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Social psychiatry

March 04, 2023

Social psychiatry is a branch of psychiatry that focuses on the interpersonal and cultural context of mental disorder and mental wellbeing. It involves a sometimes disparate set of theories and approaches, with work stretching from epidemiological survey research on the one hand, to an indistinct boundary with individual or group psychotherapy on the other. Social psychiatry combines a medical training and perspective with fields such as social anthropology, social psychology, cultural psychiatry, sociology and other disciplines relating to mental distress and disorder. Social psychiatry has been particularly associated with the development of therapeutic communities, and to highlighting the effect of socioeconomic factors on mental illness. Social psychiatry can be contrasted with biopsychiatry, with the latter focused on genetics, brain neurochemistry and medication. Social psychiatry was the dominant form of psychiatry for periods of the 20th century but is currently less visible than biopsychiatry.

After reviewing the history and activities of social psychiatry, Vincenzo Di Nicola reviews three major questions for social psychiatry and concludes with a manifesto for a 21st-century social psychiatry:

  1. What is social about psychiatry? This addresses definitional problems that arise, such as binary thinking, and the need for a common language.
  2. What are the theory and practice of social psychiatry? Issues include social psychiatry's core principles, values, and operational criteria; the social determinants of health and the Global Mental Health (GMH) Movement; and the need for translational research. This part of the review establishes the minimal criteria for a coherent theory of social psychiatry and the view of persons that emerges from such a theory, the social self.
  3. Why the time has come for a manifesto for social psychiatry. This manifesto outlines the parameters for a theory of social psychiatry, based on both the social self and the social determinants of health, to offer an inclusive social definition of health, concluding with a call for action.[1]

History

The events of the first half of the 20th century brought the issue of the relationship between the individual and the community to the fore. Psychiatrists who showed a willingness to confront these issues at home, after the war, called themselves social psychiatrists. Psychoanalytic psychotherapy and all its offshoots were grounded in an approach to the patient that focused almost exclusively on the individual—the relational aspects of therapy were implicit in the relationship between therapist and patient, but the main source of problem and motivation for change was seen as being intrapsychic (within the individual). The social and political contexts were largely disregarded. Sarason observed in 1981, that "it is as though society does not exist for the psychologist. Society is a vague, amorphous background that can be disregarded in one's efforts to fathom the laws of behavior" (Sarason 1981).[full citation needed]

Early landmarks in social psychiatry included: Karen Horney, MD, who wrote about personality as it interacts with other people (1937)[full citation needed]; Erik Erikson, who discussed the influence of society on development (1950)[full citation needed]; Harry Stack Sullivan's (1953)[full citation needed] integration of sociological and psychodynamic concepts, and his work on the role of early interpersonal interactions in the development of the self; Cornell University's Midtown Manhattan Study, which looked at the prevalence of mental illness in Manhattan; August Hollingshead, PhD, and Frederick Redlich, MD, looked at the influence of social class on psychiatric conditions (1958); Alexander H. Leighton, MD, looked at the relationship between social disintegration and mental illness (1959);[full citation needed] Burrow was an early pioneer of the social causes of mental disorder and suggested "Sociatry" as the name for this new discipline.[citation needed]

Over the years many sociologists have contributed theories and research which has enlightened psychiatry in this area (e.g. Avison and Robins[full citation needed]); The relationship between social factors and mental illness was demonstrated by the early work of Hollingshead and Readlich in Chicago in the 1930s, who found a high concentration of individuals diagnosed with schizophrenia in deprived areas of the city has been replicated numerous times throughout the world, although controversy still exists as to the extent of drift of vulnerable individuals to these areas or of a higher incidence of the disorder in the socially disadvantaged; the Midtown Manhattan Study conducted in the 1950s by Cornell University hinted at widespread psychopathology among the general population of New York City (Srole, Sanger, Michael, Opler, and Rennie, 1962); the Three Hospitals Study (Wing JK and Brown GW, Social Treatments of Chronic Schizophrenia: a comparative survey of three mental hospitals, 1961, Journal of Mental Science, 107, 847–861)[full citation needed] was a very influential work that has been replicated, that demonstrated forcefully that the poverty of the environment in poor mental hospitals lead to greater handicaps in the patients.

Social psychiatry was instrumental in the development of therapeutic communities. Under the influence of Maxwell Jones, Main, Wilmer and others (Caudill 1958; Rapoport 1960), combined with the publications of critiques of the existing mental health system (Greenblatt et al. 1957, Stanton and Schwartz 1954)[full citation needed] and the sociopolitical influences that permeated the psychiatric world, the concept of the therapeutic community and its attenuated form—the therapeutic milieu—caught on and dominated the field of inpatient psychiatry throughout the 1960s. The aim of therapeutic communities was a more democratic, user-led form of therapeutic environment, avoiding the authoritarian and demeaning practices of many psychiatric establishments of the time. The central philosophy is that clients are active participants in their own and each other's mental health treatment and that responsibility for the daily running of the community is shared among the clients and the staff. "TCs" have often eschewed or limited medication in favor of psychoanalytically derived group-based insight therapies.

