In cursed or affected by the work of

In order to define mental illness a
framework for the definition of mental health must first be put forward.  In accord to the definition provided by the
WHO (World Health Organization), mental
health is: “… a state of well-being in which the
individual realizes his or her own abilities, can cope with the normal stresses
of life, can work productively and fruitfully, and is able to make a
contribution to his or her community” (Who.int, 2017). As aforementioned,
mental health comprises of an individual’s capacity to realise one’s own
abilities, coping with the stresses faced in their lives, working productively;
therefore being able to positively contribute towards his or her community. A
mental illness in practice is therefore a state in which an individual is
unable to constitute any one of these social and personal frameworks. Furthermore,
mental illness has a number of different sociological and cultural definitions,
founded by the variety of different cultures and societies it is found in. The
APA defines mental illness as “health conditions involving
changes in thinking, emotion or behaviour (or a combination of these). Mental
illnesses are associated with distress and/or problems functioning in social,
work or family activities” (Psychiatry.org, 2017).

Mental
illness has historically been viewed in cultural contexts founded upon
religious or spiritual ideals. This most prominently, currently impacts
cultural definitions outside of modern western culture; although as
aforementioned, historically religious or spiritual ideals have also come into
play in Western societies. People have historically been found to attribute
mental illness to a number of religious and spiritual causes, these are namely
defined by “possession
by evil spirits, Djinns or demons, others however, might view a person with
mental illness as being cursed or affected by the work of witchcraft, a
Sorcerer or the devil’s eye. Some might even view such as a religious awakening
or a holy message from God and thereby link it with a higher spirit” (Mehraby,
2017).

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In
the Middle East and Asia, attitudes towards mental illness have generally
remained the same over the years. This is especially true in countries where
there is no pertinent cultural understanding or concept of psychological
problems (Mehraby, 2017). Examples of these countries include Afghanistan,
Vietnam, China, countries with Buddhist majorities, African countries such as Sudan,
Ethiopia, Somalia and Kenya and other countries where Arabic culture exists.
From the beginning, in Afghanistan there is no general comprehension of mental
problems (Mehraby, 2017). In this region an individual is
either ‘healthy or mad’ (Mehraby, 2017). In cultures
outside of Western culture, psychological problems are often expressed from the
parenthesis of somatic complaints which include; headaches, backaches and
stomach-aches. This is an acceptable way to express distress in many non-Western
cultures where psychological problems are stigmatising, and sufferers risk
being labelled ‘mad’ (Mehraby, 2017). In many cultures which believe in
Karma, an example being Vietnam; mental illness is seen as a form of punishment
for which the suffers may have sinned in a previous life. Buddhist ideals are
similar to those who believe in Karma in that mental illness is also defined as
a punishment for one’s, or their family’s misdeeds. Further east, exploring the
view of mental illness in Japan; it is often associating with undesirable forms
of weakness in an individual. Before mental illness was even represented as
deviant behaviour, Indian culture, pertinent before the 17C ‘viewed all abnormal
behaviour’ to be acts of the ‘devil’ (Mehraby, 2017). Taking into account Arab
cultures, traditionally individual’s erratic or deviant behaviour is seen to be
in line with their own or their family’s failure to uphold social values, norms
or expectations (Mehraby, 2017). It is important to ascertain that to this day
mental illness in cultures outside of the West is still viewed within a spiritual
or religious framework; this significantly impacts individuals abilities to
access support in terms of mental health services or any support framework
outside of their own close family and friends, who as aforementioned, can often
be sceptical and judgemental of the mental illnesses themselves.

 

In Western
culture mental illness has primarily been associated with deviant behaviour, as
associated with criminality; “in the west, mental illness is often associated with criminals, rapists
and serial killers portraying a discriminatory picture of sufferers as
unpredictable, violent and aggressive” (Mehraby, 2017). In various
societies, poor mental health and mental illness is often associated with
deviance; as proposed and evidenced by the Diagnostic
and Statistical Manual of Mental Disorders  which details and categorises different
illnesses (Diagnostic
and statistical manual of mental disorders, 2014), and also the Mental
Health Act (1983, 2007)  which gave the executive branch of government
the power to detain people with mental illness against their will (Nhs.uk, 2017). The strong social
stigma associated with mental illness can often impact suffers of mental
illnesses negatively, often worsening their condition; further implicating
their lives in an adverse fashion. 
Social factors such as social isolation, poor housing, unemployment and
poverty can all be linked to the persistence of mental illness, resulting in
poor mental health. The individuals most impacted by these poor social
circumstances, as aforementioned, social isolation, poor housing, unemployment
and poverty are often those most likely to be affected by mental illness. This
statement is evidenced by a statistic produced by (Counselling-directory.org.uk, 2017): “the percentages of homeless people that have been diagnosed
with mental health issues (45%) is nearly double that of the general population
(nearly 25%). The prevalence of depression is much higher amongst homeless
people” (Counselling-directory.org.uk, 2017).  Homeless people are those most affected by
social circumstances such as social isolation, poor housing, unemployment and
poverty; and are therefore perfect examples of the fact that these
circumstances; stigma; and discrimination can trap people in a cycle of
illness. (Phelan
and Link, 2004)

The media often works to exacerbate these critical problems
by associating those affected by mental illnesses as violent, further
indicative of these peoples portrayal as individuals who are dangerous,
criminal, evil, beyond repair and unable to lead normal, healthy; fulfilling
lives.  (Phelan and Link, 2004)

