly the case after the onset of the financial crisis whose consequences were extremely detrimental in Southern Europe, in general, and in Spain, in particular, with significant increases in prevalence rates of mental disorders. Nonetheless, over-medicalisation of mild symptoms is also well documented. All of this creates more demand for services and, as a result, more pressures on the healthcare systems.
Therefore, this paper examines how institutional, cultural and social contexts in Spain impact access to care and healthcare seeking in mental distress and how mental healthcare-seeking practices consequently influence functioning of the treatment system. The analysis employs data of 21 semi-structured qualitative interviews with healthcare providers and users of services who suffer from depression or anxiety disorders conducted in Spain between 2017 and 2018. Drawing on the theoretical approach of Pierre Bourdieu, I analyse how the interplay between objectified structures (such as the market or medical technology) and embodied structures as habitus shape medical practice and gradually change enactment of institution. I also intend to reveal how it results in genesis of the social field as a whole where human suffering is professionalised and interpreted as medical rather than social, consequently leading to over-dependence on healthcare services and goods.
Determinants of Social Distance towards Schizophrenia, Depression, and Alcoholism
Johannes Kepler University, Austria
Using survey data from the project “Monitoring Public Stigma Austria 2018” among the Austrian population we explore the following questions:
a) What are determinants for desired social distance towards people suffering from a mental illness?
b) Are there differences according to the type of disorder - specifically concerning schizophrenia (n~1000), depression and alcoholism (n for both ~ 500; split in questionnaire)?
Discrimination experiences – public or structural – are leading to negative consequences for people suffering from a mental illness (Millier/Schmidt/Angermeyer et al. 2014). Beside exclusion i.e. in the housing and labour market, research has pointed to tendencies of the social environment to avoid people with mental illnesses. “Social distance scales” inform about the willingness to uphold social contacts to persons with deviant psychological conditions. Based on studies in Austria (Grausgruber et al. 1989) and following Martin et al. (2000) influencing factors on social distance are seen in the nature of the problem (behaviour), causal attributions, perceived dangerousness and the treatability of the disease. Desired social distance is probably as well differing according to sociodemographic characteristics and in some studies also dependant on personal contacts to persons suffering from the illness.
Grausgruber, A./Hofmann, G./Schöny, W./Zapotoczky, K. (1989). Einstellung zu psychisch Kranken und zur psychosozialen Versorgung, Stuttgart: Thieme.
Martin, J.K./Pescosolido, B.A./Tuch, S.A. (2000). Of Fear and Loathing: The Role of “Disturbing Behaviour”, Labels, and Causal Attribution in Shaping Public Attitudes Toward People with Mental Illness. Journal of Health and Social Behaviour 41: 208-223.
Millier, A./Schmidt, U./Angermeyer, M. et al. (2014). Humanistic burden in schizophrenia: A literature review. Journal of Psychiatric Research 54: 85-93.
Networks of Depression – a Biographical Narrative Interview Analysis
University Eötvös Loránd, Hungary
Following previous research aiming at establishing connection between social distortions described by contemporary critical theories (such as Habermas’ or Bourdieu’s) and depression (Sik 2018 - https://doi.org/10.1177/1368431018760947), the presentation aims at empirically reconstructing those network features, which enable and stabilize mood disorders. Depression is understood as a specific form of social suffering, which appears in network constellations characterized by the parallel lacking of security, reinforcing feedbacks, positive collective representations and control. In order to empirically identify such constellations, biographical narrative interviews (Rosenthal 2004 - https://doi.org/10.4135/9781848608191.d7) were analysed in three steps (n=10, the interviewees were selected from people diagnosed with depression or living in marginalized or deprived position, in Hungary). First, narrative data were reinterpreted as features of various network ties: this enabled the evaluation of the depressive potential of each social relationship. Secondly, life phases were reinterpreted based on the proportion of distorted and complementary ties: this enabled the evaluation of the depressive potential of each life phase. Thirdly, the dynamics of life phases were analysed from the perspective of enablers and obstacles of transforming depressive network constellations. Such analysis not only provides a sociological explanation of the emergence and recovery from depression (as a result of the dynamics of various micro and macro networks), but also highlights new horizons for both critical theory and emancipatory praxis. Depression as social suffering emerges mostly in those constellations, where both the micro and macro patterns of communicative or instrumental networks create insecurity, negative collective identity and helplessness. Accordingly, breaking such homogenous patterns of distortion have a chance of decreasing the level of social suffering, thus overcoming depression.