Topic 3: Szasz (Study)

Question 1

Background

Answer 1

Szasz wrote a book in 1961 about “the myth of mental illness”.

In 2011, he reviewed this article

(50 years later)

Question 2

Aims of the 1961 book and 2011 review article

Answer 2

1. Challenge the medical concept of “mental illness”
2. Reject psychiatric treatments based on the medical model
3. Encourage people to avoid labels
4. Reject the image of people with mental illness as the helpless victims of pathobiological events
5. Stop coercive psychiatric practices which are incomplete with free societies (such as involuntary hospitalisation)

Question 3

Fifty years of change (politicalisation)

Answer 3

1950s = government did not provide healthcare. People with mental illness were seen as incurable and locked away.

50 years later = government has taken on legal responsibility to mental health care to prevent people being a danger to themselves or others.

Question 4

Mental illness - a medical or legal concept?

Answer 4

If mental illness was a real phenomenon the criteria would not change so easily - for example, homosexuality used to be considered a mental disorder but now it is not.

This politicalisation means that those in power have determined that mental illness is like any other physical illness. The argument is not based on scientific evidence.

Psychiatric hospitals are like prisons - people labelled with mental illnesses are treated like prisoners rather than receiving treatment for their illness. Psychiatrists act like judges rather than healers.

Question 5

“Mental illness is a metaphor”

Answer 5

People diagnosed with mental illness may later be found to have a physical illness. Showing misdiagnosis. They did not have a mental illness; they had an undiagnosed physical illness.

Question 6

Changing perspectives

Answer 6

Shakespeare’s Lady Macbeth (16th century) was experiencing hallucinations and was prescribed religion by the doctor. By the end of the 19th century, the physician took on the role of curing the soul.

Question 7

In the eye of the beholder

Answer 7

Diseases of the body have causes which can be cured, whereas mental illness must be understood (and interpreted by a psychiatrist) but cannot be cured. Feelings do not matter in physical illness.

Ethical principle: “do no harm” …
People with physical diseases have a choice which is not given to people with mental illness

Question 8

Having an illness does not make a person a patient

Answer 8

Worst assumption = if someone is labelled as mentally ill then they require some form of treatment, whether they choose to or not.

Leads to:
Curing/healing with conversation (talking therapy)

Controlling or coercing patients forcefully, which is authorised by the government

Question 9

How does the research explain the alternatives to the medical model?

Answer 9

Explaining psychological disorders:
If a disorder has a biological basis then it should be diagnosed as a physical illness rather than a mental illness. Behaviours that are disturbing should be explained psychologically because they are psychological symptoms.

Treating psychological disorders:
1. Talking therapy (consensual)
2. Controlling people against their will

Question 10

Validity

Answer 10

Low

Based on own views (subjective)
No empirical evidence

Question 11

Reliability

Answer 11

Low

fMRI scans can be used to study brain function - reliability is variable (depends on task)