Crazy, Sad, Or Just Different: Representations of Mental Illness
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CRAZY, SAD OR JUST DIFFERENT: EVOLVING REPRESENTATIONS OF MENTAL ILLNESS AND THE MENTALLY ILL DURING PSYCHOLOGY EDUCATION. Helen Correia B.A. (Hons) Thesis submitted in fulfillment of the requirements For the Degree of Doctor of Philosophy December, 2002 School of Psychology, Murdoch University Western Australia Declaration I declare that this thesis contains as its main content work which has not previously been submitted for a degree at any tertiary education institution and, to the best of my knowledge or belief, contains no material previously published or written by another person, except when due reference is made in the text. Helen Correia December, 2002 ii Table of Contents List of Tables..............................................................................................................................viii List of Figures................................................................................................................................x List of Appendices ........................................................................................................................xi Acknowledgments........................................................................................................................xii Abstract .....................................................................................................................................xiii CHAPTER 1..................................................................................................................................1 Introduction ...................................................................................................................................1 1.1. The nature of 'mental illness'...................................................................................................3 1.1.1 Definitions of mental illness ...........................................................................................3 1.1.2 Perspectives and models of mental illness.......................................................................6 1.1.3 The social context of perspectives on mental illness......................................................10 1.2. Social representations..........................................................................................................10 1.2.1 Key concepts in social representations ..........................................................................11 1.2.2 Social representations and other orientations.................................................................16 1.3. Social representations of mental illness................................................................................19 1.3.1 Representations in the general community ....................................................................19 1.3.2 Representations in student populations..........................................................................22 1.3.3 Representations in the mental health profession ............................................................24 1.3.4 The portrayal of mental illness......................................................................................26 1.4 The diffusion and infusion of representations of mental illness..............................................29 1.5 The psychologist and the profession of psychology...............................................................32 1.5.1 Representations of the psychologist ..............................................................................32 1.5.2 The model of psychology and its influence on practice..................................................34 1.6 Levels of investigation..........................................................................................................36 1.7 Social representations and psychology education..................................................................39 CHAPTER 2................................................................................................................................41 Present Study and Overview.........................................................................................................41 2.1 Target terms and themes.......................................................................................................41 2.2 Target groups .......................................................................................................................43 2.2.1 Levels of education and experience: National and regional influences...........................43 2.2.2 Levels of education and experience: Program and employment influences ....................47 2.3. Levels of investigation.........................................................................................................51 2.3.1. Intra-individual methods of investigation.....................................................................52 2.3.2. Inter-individual methods of investigation.....................................................................53 2.4. Aims ...................................................................................................................................54 iii 2.5. General methodological overview........................................................................................55 2.5.1. Design.........................................................................................................................56 2.5.2. Participants..................................................................................................................56 2.5.3. Materials .....................................................................................................................58 2.5.4. Procedure ....................................................................................................................59 CHAPTER 3................................................................................................................................60 Awareness of mental disorders and categorisation of mental illness..............................................60 3.1 Differentiation and classification of "mental illnesses"..........................................................60 3.2. Method................................................................................................................................61 3.2.1. Participants..................................................................................................................61 3.2.2. Materials .....................................................................................................................62 3.2.3. Procedure ....................................................................................................................62 3.3. General analysis ..................................................................................................................63 3.3.1. Awareness of mental disorders and conditions .............................................................63 3.3.2. Classification of mental disorders and conditions as a "mental illness" .........................66 3.4. Conclusions.........................................................................................................................71 CHAPTER 4................................................................................................................................74 Social representations of the mentally ill and other individuals: Difference and sameness in repertory grid responses ...............................................................................................................74 4.1. Repertory grids and social representations ...........................................................................75 4.2. Aims and research questions................................................................................................77 4.3. Development of the repertory grid .......................................................................................78 4.3.1. Elements.....................................................................................................................79 4.3.2. Constructs ..................................................................................................................79 4.3.3. Constructs and elements: pilot study ...........................................................................85 4.4. Method................................................................................................................................85 4.4.1. Participants.......................................................................................................................85 4.4.2. Materials .....................................................................................................................86 4.4.3. Procedure ....................................................................................................................88 4.5. Analysis and Discussion......................................................................................................89 4.5.1. Analysis overview and considerations..........................................................................89 4.5.2. Representations of the mentally ill person and others ...................................................94 4.5.3. Clustering and differentiation of elements..................................................................114 4.6. General Conclusions and Summary ...................................................................................117