The Social Construction of Mental Disorders: Three Inevitable Consequences

The concept of mental disorder has been a hotly contested issue for many decades.  Arguments have often revolved around whether there is a biological basis for mental disorder.   Biological psychiatrists have argued that mental disorders are best understood as a physical disease.   By contrast, anti-psychiatrists and psychiatric survivors have argued that there is no evidence for mental disorder and that psychiatry is used to control social deviance.  We argue that this duality is unhelpful and re-examine social constructionist arguments to provide a fine-grained critique.  Drawing on the epistemological and sociological literature we argue that social constructionism is necessary to understanding mental disorder and that there are three consequences of adopting this position.   First, although we can assume that there is a world external to human beings, our view on ‘natural kinds’ (brain processes and their consequences) are deeply influenced by social and cultural perspectives.   This makes it impossible to gain access to such issues without socially constructed concepts.  Second, in the face of deep cultural fragmentation in western societies, psychiatry inevitably has to face divided public opinion on mental health issues.   Individuals adopt a wide range of positions which range from lobbying for to opposition to mental health services.  However, in all cases individuals use social constructions to orientate themselves to social problems.  Third, as long as psychiatry is part of the medical field, it inevitably has to use and to apply socially constructed medical diagnoses.  We conclude that the social construction of mental disorders is no argument for their non-existence.  The social construction of mental disorders, however, is a major cause of the widespread medicalization of human problems.