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Medicalizing deviance in the community of elderly : a new psychiatric entreprise Smith, André Philippe

Abstract

This study is about the process by which deviance is transformed into the medical category of medical illness in the elderly living in the community. Mental illness is considered here as a form of deviance in the sociological sense of term as it involves departure from socially expected rational behavior. More specifically, the study demonstrates by using a participant observation approach how psychiatric professionals in a community mental healthy team have created a new market for the distribution of their specialized geriatric services by establishing a network of both lay people and professionals who are trained to refer to the team elderly people whom they identify as mentally ill. However, much of the illness in the study's sample of referred elderly related more to the 'problems of living' they experienced in struggling with the generally poor social conditions they were faced with, including forced retirement, inadequate income and housing, and physical illness. In some instances, such problems also stemmed from their differences in lifestyle, personal needs, and beliefs with the staff in the institutions caring for them. By acknowledging the elderly's 'problems of living’ as psychiatric disorders, the community mental health team effectively isolated them from their social and political context by making them into individual problems. This approach become a move towards 'blaming the victim1, hence ignoring the political (rather than therapeutic) interventions needed to improve the conditions contributing to the presence of such problems. Finally, the study shows that community psychiatric professionals within the team tend to medicalize deviance as a response to the constraints imposed on them by their agency, which functions within a bio-medical framework in delivering mental health services to the community.

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