The aim of this assignment is to discuss the contribution of medical, sociological and psychological models to understanding emotional health and examine the impact of race, class and gender on emotional health. Furthermore the assignment will discuss appropriate theories to understanding the emotional health linking them to race in case study one.
According to World Health Organisation, 2005 “Mental health and mental well being are fundamental to the quality of life and productivity of individuals, families, communities and nations, enabling people to experience life as meaningful and to be creative and active citizens”. Hales ( ) defines emotional health as the ability to express, acknowledge how one feels, their moods and be in a position to adapt to situations and be compassionate to others.
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The medical model views the diseases as coming from outside and invading the body, causing changes within the body. It can also originate as internal, involuntary physical changes caused by chemical imbalances and can also be genetic (Nolan 2009). This model considers the mental malfunction of schizophrenia to be a consequence of chemical and physical changes in the brain. Environmental factors may be the causation of illness, but the disorder might still be influenced by hereditary factors (Tyrer and Steinberg 2008). The abnormal behaviour in an individual is a result of physical conditions such as brain damage, meningitis and others. The treatment given is aimed at controlling the root cause of the disease by changing the individual’s biochemistry. This approach does not account for the occasions this evidence can be found in mental disorders such as such bipolar and unipolar depression and schizophrenia.
The sociological model of health places more emphasis on the individual’s environmental, social and economic causes of disease rather than solely focusing on the biological aspect (Duggan 2002). The socio-cultural aspect refers to the role socio-cultural environments play in a given psychological phenomenon such as parental and peer influence in the behaviours or characteristics of an individual. “Social factors encompass a discrete subject matter because, as collective representations, they are independent of psychological and biological phenomena, although we have individual actions, thoughts and feelings we tend to live our lives through institutions: family, corporation, church, school and nights” (Hadden 1997 p 105).
The Psychological model suggests that human behaviour is strongly affected by experiences from childhood and also that behaviour is the result of interaction between the conscious and the unconscious (Nolan 2009). Mind (2010) points out that cannabis may cause psychological effects that lead to psychotic experiences such hallucination, depersonalisation and paranoid ideas. Rack (1982, p. 124) points out that Cannabis is readily available throughout the Caribbean and the northern parts of the Indian subcontinent its use is not restricted to any particular age-group. In support of this point Cockerham (2007) observes that living in a household with both parents who smoke or having a spouse who smokes can promote smoking behaviours. A psychological model is based on the assumption that conscious thought mediates an individual’s emotional state or behaviour in response to stimulus. The model suggests that people may create their own problems through interpretation.
The psychological model will look a lot deeper into the individuals and not merely the symptoms in which they are showing. It suggests that our thought may cause the disturbances or it may indeed by the disturbances causing our thought. The model refers to the role that cognition and emotions play in any given psychological phenomenon, such as the effects of mood, beliefs and expectation on an individual’s reaction to the event. The biological aspects refer to the role of the prenatal environment on brain development and cognitive abilities or the influence of genes on individual’s dispositions (Rogers and Pilgrim 2000).
Hatty (2000) in Barack (2006) observes that Gender refers to nature and the psychological, social, and cultural components that summarizes the leading ideas about feminine and masculine characteristics and behaviours dominating in any society at one time. According to Pilgrim (2009) gender is a social description. Rogers and Pilgrim (2005) points out that men are prone to be involved in antisocial behaviour and can be categorised as dangerous and criminally deviant, which leads to their removal. The idea of danger to society is always attributed to men than women. There is evidence to propose that men are often sectioned under Mental Health Act 1983 and referred to psychiatric hospitals by the police under section 136 removal to a place of safety. Men are more likely to be hand cuffed and detained in cells more than women (Rogers (1990) cited in Rogers and Pilgrim 2000).
Gove (1984) in Rogers and Pilgrim (2005) shows that there is now a general consensus among social scientists that women experience more psychological distress than men and that this is largely due to aspects of their societal roles. Another view point is that, throughout the life span women report greater psycho-social malaise than men and the gap between sexes increases in older people with self-reported factors like depression, worry, sleep disturbances and feelings of strain. There have used the societal role to explain why women experience psychological distress than men. Women’s unstructured roles tend to be more domestic than men which contribute to their vulnerability to mental distress because they have time to dwell on their problems (Blaxter (1990) cited in Rogers and Pilgrim 2005).
