SOCI 422: Sociology of Health and Mental Illness
- Course Overview
- Required Reading
- Course Structure and Requirements
- Academic Policies
- Lesson Schedule
About your Instructor
Welcome to SOCI 422, Sociology of Health and Mental Illness! As an instructor, I see a class as a cooperative, group effort, which means that we learn together and with one another. In this effort, I see us as cooperating toward achieving a joint goal, rather than competing as individuals to achieve solo goals. I will help you with course content, and I hope that you will help your fellow students as well. I expect to learn from you, and for you to learn from each other. Whether your interest in health is piqued from personal or professional interests (perhaps both), I think you will find that sociology can offer a useful paradigm to benefit your understanding of the history, current trends, and future of health and mental illness in the United States!
This upper-level sociology course offers an introduction to sociological theories and research related to health and illness, with a focus on mental health and mental illness. In terms of course content, it is a fundamental observation that in any society, some people are healthy and others are not. Health (and lack thereof) has become a highly visible public issue as politicians, healthcare providers, insurers, and lay persons debate the nature of various health concerns, including mental illness. What does sociology have to say about health and mental illness and the organization of health care? Perhaps more than you would expect! Health is a relatively scarce and highly valued commodity, which, like wealth or education or power, is socially—and very unequally—distributed in this country (as well as others).
After taking this course, you should be able to identify the perspective and evaluate the strengths and weaknesses of policies and claims. In order to do so, however, you need some tools to disentangle the debates and to sort rhetoric from evidence. These tools include:
- knowledge of the various perspectives on health and illness
- an understanding of how illness undergoes a definitional process (and is not merely a biomedical fact)
- some history of how illness (mental illness in this course) has been treated and the implications for those treatments.
This course offers an introduction to sociological theories and research related to health and illness, with a focus on mental health and mental illness. Although many people think of mental illness as under the purview of healthcare providers (such as psychiatrists and psychologists), sociologists have made significant contributions to our understanding and conceptions of health, illness, and mental illness. Sociologists have challenged overlooked assumptions about how health and illness are defined and how these definitions are applied to individuals. They have also examined the social sources and (unequal) distribution of health in the population as well as the structure, organization, and provision of health services. Thus, issues of health and illness are by no means exclusive to the traditional medical professions; social science is now recognized as a critical tool needed to understand individual and population health patterns, and to determine the best and most efficient way to distribute health care in our society.
We have loosely organized this course into three main sections. We will begin by examining multiple perspectives on health, illness, and mental illness. Next, we will study several major theories about these topics, and we will finish the course by focusing solely on mental illness and the history of treatment for mental illness.
This course should provide you with a framework for examining health and mental illness in current society. Hopefully, this course will pique your curiosity to study other topics within the sociology of health, illness, and mental illness, as a vast literature exists for further learning (on aspects such as race, class, and gender and health/mental health; or the criminal justice system and mental health). We will not have enough time to explore all of these fully, but will touch on them throughout the semester. Should you have a desire to learn more, I would be happy to guide you to other readings!
- Creating Mental Illness (2003) by Allen Horwitz; Chicago: University of Chicago Press. ISBN: 978-0226353821
- The Medicalization of Society (2007) by Peter Conrad; The Johns Hopkins University Press.ISBN: 978-0801885853
- Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness (2002) by David Karp; Oxford University Press. ISBN: 978-0195113860
- The Mad Among Us: A History of the Care of America’s Mentally Ill (1995) by Gerald Grob; Harvard University Press. ISBN: 978-0674541122
- Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (1961) by Erving Goffman; Anchor Press. ISBN: 978-0385000161
E-reserves and E-Journals
Throughout the semester, I will have several assigned readings available online through the UNC-Chapel Hill Libraries website. Some of the readings will be listed as “e-reserve,” and you can access them through the library’s electronic reserves system. Others, designated “e-journal,” will be available through the library’s electronic journal subscriptions. Both types of articles will be in PDF format, so you will need Adobe Acrobat Reader to view the articles. If you don’t have it on your computer, you can download it for free at the Adobe website. More information on accessing the library’s electronic resources is included in Course Mechanics. If articles are not listed as “e-reserve” or “e-journal,” then they can be found in the Resources folder.
