Doctoral Dissertation: Medicalizing Mental Health: A Comparative View of the Public, Private, and Professional Construction of Mental Illness

本论文的研究将研究心理健康如何以及为什么被医疗化，特别是全球思想和国家背景如何相互作用，在社会内部和跨社会创造心理健康景观。了解这些过程是至关重要的，因为社会越来越依赖医疗专业来解决各种各样的问题，包括控制表现为精神健康问题的社会行为。社会学家将这一过程理论化为医学化，但这些理论是为美国社会发展并应用于美国社会的。这是有问题的，因为这一定义没有考虑到与医疗行业相互作用的反补贴行为者，如国家和保险公司。本文采用定量与定性相结合的研究方法，以最有效地回答其研究问题。具体来说，来自经济合作发展组织（OECD）和世界卫生组织（WHO）的数据将用于检查21个西方工业化社会的医疗化水平，并测试全球化和福利国家措施对精神健康医疗化的影响。此外，将完成对冰岛心理健康领域主要参与者的深入访谈，以产生关于医疗化进程和全球观念与一国福利国家之间相互作用的进一步假设。本研究探讨了全球化和福利国家的宏观理论以及医学社会学中的理论如何相互告知，以增加我们对社会组织和结构如何影响个人生活的理解。具体而言，本研究从比较的角度重新定义了医疗化的概念，为医疗化理论提供了更广泛的应用。此外，它通过关注福利国家最大但理论化程度最低的领域之一：医疗支出，推进了福利国家的文献。最后，它通过提供全球过程和嵌入在这些过程中的本地参与者之间的联系，促进了我们对全球化过程的理解。更广泛的影响：该研究系统地解决了与医疗化的原因和后果有关的问题。具体来说，它将更准确地了解不同社会中面临心理健康问题的个人的经历。对国家和专业之间相互作用的核心关注可以更好地为个人、国家和国际层面的干预策略提供信息，以理解和应对心理健康问题。

SES-0526236Bernice A. PescosolidoSigrun OlafsdottirIndiana UniversityThis dissertation research will examine how and why mental health has been medicalized, specifically how global ideas and national context interact to create a mental health landscape within and across societies. Understanding these processes is crucial, given that societies increasingly rely on the medical profession to provide solutions to wide array of problems, including the control of social behaviour as manifested in mental health problems. Sociologists have theorized about this process as medicalization, but these theories were developed for and applied to American society. This is problematic, since this definition fails to take into account countervailing actors that interact with the medical profession, such as the state and insurers. This dissertation uses a combination of quantitative and qualitative research methods in order to most effectively answer its research question. Specifically, data from the OECD (Organization for Economic Co-Operation Development) and WHO (World Health Organization) will be used to examine the levels of medicalization in 21 Western, industrialized societies and to test the effects of globalization and welfare state measures on the medicalization of mental health. In addition, in-depth interviews with key players in the mental health field in Iceland will be completed to generate further hypotheses regarding processes of medicalization and the interaction between global ideas and the welfare state within one national setting. This study addresses the ways in which macro-theories of globalization and the welfare state and theories within medical sociology can inform one another to increase our understanding of how social organization and structures affect individual lives. Specifically, by reconceptualizing the notion of medicalization in a comparative perspective, this research provides a broader application of theories of medicalization. Furthermore, it advances the welfare state literature by concentrating on one of the largest, yet least theorized, domains of the welfare state: spending on health. Finally, it advances our understanding of globalization processes by providing a link between global processes and the local actors embedded in these processes. Broader Impacts: The research systematically addresses questions related to the causes and consequences of medicalization. Specifically, it will provide a more accurate understanding of the experiences of individuals facing mental health problems across different societies. The core focus on the interplay between the state and professions can better inform intervention strategies at the individual, national, and international levels in understanding and responding to mental health problems.