Women’s natural disposition is known to be maternal, caring, passive and home centred. Their inferiority, instability and lack of control are increased as their biology takes over (Jones 1994). WHO (2010) states that while childbearing and motherhood are often positive and fulfilling experiences, for many women these are associated with suffering, ill-health and even death. The estimation of illness is different between men and women, the peak age for men is 15-24 and for women is between 25 and 34. According to Rogers (1990) cited in Rogers and Pilgrim (2000)
Class remains a predictable correlate of mental ill health. Basically the poorer a person is the more likely they are to have a mental health problem. A class gradient is evident in mental health status across the bulk of the diagnostic groups but it is not a neat inverse relationship. For example affective disorders are not diagnosed evenly in all social classes whereas a very strong correlation exists between low social class and the diagnosis of schizophrenia. In the case of depression and anxiety the underlying assumption has been clearer cut, perhaps because minor morbidity is less strongly identifiable as biologically derived illness (Jones 1994). They found a complex relationship of social class to anxiety and depression linked to changing employment status they furthermore examined three different ways of describing social position: income; social advantage and lifestyle; and social class.
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Poor accommodation produces stress reactions in inhabitants (Hunt 1990; Hyndman 1990). Social and environmental causes are those factors around us such as where we live, whether we have strong family support networks, our place of work and how and where we can relax (Royal College of Psychiatrists, 2004). Social class is one of the determinants of health which includes; wealth, culture, background, family, financial constraints, accommodation and lifestyle WHO (2010).
According to Barak et al race is socially defined by a collection of traits such as; physical characteristics, culture and religion, national origin and language. King et al (1994) and other authors cited in Kaye and Lingiah (2000) states that there is evidence that, with the intervention of the police and social services, African -Caribbean people are more likely to be admitted to psychiatric hospitals compared to whites. There is a belief that African-Caribbean people are not provided with preventive and supportive measures before there is a crisis, but when the crisis starts and escalates the emergency services get involved which leads to compulsory admission (Bhuil et al (1998) and other authors cited in Kaye and Lingiah 2000). Rogers 1990 in (Rogers and Pilgrim 2005) states that Afro-Caribbean people are found to be less frequently referred by relatives or neighbours but by strangers and passers-by of other ethnic groups. In support of the above statement Reiner 1996 in Rogers and Pilgrim (2005) suggests that there is a process of transmitted discrimination in the way in which black people’s behaviour is viewed which is interpreted in a more negative way. Furthermore the Department of Health (DH 2005) states that the black and minority ethnic groups who live in England are deprived of the quality of mental health care that they need. Black and minority ethnic patients are more likely than the white British to be detained compulsorily, to be admitted to hospital rather than treated in the community, to be subject to measures like seclusion in hospital, and to come into contact with services through the criminal justice system. This leads to a vicious circle of BME people refraining from seeking care early in their illness. According to Rogers and Pilgrim (2005) most blacks including African-Caribbean people who live in the inner cities suffer from recurrent racism and are over represented in psychiatric records.
Looking at what the medical model says and comparing to Daniel’s behaviour, it may be suggested that he was suffering from schizophrenia which is more dominant in African Caribbean people, which could have been caused by substance abuse. Royal College of Psychiatrists (2004) states that there is a causal relation between substance misuse, particularly alcohol, cannabinoids, hallucinogens, and stimulants (such as amphetamines), can produce psychotic symptoms directly without mental illness. They may also precipitate psychotic disorders among people with a predisposition. Kaye and Lingiah (2000) points out that African Caribbean people have a higher rate of admissions for schizophrenia and effective psychosis compared to their white counterparts.
Hales (2010-2011) states that social health refers to the ability to interact effectively with other people and the social environment in order to develop satisfying interpersonal relationships and fulfil social roles. Looking at the changes in Daniel’s behaviour it may be suggested that it was down to living on his own, lack of support, change of environment and financial problems. Frederick 1991 in Rogers and Pilgrim (2005) observes that the various factors identified by Afro-Caribbean mental health users are; coping with adolescence and education system; building up relationships and then dashes their expectations; growing up in a hostile environment with few positive images of black people, parental and with British white cultural input leading to confusion and conflict over identity. Argyle (1994) states that there is a theory that failing to learn correct social skills during the early stages of life can contribute to social rejection there by cause one to fail to cope with life events and can cause anxiety, depression or other symptoms.
Hales (2010-2011) points out that those who are psychologically fit normally share the following characteristics: they have high self-esteem and aim towards happiness and fulfilment, they establish and maintain close relationships, they accept their own limitations in life and they feel a sense of meaning and purpose of life. Daniel started neglecting himself and acting on the voices that he heard, which may be suggested he had a problem with his psychological well-being. African Caribbean people are likely to be offered physical treatments, strong medication and not likely to be offered psychotherapy and counselling.
In conclusion analysing approaches to health and illness in terms of medical versus a social model henceforth the medical model is a key concept in both medical sociology and medical anthropology (Chang and Christakis 2002). A lack of social support also can be due to social stigma which is the main reason why mental people’s social network becomes narrow. Also because of schizophrenia’s pervasive effects on daily functioning a range of psychosocial approaches has been developed to improve emotional and psychological well-being.
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