Your final grade will be based on the following assignments:
|Discussion Forum participation||30
(7 forums, 4 points each, 2 points for completing all forums)
|Weekly paragraphs and comments|
|Paper: Sick Role Memoir||20||5-7 pages|
|Paper #2: Pharmaceutical Ad Analysis or Advising Mental Health Care Providers||20||5-7 pages|
|Final Exam (essays)||30||12-16+ pages|
As an instructor, I respect extenuating circumstances that may arise for you throughout the course, but I also expect you to consider my position in making decisions about what is an acceptable excuse. Be proactive about the decisions you make and be responsible for the consequences of your choices. Please note that you are responsible for submitting all work by the due date. I do not accept late work unless there is an exceptional circumstance. I will not accept assignments that are more than forty-eight hours late unless we have discussed your submission prior to the assignment due date listed in the course schedule. If you need to discuss an assignment due date with me, do not assume that I have received your message unless you get a response from me.
I will describe each component in detail below, but please let me begin by suggesting that you save all of your work! Technology can be a temperamental beast, and if you lose an assignment somewhere in cyberspace, I’m not savvy enough to help you retrieve it. You’d be responsible for doing the assignment all over—not the most fun prospect!
Readings, Key Questions, Lesson Notes
I have based this course on one taught in a traditional classroom, and I have assigned the typical amount of reading I would assign in that setting. It may look like a lot of reading, but I promise that it is consistent with what you’d be getting if we were in the traditional classroom. Besides, you’re paying good money for this course, and I want you to get your money’s worth!
For each set of readings, I provide a list of key questions. You don’t need to write out answers to these or hand them in. The questions are guides that will help you pick out what I see as key ideas in the readings. When you’re finished with a reading, go through the questions again to check your understanding—you should be able to answer the questions for yourself. If you are unsure of an answer, then you know to follow up with me either using our Online Q&A discussion forum or via email.
Each lesson also includes Lesson Notes to supplement your readings, and sometimes to guide you through more challenging readings.
Weekly Discussion Forums
Each lesson will include a short online activity or a couple of thought questions to provoke and guide discussion. You need to submit at least three posts each week. The first should address the question(s) in the discussion forum assignment, and the additional posts should be a response to at least two other students. Your first response should be at least six sentences long. Keep in mind that most posts are longer than this requirement and that all posts should sufficiently answer all questions posed in the discussion forum assignment.
Guidelines and grading criteria for forum discussions:
- Make these discussion forums a safe and comfortable environment for everyone by being respectable, open-minded, non-judgmental, and thoughtful.
- Engage is conversation with other students in the forum by responding to their posts with observations and questions. Each student should expect to make at least 3 posts to discussion over the week.>
- Each student will be graded on the quality of their posts. In this case “quality” means that you are creating engaging, interesting, and meaningful discussions and not just “posting to post.”
- Your posts will be graded with a check, check-minus, or zero. I will look for a thesis statement, whether you brought ideas from the reading assignment into your post, and whether you made an argument instead of simply stating “I like this.” You will receive up to 4 points on your weekly discussion forum assignments based on the quality of your posts.
- The quality of your posts will count more than the quantity. I will assess quality by determining if you integrate the readings into your comments and make a good argument. If you agree or disagree with something or someone, explain why and give sound empirical evidence for your position.
- PLEASE note: you can’t simply cite a statement by Al Franken or Bill O’Reilly as “proof” of your position. These kinds of statements as well as editorials from news sources are rhetorical positions and not evidentiary statements. You have to find peer-reviewed examples that use evidence tothat support your argument, rather than rhetorical positions. When you provide evidence for your statements, be sure to provide a short citation or link to this information.
Your first post of each week is typically due by THURSDAY (before 11:59 pm) , and additional posts are due by MONDAY (except Memorial Day weekend) before 11:59 pm.
Online discussion need not be limited to the activity or questions I provide. If you find another idea in the readings compelling, I welcome additional thoughts or comments. I also welcome you to share current events you come across that relate to the course content from legitimate new sources (e.g., CNN, Time, New York Times).
A note about civility: I want to remind everyone to be respectful and sociological in your responses. Sociology is a science. Personal experiences are welcome when they clearly relate to course subject matter, but keep in mind that your individual experience is not a counterargument against a larger trend. For example, if you saw one mini-van speeding, it wouldn’t be logical to say that all mini-van drivers are speeders, or if you like to talk during a movie, that doesn’t invalidate the fact that most people don’t talk while at a theater.
If you are considering discussing your personal experience in the discussion forum, you might think about why and how you fit (or don’t fit) the trend. This doesn’t mean that your personal experiences don’t matter; of course, they have meaning for you. But, they are not counterarguments.