Current work

Social psychiatry can be most effectively applied in helping to develop mental health promotion and prevent certain mental illnesses by educating individuals, families, and societies.[2]

Social psychiatry has been important in developing the concept of major "life events" as precipitants of mental ill health, including, for example, bereavement, promotion, moving house, or having a child.

Originally inpatient centers, many therapeutic communities now operate as day centers, often focused on borderline personality disorder and run by psychotherapists or art therapists rather than psychiatrists.

Social psychiatrists help test the cross-cultural use of psychiatric diagnoses and assessments of need or disadvantage, showing particular links between mental illness and unemployment, overcrowding and single parent families.

Social psychiatrists also work to link concepts such as self-esteem and self-efficacy to mental health, and in turn to socioeconomic factors.

Social psychiatrists work on social firms in regard to people with mental health problems. These are regular businesses in the market that employ a significant number of people with disabilities, who are paid regular wages and work on the basis of regular work contracts. There are approximately 2,000 social firms in Europe and a large percentage of people with disabilities who work in social firms have a psychiatric disability. Some are specifically for people with psychiatric disabilities. (Schwarz, G. & Higgins, G: Marienthal the social firms network Supporting the Development of Social Firms in Europe, UK, 1999)[full citation needed]

Social psychiatrists often focus on rehabilitation in a social context, rather than "treatment" per se. A related approach is community psychiatry.

Facilitating the social inclusion of people with mental health problems is a major focus of modern social psychiatry.

See also

References

  1. ^ Di Nicola, Vincenzo (2019). ""A person is a person through other persons": A social psychiatry manifesto for the 21st century". World Social Psychiatry. 1 (1): 8–21. doi:10.4103/WSP.WSP_11_19. S2CID 239305698.
  2. ^ Bhugra, D., & Till, A. (March 2013). "Public mental health is about social psychiatry". International Journal of Social Psychiatry. 59 (2): 105–106. doi:10.1177/0020764012464184. PMID 23418192.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • S Moffic (1998) Social Psychiatry, Managed Care and the New Millennium. Psychiatric Times. December 1998 Vol. XV Issue 12
  • L. Srole, T. Sanger, S. Michael, M.K. Opler, and T.A.C. Rennie, Mental Health in the Metropolis: The Midtown Manhattan Study, McGraw, 1962
  • Mohan, Brij. 1973. Social Psychiatry in India: A Treatise on the Mentally Ill. Calcutta: Minerva.

