Mental illness, social status and health care utilization: a test of societal reaction theory

Sociology has made many contributions to the study of mental illness. One of those contributions has been in the area of theory. Sociologists maintain that social variables such as age, social class, marital status, gender, and race are important in understanding mental illness and its treatment. Although sociologists agree that social variables are important in understanding mental illness, they are not always in agreement about the direction of the relationships. Labeling theorists claim that psychiatric symptoms do not differentiate those who seek treatment from those who do not. Instead, they believe that those who have the least amount of social power are most likely to be forced into treatment. Conversely, sociologists who are critical of labeling believe that there is a positive correlation between symptoms and mental health treatment. However, critics of labeling also maintain that social characteristics are related to treatment. Unlike labeling perspective theorists, critics of labeling claim that the greater the amount of social resources people have, the more likely they are to seek treatment. Besides these general perspectives, other sociologists have developed theories which are hybrids of the labeling and the critics of labeling. Former tests of these theoretical perspectives have utilized small, convenience samples. These studies have produced conflicting results. This work uses data from the Epidemiologic Catchment Area (ECA) study, a community sample, to test research questions from the labeling perspective, critics of labeling, and combined perspectives. Results provide mixed support for each perspective. Results vary by inpatient and outpatient treatment and by particular sector of treatment.