Mental
illness has been cited as being a paradigm which the public are often afraid of
when confronted with (Phelan and Link, 2004).  Historical reactions towards the mentally ill
have been to isolate, marginalize and alienate those affected by mental
illnesses; for the purpose of protecting the sanctity of the wider public and
society as a whole (Phelan and Link, 2004). Recent
legislation such The Equality Act 2010 has made it illegal to directly or
indirectly discriminate against people suffering from mental illnesses in the
public eye, this includes public services, functions, access to premises, work,
education, associations and transport (Legislation.gov.uk, 2017).
Research has generally shown that the best way to challenge existing cultural
and sociological stereotypes of mental illness is through direct, first hand
contact with the people suffering from and with experience of mental health
problems. As society moves towards a more tolerant and accepting attitude to the
treatment of those suffering from mental illness, several national and local
campaigns have been sprung, whose purpose it is to change public attitudes
towards mental illness; this includes the national voluntary sector campaign
Time to Change. (Evans-Lacko et al., 2013)

Public perspective is relevant to both media and literature. As
aforementioned, the media have had an adverse effect on the precedent of mental
health; in terms of propagating links between the mentally ill and deviant
types, further subjugating these individuals into groups which include
criminals, rapists and serial killers, alike other propagators of deviant
behaviour which associate the mentally ill with characteristics such as
instability and dangerousness which further associate them with crimes such as
violent assaults (Phelan and Link, 2004). Famous
literature such as Jekyll and Hyde, Robert Louis Stevenson’s 1886 Scottish
novel; and “I hate you, don’t leave me”,
the title of Jerold Kreisman’s (MD) 1991 book describing Borderline personality
disorder; illustrate mental illness in fashions which have become widely
accepted since their publication. These books have become so ingrained in
common western culture that individuals now describe those with the symptoms of
borderline personality disorder as being ‘Jekyll and Hyde’.  This essay propagates that literature is a
method in and of itself of both defining and rationalizing mental illness for
the broader public. This essay would posit the point that literature can
furthermore be used to “confront the stigma of mental illness, teach empathy,
and break stereotypes”; as introduced and argued by Kia Jane Richmond (Richmond, 2014).
 Although general
understanding of mental illnesses has on the whole improved dramatically last
few centuries, particularly in the West; especially considering stereotyping
individuals with mental illnesses, as indicated by (McCullough, as cited in
Kelly & Winterman, 2011) “we still have a long way to go when it comes to educating
people about mental health (Richmond, 2014).  Literature often serves the purpose of
identifying mental illness, from this foundation English teachers are able to
break certain stereotypes associated with mental illnesses through helping
students identify with the characters in the books. As referenced in a 2006
report to congress, the U.S. Government Accountability Office
found that approximately 2.4 million teens had at least one serious mental
illness, most with “multiple disorders” (Psychology Today, 2017).

The definition of mental illness is based in the appropriation of
the support available for young people and adults alike. As aforementioned the
U.S. Government Accountability Office found that approximately 2.4 million
teens had at least one serious mental illness (Psychology Today, 2017). 46.4 percent of Americans will have a diagnosable mental illness
in their lifetimes, based on the DSM-IV (Psychology Today,
2017). With the publication of
the DSMV in May 2013, it is recognised that is easier to become identified as
having some form of mental illness/disorder. With every publication of a new
DSM the criteria for which one may become diagnosed as having some form of
mental disorder widens. This essay posits a problem in that the wider the
parenthesis under which mental illness falls, more and more individuals are
wrongly diagnosed as having mental illnesses. Medicalization of proposed mental
illnesses results in casting the “net too
wide and captured many “patients” who might have been far better off
never entering the mental health system” (Psychology Today, 2017). The pharmaceutical
industry in part definitely sponsors the “wholesale medical imperialization
of normality” ” (Psychology
Today, 2017). We as a society then come face to face with a problem
where the majority of individuals targeted as having a mental disorder are
mistakenly attributed as having a mental illness or disorder. These, in ties
with the ongoing problems we face as members of societies worldwide, propel
individuals into worlds of stigmatization and equivocation which they would
excel outside of: “young
adults with serious mental illness face several challenges, including finding
services tailored to their specific needs, qualifying for adult programs that
provide access to mental health services, and navigating multiple programs and
delivery systems. Existing public mental health, employment, and housing
programs are not necessarily tailored to their mental disability or age range,
which may discourage these young adults from participating.”

In order to define mental illness one must first understand the
vested pretext through which the purpose of the definition lies. As versions of
the DSM are updated, as aforementioned, they extend the appropriate boundaries of
diagnosis for mental illness. This extension of the boundary for diagnosis for
mental illness plays not only into the hands of the global pharmaceutical
industry, but also implicates, as aforementioned, large numbers of individuals
whom might otherwise not require any medical intervention in their varying normal
mental states. At the end of the day it is important to realise whose vested
interests the definition of mental illness plays into, with the global
pharmaceutical market predicted to reach $1.12 trillion in 2022. This essay
would argue, alongside the aforementioned points of the prominence of taking
into account the varying cultural contexts in which mental illness is defined,
the importance of the media/literature in having created/being involved in the
process of the disassembly of existing cultural and sociological stereotypes
regarding mental health/illness and the importance of new legislation facilitated
by governments for the purpose of dismantling/changing public attitudes and
discrimination towards mental illness; in the conclusion of this essay: result
in the over-medicalization of normal humane reactions to changing personal/social
circumstances.