Online Q&A: An optional component of the course is our Online Q&A forum. If you have questions about the readings, you can post them to the Online Q&A for answers from your classmates or me. You can also email me privately, but if your question is important for everyone to know, I’ll also post an answer on the Online Q&A.
One more reminder: You are responsible for submitting all posts on time. I will not accept late posts (unless you have compelling reasons for their lateness). You should verify that your post appears in the forum after you submit it.
You will prepare three papers for this course. Each paper is described below; links to return you to these instructions will be included in the appropriate lessons.
Please type your papers double-spaced, using one-inch margins and 12-point type Calibri or Times New Roman font. Proofread your papers carefully; I expect them to be free of spelling, grammar, or punctuation errors. Be sure to number the pages. You do not need to include a separate title page.
- Paper 1: Sick Role Memoir (approximately 5-7 pages):This paper is designed to develop your understanding of the sick role, its conceptual strengths, and its limitations through the lens of a personal experience. It should also demonstrate how illness is profoundly social.
Read A.S. Trillin, “Of Dragons and Garden Peas: A Cancer Patient Talks to Doctors” (located in Resources).
Being sick is a universal human experience. Think about a time when you, a family member, or a close friend was sick. Write a personal memoir along the lines of Alice Trillin’s “Of Dragons and Garden Peas.” What was it like to be ill, or to deal with the illness of someone close to you? Did you experience any socialization into the “Land of the Sick People”? How so? Were there any special rituals or talismans associated with illness? Consider whether you fulfilled the sick role as envisioned by Talcott Parsons. If so, in what ways? How did you deviate from Parsons’ model?
As you write your paper, try to be as personal—but not conversational—as you can. Try to reflect on your experience using your knowledge of sociology. You do not need to answer all the questions I have posed: They are merely starting points for your thinking. I am more interested in your interpretation of your experience.
- Paper 2: Choose either Option 1 or Option 2:
Option #1: Constructing illness through deconstructing pharmaceutical advertisements (approximately 5-7 pages)
In this paper, you will rely on course materials and outside sources to apply a sociological perspective to illness through analyzing a pharmaceutical advertisement. As you all know, pharmaceutical advertisements are prevalent in the US media. Just flip open a magazine or turn on the television, and you will be exposed to pharmaceutical ads to treat conditions ranging from depression to premenstrual dysphoric disorder (PMDD) to social anxiety disorder to attention deficit hyperactivity disorder (ADHD) to countless other disorders.
Find a recent advertisement (2008 or later) in a magazine for a condition that has been medicalized in recent years. In other words, do not look for advertisements aimed at treated diseases such as cancer, diabetes, or cardiovascular disease (CVD). Be sure to choose an ad that you can scan. There are a number of magazines available at UNC libraries or any libraries that can be easily scanned.
After finding which drug advertisement you want to use, apply a sociological framework to illustrate how this ad contributes to medicalization and the construction of illness for the targeted disorder. In an essay format, answer the following questions:
- To start, what is the name of the drug being advertised and what disorder is it supposed to treat? What is the history of this disorder? Using course materials or outside sources, illustrate the medicalization of this disorder. When was this disorder medicalized? What factors were salient to the medicalization of this disorder? Using data from reliable sources (such as CDC), illustrate in detail trends in the disorder being targeted. Be sure to include trends over time as well as trends according to race/ethnicity, sex, age, and social class (education, income, occupation).
- Where did you find this advertisement? Who is the target audience for this media? Be sure to include demographic information on the readership for this publication. Using evidence based reasoning and available data on this disorder (from non-industry groups, like CDC), explain why you think the advertised drug to treat a specific disorder is being targeted at a specific group.
- What is the history of this drug? Has it been used to treat other disorders?
- Describe the ad. What visual images are used? What words pop out on the page? Explain in detail how these words or images contribute to the construction of illness for the disorder and the message being conveyed to readers. What does the visual imagery of the ad tell you about illness experiences related to the disorder?
- What does the advertisement tell you about who is being targeted for this advertisement? Be sure to incorporate how race/ethnicity, age, class, and gender are relevant to the illness construction being presented in the ad.
- Provide a comprehensive analysis of how the social sources of illness are related to this disorder and the pharmaceutical therapy being advertised to treat this disorder.
- Pharmaceutical treatments are rarely considered a panacea for a number of disorders and carry with them a number of side effects that can adversely affect a person’s health. With that in mind, what is not being communicated in the ad about other ways to treat this disorder? Are there social approaches to treating this disorder that are overlooked in the ad? Be sure to elaborate on other potential approaches for this disorder in detail.
