A Handbook for the Study of Mental Health Social Contexts, Theories, and Systems

This chapter reviews sociological theories and measurements of stratification and social class in the process of relating social inequality to mental disorder. Eaton and Muntaner argue that processes of stratification and periods of high vulnerability to mental disorder are related to different stages in the life course. Consequently, stratification and one's place in the socioeconomic system have a complex relationship to the occurrence of mental disorder. Both individual and environmental factors must be taken into account. Eaton and Muntaner review the major research studies, noting differences in indicators of social class and methodological variations. In general, researchers have found that socioeconomic position (SEP) is inversely related to mental disorder; that is, those in the “lower” classes experience higher rates of disorder. Two contrasting frameworks for understanding the relation of SEP to mental disorder are selection and drift on the one hand and social causation on the other hand. Selection refers to the idea that individuals who are predisposed to mental disorder have lower than expected educational and occupational attainment. Drift refers to the idea that those with mental disorders are likely to drift down the SEP ladder, after onset of the mental disorder, as they will have more trouble with employment and other means of attaining higher-SEP positions. In contrast, social causation explanations emphasize how the social experiences of members of different social classes influence their likelihood of becoming mentally ill or distressed. The authors conclude by reviewing two studies that illustrate the complexity of the relationship between SEP and mental disorder. More research is needed on the specific ways in which social class affects mental disorder and how mental disorder affects the attainment of social status. Students should compare the selection and drift frameworks. Is it likely that an individual born of a wealthy family will drift down the socioeconomic ladder if they experience a mental health problem? Consider the role of stress and social resources in understanding the relationship between SEP and mental health.