External links

March 04, 2023
social, psychiatry, branch, psychiatry, that, focuses, interpersonal, cultural, context, mental, disorder, mental, wellbeing, involves, sometimes, disparate, theories, approaches, with, work, stretching, from, epidemiological, survey, research, hand, indistinc. Social psychiatry is a branch of psychiatry that focuses on the interpersonal and cultural context of mental disorder and mental wellbeing It involves a sometimes disparate set of theories and approaches with work stretching from epidemiological survey research on the one hand to an indistinct boundary with individual or group psychotherapy on the other Social psychiatry combines a medical training and perspective with fields such as social anthropology social psychology cultural psychiatry sociology and other disciplines relating to mental distress and disorder Social psychiatry has been particularly associated with the development of therapeutic communities and to highlighting the effect of socioeconomic factors on mental illness Social psychiatry can be contrasted with biopsychiatry with the latter focused on genetics brain neurochemistry and medication Social psychiatry was the dominant form of psychiatry for periods of the 20th century but is currently less visible than biopsychiatry After reviewing the history and activities of social psychiatry Vincenzo Di Nicola reviews three major questions for social psychiatry and concludes with a manifesto for a 21st century social psychiatry What is social about psychiatry This addresses definitional problems that arise such as binary thinking and the need for a common language What are the theory and practice of social psychiatry Issues include social psychiatry s core principles values and operational criteria the social determinants of health and the Global Mental Health GMH Movement and the need for translational research This part of the review establishes the minimal criteria for a coherent theory of social psychiatry and the view of persons that emerges from such a theory the social self Why the time has come for a manifesto for social psychiatry This manifesto outlines the parameters for a theory of social psychiatry based on both the social self and the social determinants of health to offer an inclusive social definition of health concluding with a call for action 1 Contents 1 History 2 Current work 3 See also 4 References 5 External linksHistory EditThe events of the first half of the 20th century brought the issue of the relationship between the individual and the community to the fore Psychiatrists who showed a willingness to confront these issues at home after the war called themselves social psychiatrists Psychoanalytic psychotherapy and all its offshoots were grounded in an approach to the patient that focused almost exclusively on the individual the relational aspects of therapy were implicit in the relationship between therapist and patient but the main source of problem and motivation for change was seen as being intrapsychic within the individual The social and political contexts were largely disregarded Sarason observed in 1981 that it is as though society does not exist for the psychologist Society is a vague amorphous background that can be disregarded in one s efforts to fathom the laws of behavior Sarason 1981 full citation needed Early landmarks in social psychiatry included Karen Horney MD who wrote about personality as it interacts with other people 1937 full citation needed Erik Erikson who discussed the influence of society on development 1950 full citation needed Harry Stack Sullivan s 1953 full citation needed integration of sociological and psychodynamic concepts and his work on the role of early interpersonal interactions in the development of the self Cornell University s Midtown Manhattan Study which looked at the prevalence of mental illness in Manhattan August Hollingshead PhD and Frederick Redlich MD looked at the influence of social class on psychiatric conditions 1958 Alexander H Leighton MD looked at the relationship between social disintegration and mental illness 1959 full citation needed Burrow was an early pioneer of the social causes of mental disorder and suggested Sociatry as the name for this new discipline citation needed Over the years many sociologists have contributed theories and research which has enlightened psychiatry in this area e g Avison and Robins full citation needed The relationship between social factors and mental illness was demonstrated by the early work of Hollingshead and Readlich in Chicago in the 1930s who found a high concentration of individuals diagnosed with schizophrenia in deprived areas of the city has been replicated numerous times throughout the world although controversy still exists as to the extent of drift of vulnerable individuals to these areas or of a higher incidence of the disorder in the socially disadvantaged the Midtown Manhattan Study conducted in the 1950s by Cornell University hinted at widespread psychopathology among the general population of New York City Srole Sanger Michael Opler and Rennie 1962 the Three Hospitals Study Wing JK and Brown GW Social Treatments of Chronic Schizophrenia a comparative survey of three mental hospitals 1961 Journal of Mental Science 107 847 861 full citation needed was a very influential work that has been replicated that demonstrated forcefully that the poverty of the environment in poor mental hospitals lead to greater handicaps in the patients Social psychiatry was instrumental in the development of therapeutic communities Under the influence of Maxwell Jones Main Wilmer and others Caudill 1958 Rapoport 1960 combined with the publications of critiques of the existing mental health system Greenblatt et al 1957 Stanton and Schwartz 1954 full citation needed and the sociopolitical influences that permeated the psychiatric world the concept of the therapeutic community and its attenuated form the therapeutic milieu caught on and dominated the field of inpatient psychiatry throughout the 1960s The aim of therapeutic communities was a more democratic user led form of therapeutic environment avoiding the authoritarian and demeaning practices of many psychiatric establishments of the time The central philosophy is that clients are active participants in their own and each other s mental health treatment and that responsibility for the daily running of the community is shared among the clients and the staff TCs have often eschewed or limited medication in favor of psychoanalytically derived group based insight therapies Current work EditSocial psychiatry can be most effectively applied in helping to develop mental health promotion and prevent certain mental illnesses by educating individuals families and societies 2 Social psychiatry has been important in developing the concept of major life events as precipitants of mental ill health including for example bereavement promotion moving house or having a child Originally inpatient centers many therapeutic communities now operate as day centers often focused on borderline personality disorder and run by psychotherapists or art therapists rather than psychiatrists Social psychiatrists help test the cross cultural use of psychiatric diagnoses and assessments of need or disadvantage showing particular links between mental illness and unemployment overcrowding and single parent families Social psychiatrists also work to link concepts such as self esteem and self efficacy to mental health and in turn to socioeconomic factors Social psychiatrists work on social firms in regard to people with mental health problems These are regular businesses in the market that employ a significant number of people with disabilities who are paid regular wages and work on the basis of regular work contracts There are approximately 2 000 social firms in Europe and a large percentage of people with disabilities who work in social firms have a psychiatric disability Some are specifically for people with psychiatric disabilities Schwarz G amp Higgins G Marienthal the social firms network Supporting the Development of Social Firms in Europe UK 1999 full citation needed Social psychiatrists often focus on rehabilitation in a social context rather than treatment per se A related approach is community psychiatry Facilitating the social inclusion of people with mental health problems is a major focus of modern social psychiatry See also EditAmerican Association of Community Psychiatrists DSM IV Codes Structured Clinical Interview for DSM IV SCID Relational disorder proposed DSM V new diagnosis References Edit Di Nicola Vincenzo 2019 A person is a person through other persons A social psychiatry manifesto for the 21st century World Social Psychiatry 1 1 8 21 doi 10 4103 WSP WSP 11 19 S2CID 239305698 Bhugra D amp Till A March 2013 Public mental health is about social psychiatry International Journal of Social Psychiatry 59 2 105 106 doi 10 1177 0020764012464184 PMID 23418192 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link S Moffic 1998 Social Psychiatry Managed Care and the New Millennium Psychiatric Times December 1998 Vol XV Issue 12 L Srole T Sanger S Michael M K Opler and T A C Rennie Mental Health in the Metropolis The Midtown Manhattan Study McGraw 1962 Mohan Brij 1973 Social Psychiatry in India A Treatise on the Mentally Ill Calcutta Minerva External links Edithttps web archive org web 20050327051651 http www sanctuaryweb com main social psychiatry htm http library cpmc columbia edu hsl archives findingaids opler html Faculty of Rehabilitation and Social Psychiatry of the Royal College of Psychiatrists in the UK Social psychiatry and public mental health present situation and future objectives Time for rethinking and renaissance Retrieved from https en wikipedia org w index php title Social psychiatry amp oldid 1100526278, wikipedia, wiki, book, books, library,

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