Key research for Mental Health (Szasz, Rosehan and Gottesman)

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  • Issues in Mental Health - Key Research.
    • Rosenhan (1973)
      • Theory - He argues that diagnoses were in the mind of the observer, rather than a result of valid summaries.
        • Diagnosis depends on the context in which the behaviour is observed.
        • Rosenhan's idea was to place sane people inside mental institutes and see if they could be identified as sane.
      • A field experiment was used with observations and self report methods.
        • 8 psuedo patients aged over 20. all were mentally healthy.
        • peadiatrician, psychiatrist, housewife, painter and psychology undergraduate.
        • studied 12 hospitals in 5 different US states - private and public.
      • Results of Study One
        • All bar one were given a diagnosis of Schizophrenia.
        • Length of stay in the hospital ranged from 7 - 52 days. average of 19.
        • 35 out of 118 real patients voiced suspicions on the sanity of the pseudo patients.
          • no staff suspicion.
        • bored pacing was nervousness and diary writing was obsessive writing disorder.
        • attendants spent 11.3% of their time with patients.
        • average daily contact with doctors was 6.8 minutes.
        • 2100 pills.
      • Second study
        • Staff at hospitals were told about the previous research.
        • They were told that within the next 3 months one or more pseudo patients would seek entry. (none were used)
        • Staff were asjed to rate each patient on a scale of 1-10 on the likelyhood that they were fake patients, with 1 being the strongest belief.
        • 41 of the 139  patients in this time were judged as pseudo.
        • Of these 41, 23 were judged by at least 1 psychiatrist and 19 by 1 psychiatrist and at least one other member of staff.
      • Conclusions
        • situation leads to misinterpretation.
        • mental health workers are insensitive - patients feel powerless and depersonalisation.
        • stickiness of labels.
    • Gottesman et el (2010)
      • Theory
        • used the Maudsley twin register to find identical twins who had been reared apart.
        • eliminates the effect of the enviroments.
        • studied 12 twins and found in 7 pairs both had schizophrenia
        • new research wanted to use a bigger sample and wanted to see how vulnerable children were.
      • sample
        • cohort study - used all children born within certain dates.
        • danish population with an identifiable mother and father.
        • 196 couples both had schizo - 270 kids.
        • 83 couples both had bipolar - 149 children.
        • 8006 couples where one had schizo - 13,878 children.
        • 11,995 couples where one had bipolar - 23,152 children.
      • Results
        • Schizo (One) - 7%
        • Schizo (none) - 0.86%
        • Bipolar (None) - 0.48%
        • Bipolar (One) - 4.4%
        • Schizo (Both) - 27.3%
        • Bipolar (Both) - 24.95%
      • Conclusions
        • having (two) parents with a disorder significantly increases your chances of developing the disorder.
        • genes may not influence a specific disorder, rahter a catagory.
        • not all children with 'sick' parents developed a disorder, so genes only play a part.
    • Szasz (2011)
      • Section 2
        • MI has been medicalised and politicalised.
        • The government decides what illnesses exist.
      • Section 3
        • mental illness is a metaphor.
        • the person isnt ill - they are just showing behaviours that have been catagorised as illness.
        • if MI has a physical cause, it is a physical illness.
        • this has implications for the plea of insanity.
      • Section 1
        • Fifty Years of Change in US mental healthcare.
        • Everyone defined as a MH professional is legally responsible for preventing danger.
        • MI is a big business with pharmacuetical industries benefiting.
      • Section 4
        • psychiatry is a psuedo science.
        • has the appearance of a science, but lacks the features of science.
        • seeing these as disorders denies responsibility.
      • Background
        • Challenged the medical view of mental illness.
        • he suggests we move away from seeing people with MI as helpless victims.
        • szasz is an alternative to the medical model.

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