Mainstream approaches to mental health and illness: an emphasis on individuals and a de-emphasis of inequalities

This theoretical paper argues that structured class, ethnicity and gender factors systematically contribute to people's vulnerability to experiencing a psychiatric disorder. In their denial of group-based contributions to psychiatric problems, mainstream psychiatric disciplines focus on the disturbed individual. It argues that the concept of individualism is a crucial modern European epistemological assumption which underpins definitions of normality and abnormality. An investigation of contemporary mainstream mental health texts reveals their trenchant individualism and the marginalization of life circumstances arising from class, ethnicity and gender relations with regard to assessing, and working with, people with psychiatric difficulties. The paper argues that modern non-ideal human qualities are associated with the social ‘other’. Middle class, Eurocentric and patriarchal assumptions increase the likelihood that people outside these categories are more likely to receive psychiatric diagnoses. Consequently the discipline of psychiatry constructs the notion of the mad ‘other’. Mainstream mental health nursing, clinical psychology and health psychology support medical psychiatry in individualizing and psychologizing the difficulties experienced by consumers of psychiatric services.