Community Medicine, Mental Illness and Social Control

This article explores the dualism of historic and contemporary rise and consolidation of Psychiatry and its relationship to the social construction of mental illness in Europe. It explores the emergent power dynamics that are inherent in how mental illness and disorder has been classified by the psychiatric profession. It does this in three processes. First, the article questions the historical rise of how ‘madness’ had and has been problematized as deviant and criminal for social order and is a form of hegemonic control and masculinity. Is psychiatric power about human development or discipline? Second, it introduces critical trajectories that provide a thorough underpinning of how and why certain acts of mental illness have been classified as an intensified threat to morality and society rather than out of concern. Finally, the article assesses the possibilities and problems for understanding mental illness for future concerns by stating that psychiatric power needs to be “un-masked” in allowing self-governance to be realised for those that have been at the centre of the clinicians’ gaze and the rethinking of the medical profession itself. It is clear that bio-psychological paradigms have dominated discussion in relation to mental illness that underpins the knowledge base of Psychiatry and there is an urgent need to develop other explanatory frameworks because dominant frameworks have failed to identify underlying social structures, processes, attitudes and social practices which inter-combine to oppress and disadvantage people who are mentally ill whilst simultaneously reproducing negative aspects of hegemonic masculinity within psychiatric regimes. What opportunities are there for meaningful human agency in the light of this? This is a long enduring question.

Keywords: power, psychiatry, social order, gender, hegemony, madness and mental illness.