What is wrong with Madame Bovary? In the novel of the same name, Gustave Flaubert portrays the life of a woman in mid-nineteenth century France. The wife of a rural doctor, Emma Bovary struggles with the limitations of her existence. She invests herself in varied activities, navigating uneven mindsets and emotions, hoping to make sense of mundanity and tackling the boredom of her milieu – the petit bourgeoisie of a small town in Normandy. She tries to be a perfect housewife. She attempts to be a dedicated devotee. She daydreams of affairs. She has affairs. She plays the piano. She supports the professional achievements of her husband. She has problems with her ‘nerves’. At least, this is what the men around her imagine. Madame Bovary's changing mood, they assume, is due to her feminine nature. Doctors seek to solve the problem with drugs. Drowning in debts, she kills herself.

This story illustrates a very sociological question. Does the position someone holds in their society influence and/ or result from their mental health? In this chapter, we use the term ‘social position’ as the broadest expression to denote the status and situation individuals hold in their society, including their position in terms of social class but also gender, ‘race’, geographical residence, age, and so forth. This is a way for us to discuss the field of mental health inequalities taken as a whole, without stumbling upon each conceptual particularity. Manifold studies have demonstrated a ‘relationship’ between several measures of social position and rates of various mental illnesses: in general, the lower people are in the social hierarchy, the higher their chance of experiencing some mental health-related difficulties. This consistent finding represents a major component in our understanding of the social genesis of mental disorders. It tells us that mental health has something to do with social position – but not what.

Indeed, the mechanisms through which such correlation operates remain subject to much debate. Do mental health problems cause people to ‘drift’ to a lower socioeconomic status or do they develop such problems because of socioeconomic disadvantages? More fundamentally, why? Let us return to Emma Bovary.