Finally, provide a comprehensive conclusion to this essay that demonstrates the sociological perspective you have applied to the advertisement. Be sure to incorporate concepts including medicalization, stigma, social power, and social sources of illness throughout your essay. You must also cite sources you use for this essay.
PLEASE NOTE: Your paper should be double spaced, with one-inch margins, and free of grammatical or spelling errors. Do not use quotes from outside sources when you can put these ideas into your own words. Quotes should be used sparingly at most.
Option 2: Advising Mental Health Care Providers (approximately 5-7 pages): This paper draws on all of the course readings to date. It should demonstrate how the perspectives and concepts used in the course might be applied to a real-life situation. You are asked to synthesize and evaluate the perspectives and theories. Please follow these instructions in preparing your paper:
You have been asked to participate in a panel of technical experts who will discuss depression. The major topics are updating the DSM and modernizing approaches to treatment. The panel organizer asks you to prepare a short paper to clarify your thoughts. Your paper will be offered to the audience after the panel discussion.
To prepare your paper, begin by reading the DSM definition of Major Depressive Disorder. Then, elaborate on and explain your recommendations for:
- revising the definition of major depressive disorder for the next version of the DSM
- improving treatment practices and options.
In accomplishing these two tasks, be sure to explain how various perspectives (sociological, biomedical, and so on) and theories or theoretical constructs (such as, labeling theory or social power) of illness inform your recommendations. (Feel free to draw from the multiple perspectives we have studied in developing your response. No single discipline has all the answers.) Acknowledge where any particular strengths or weaknesses/drawbacks to your recommendations lie, and propose means to deal with weaknesses or obstacles.
Also, be certain to acknowledge a person’s individual experience of illness (as in Speaking of Sadness) with institutional effects (as in Creating Mental Illness). In other words, how would you reconcile Katz’s work with Horwitz’s or Szazs’s? How do institutions frame individual experiences?
Final “Take-home” Essay Exam
The course will conclude with one cumulative exam, which will consist of several essay questions, and will cover the readings, activities, and discussions. I will post the essay exam on July 16. Each answer should be in 12 pt. Times New Roman or Calibri font, double-spaced. Each essay should be three to four pages each.
Letter grades will be assigned using the following scale:
A 95-100 A- 90-94 B+ 87-89 B 83-86 B- 80-82 C+ 77-79 C 73-76 C- 70-72 D+ 67-69 D 63-66 D- 60-62 F under 60
By enrolling as a student in this course, you agree to abide by the University of North Carolina at Chapel Hill policies related to the acceptable use of online resources. Please consult the Acceptable Use Policy on topics such as copyright, net-etiquette, and privacy protection.
As part of this course, you may be asked to participate in online discussions or other online activities that may include personal information about you or other students in the course. Please be respectful of the rights and protection of other participants under the UNC-Chapel Hill Information Security Policies when participating in online classes.
When using online resources offered by organizations not affiliated with UNC-Chapel Hill, such as Google or YouTube, please note that the terms and conditions of these companies and not the University’s apply. These third parties may offer different degrees of privacy protection and access rights to online content. You should be well aware of this when posting content to sites not managed by UNC-Chapel Hill.
When links to sites outside of the unc.edu domain are inserted in class discussions, please be mindful that clicking on sites not affiliated with UNC-Chapel Hill may pose a risk for your computer due to the possible presence of malware on such sites.
Remember that as a student of UNC-Chapel Hill, you are bound by the University’s Honor Code, which states that “It shall be the responsibility of every student at The University of North Carolina at Chapel Hill to obey and support the enforcement of the Honor Code, which prohibits lying, cheating, or stealing when these actions involve academic processes or University students or academic personnel acting in an official capacity.”
All graded academic work must include a pledge comprised of the following: “No unauthorized assistance has been received or given in the completion of this work.”
An especially serious Honor Code violation is plagiarism. If you are uncertain about what constitutes plagiarism, please familiarize yourself with this plagiarism tutorial, courtesy of UNC Libraries.
- Lesson 1: Perspectives on Health, Disease, and Illness
- Lesson 2: Social Sources of Illness
- Lesson 3: Meaning and the Experience of Illness
- Lesson 4: Illness as Deviance: Medicalization and Stigma
- Lesson 5: Illness as Deviance: Labeling
- Lesson 6: Defining and Creating Mental Illness
- Lesson 7: Institutions and Mental Illness: Institutionalization and Deinstitutionalization; Mental Illness and Social Control