Saturday, March 3, 2018

Social class and mental illness: Community study (Hollingshead, A. B., & Redlich, F. C., 1958)

http://psycnet.apa.org/record/2005-00650-000

Hollingshead, A. B., & Redlich, F. C. (1958). Social class and mental illness: Community study. Hoboken, NJ, US: John Wiley & Sons Inc.
http://dx.doi.org/10.1037/10645-000


Abstract

This is the final report of one part of a research project carried out by a
team of social scientists and psychiatrists which examined the interrelations
between social stratification and mental illness in an urbanized community
centered in New Haven, Connecticut. The research reported here focused on two questions:
Is mental illness related to social class? Does a mentally ill patient's position in the status
system affect how he is treated for his illness? To answer these questions the authors studied
the social structure of the community, the psychiatric patients in treatment, the institutions
where they are cared for, and the psychiatrists treating them. Successive chapters tell the
story of how members of the community became patients, how they and their families
responded to psychiatric intervention, and the effects of social class on patients and
therapists. The book ends with some recommendations on what our society could do about
improving socially determined shortcomings of psychiatric practice. (PsycINFO Database
Record (c) 2016 APA, all rights reserved)

There have always been two kinds of psychiatry. After World War II, a book by a sociologist 
and a psychiatrist (Hollingshead & Redlich, 1958) described two types of practitioners. 
The “directive–organic” type wore a white coat and prescribed medication, whereas the 
“analytical–psychological” type wore a sport jacket and practiced psychotherapy. 
These distinctions never entirely disappeared. Mental health treatment split into two extreme 
positions, making the middle ground difficult to sustain. 

Paris, Joel. Psychotherapy in An Age of Neuroscience (p. 2). Oxford University Press. 
Kindle edition. 


And although many practitioners report that they continue to provide psychotherapy 
(Mojtabai & Olfson, 2008), it is not always clear what they mean. (I cannot help but wonder 
if they are describing taking a few minutes to talk to patients whose prescription is being 
re-evaluated.) (ibid, p. 3)