The labeling paradox: Stigma, the sick role, and social networks in mental illness
Does the growing number of psychiatric disorder diagnoses have an effect on people with mental illnesses? According to this study, as definitions of mental illnesses become broader, people who show signs of depression and other common mental illnesses are less likely to evoke a supportive response from friends and family members as are people with other severe mental disorders.
The author studied interviews conducted with 165 individuals with a range of mental health disorders, who were undergoing treatment for the first time. She found that those with more socially-accepted and commonplace mental illnesses, such as depression and mild mood disorders, did not receive strong reactions to their conditions from family members, friends, or others with whom they came in contact. As a result, their support networks may be less willing to take on caregiver responsibilities or to excuse them when their behavior deviates from what is considered normal. This study also found that diagnosing someone with a severe mental illness that is more outwardly recognizable such as schizophrenia and the manic phase of bipolar disorder can lead to a higher amount of rejection and discrimination by acquaintances and strangers while at the same time creating a stronger social support system among close friends and family.
Although research supports the stigma and labeling perspective, empirical evidence also indicates that a social safety net remains intact for those with mental illness, recalling the classic “sick role” concept. Here, insights from social networks theory are offered as explanation for these discrepant findings. Using data from individuals experiencing their first contact with the mental health treatment system, the effects of diagnosis and symptoms on social networks and stigma experiences are examined. The findings suggest that relative to those with less severe affective disorders, individuals with severe diagnoses and more visible symptoms of mental illness have larger, more broadly functional networks, as well as more supporters who are aware of and sympathetic toward the illness situation. However, those with more severe diagnoses are also vulnerable to rejection and discrimination by acquaintances and strangers. These findings suggest that being formally labeled with a mental illness may present a paradox, simultaneously initiating beneficial social processes within core networks and detrimental ones among peripheral ties.
Perry, B. (2011). The Labeling Paradox: Stigma, the Sick Role, and Social Networks in Mental Illness Journal of Health and Social Behavior, 52 (4), 460-477 DOI: 10.1177/0022146511408913