Medicalization and Social Constructionism

Medicalization is a term that came into wide use in the discipline of social science during the 1970s. It can be described as defining behaviour as “a medical problem or illness and mandating or licensing the medical profession to provide some type of treatment for it” (Conrad)
Throughout American history, scholars have identified mental disorders amongst the population. Previous studies like the Epidemiological Catchment Area (ECA) in 1978 and the National Comorbidity Study (NCS) shortly afterwards concluded that the prevalence rate of such disorders is high. As such, each individual study has come up with different statistics regarding the prevalence of mental illnesses depending on the structure of each study. The NCS for example reported that nearly 50% of the respondents experienced at least one lifetime disorder.
This notwithstanding, social scientists such as David Mechanic, Michael Bury and Conrad caution against quickly believing in the studies that tend to report such high prevalence rates of mental illnesses, instead urging caution. This could be due to a number of reasons. In his publication ‘Medical Sociology’, David Mechanic proposes a different view on the subject, grounding his argument on a number of reasons.
Lack of laboratory measures that substantiate patients’ complaints or disturbing behaviour affects the credibility of studies on mental illness. Much of clinicians’ descriptive categories are more of conveniences and further inquiry than they are representative of confirmed diagnostic theories. Diagnostic theories identify a related cluster of signs and symptoms representing an underlying disorder, provide information on the expected course or natural history, causes and needed treatment. Further, diagnostic theories in psychiatry are more likely to be partially confirmed or unconfirmed with limited understanding of causes, uncertain understanding of course and fewer specific treatments. (Mechanic).
Michael Bury in his publication ‘Social Constructionism and the Development of Medical Sociology’ (1986) opines that since social constructionism assumes the relativity of all knowledge, constructionism itself is affected by the same forces as scientific knowledge. As such, it cannot be solely depended upon when arriving at conclusions regarding mental illness. This combined with the thin line separating ‘discovery’ from ‘invention’ has led analysts to exaggerate the extent of medicalization in the society today.
Conrad says that most medicalization studies place little emphasis on the question of causation of the particular behaviour, and focus instead on how the problem came to be designated as medical. In that respect, medicalization researchers value more the aetiology of definitions than the aetiology of the behaviour or condition.
In light of the above statements, it is safe to assume that proponents of most medicalization analyses prefer to depict a scenario where there is a high prevalence rate of mental illnesses. This results from among other things inconsistencies in the laboratories, limited understanding of diagnostic theories in psychiatry, inability to separate discovery from invention as well as the urge to exaggerate the extent of medicalization in the hope of creating awareness, and finally the desire of some researchers lay more emphasis on definitions than the actual behaviour. However, critics have spotted gaps in the analyses and advised caution, hoping to improve the credibility of such analyses.

Conrad, Peter. “Medicalization, Etiology and Hyperactivity: A Reply to Whalen and Henker”. Social Problems, vol 24, no. 5, 1977, pp. 596-598. Oxford University Press (OUP), doi: 10.2307/800129.
Mechanic, David. Medical Sociology. 2nd Ed., Free Press, 1978, P. Chapter 3.

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