The Labeling Paradox: Stigma, the Sick Role, and Social Networks in Mental Illness

Department of Sociology, University of Kentucky, Lexington, KY 40506, USA.
Journal of Health and Social Behavior (Impact Factor: 2.72). 12/2011; 52(4):460-77. DOI: 10.1177/0022146511408913
Source: PubMed


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.

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Available from: Brea L Perry, Sep 12, 2014
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    • "In contrast, rejection due to the stigma and nonnormative behavior associated with SMI is likely to be fully operative among strangers, acquaintances, casual friends, and other peripheral members of the social network (Perry, 2011). Weaker relationships are unlikely to be characterized by a strong sense of obligation, reciprocity, and shared history that helps to preserve social bonds when relationships are strained (Wellman, 2000). "
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    ABSTRACT: Research has documented social network instability among people with serious mental illness focusing on (1) psychiatric symptoms that interfere with social skills and interaction and (2) stigma, discrimination, and social rejection. However, the social network consequences of disruptive events that often accompany onset of serious mental illness (e.g., divorce, job loss, and residential instability) are seldom considered. In this study, the relative impact of symptoms, stigma, and secondary disruptive events on membership turnover was examined using data from 100 people experiencing first contact with the mental health treatment system. Findings indicated that disruptive events and, to a lesser degree, psychiatric symptoms predicted membership turnover. A theory of relationship and network dynamics in mental illness integrating insights from the psychiatric, labeling, and social network perspectives is proposed.
    Journal of Social and Personal Relationships 02/2014; 31(1):32-53. DOI:10.1177/0265407513484632 · 1.29 Impact Factor
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    • "selective disclosure (Corrigan & Rao, 2012) and be more open about their psychiatric diagnosis with doctors, parents, and friends than with employers or police (Pandya, Bresee, Duckworth, Gay, & Fitzpatrick, 2011). The responses from social networks may be paradoxical, simultaneously enacting social support in core networks yet initiating detrimental consequences among peripheral ties (Pandya et al., 2011; Perry, 2011). Because evidence shows that people with larger social network size and higher network satisfaction were more likely to experience mental health recovery than their counterparts (Corrigan & Phelan, 2004), understanding how disclosure of mental illness influences a person's relationships with existing social networks has crucial implications. "
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