Mental Health and Mental Illness: Definitions, Perspectives, and Stigma

Posted on Oct 15, 2026 in Psychology and Sociology

Q1. Define mental health. Explain its key features.

The WHO defines mental health as a state of well-being in which a person realizes their own abilities, copes with the normal stresses of life, works productively and contributes to their community. It is more than the absence of disease.

Key features:

• Emotional well-being: the ability to experience, express and regulate feelings.
• Psychological well-being: self-acceptance, purpose in life, autonomy, positive relationships and personal growth.
• Social well-being: a sense of belonging, contribution and healthy relationships.
• Resilience: bouncing back from setbacks and adapting to change.
• Realistic perception: accurate contact with reality and sound decision-making.

Q2. Define mental illness. Explain the criteria (4 Ds) used to judge abnormality.

Mental illness is a clinically significant disturbance in thinking, emotion regulation or behavior. It reflects dysfunction in psychological, biological or developmental processes and is usually linked to distress or impairment (DSM-5-TR). Expected reactions such as grief after a loss are not disorders by themselves.

The 4 Ds:

• Deviance: behavior differs from cultural or statistical norms (e.g. hearing voices others cannot hear).
• Distress: it causes significant suffering (e.g. constant overwhelming sadness).
• Dysfunction: it interferes with daily life, work or relationships (e.g. missing work due to panic attacks).
• Danger: risk of harm to self or others (e.g. suicidal thoughts, violent behavior).

Mental health and illness lie on a continuum, from flourishing to languishing. A person with a diagnosis can still have good well-being with treatment and support.

Q3. Trace the historical perspectives on mental illness.

• Prehistoric/Ancient: attributed to evil spirits or gods. Treatments were exorcism, rituals and trephination (drilling holes in the skull).
• Greek and Roman: Hippocrates and Galen gave natural explanations, such as an imbalance of the four humors. The brain was seen as the organ of the mind.
• Middle Ages: demonology returned in Europe, linking madness to sin and witchcraft. The Islamic world built humane hospitals (bimaristans).
• Renaissance to 18th century: asylums and madhouses (e.g. Bethlem) confined patients in poor conditions.
• Late 18th–19th century (moral treatment): Pinel, Tuke and Dorothea Dix promoted humane care, and Kraepelin classified disorders.
• 20th century: Freud’s psychoanalysis, behaviorism, psychotropic drugs (1950s), deinstitutionalization, and the DSM and ICD systems.
• Contemporary: biopsychosocial, recovery and rights-based approaches.

Q8. Explain the biological approach to abnormal behavior with its strengths and limitations.

It views mental disorders as medical illnesses with physical causes, especially in the brain.

• Genetics: family, twin and adoption studies show heritability. For example, an identical twin of a person with schizophrenia has about 40–50% risk versus about 1% in the general population. Most disorders are polygenic, with gene–environment interaction.
• Neurochemistry: serotonin and norepinephrine are linked to depression and anxiety, dopamine to psychosis and addiction, GABA to anxiety and glutamate to cognition. Hormones such as cortisol and thyroid also matter.
• Brain structure and function: imaging (MRI, fMRI, PET, EEG) shows enlarged ventricles in some people with schizophrenia, reduced hippocampal volume in depression and PTSD, and a hyperactive amygdala in anxiety. The Phineas Gage case shows prefrontal damage affects impulse control.

Q13. Compare the four approaches to understanding abnormal behavior. What is the integrative view?

Q15. Explain the types of stigma with examples.

• Public stigma: negative attitudes of society, such as mocking a colleague with depression.
• Self-stigma: the person internalizes stereotypes, thinking “I am weak, I am a burden”, and hides the diagnosis.
• Structural/institutional stigma: policies and laws that limit opportunities, such as lower insurance coverage or discriminatory job rules.
• Courtesy/associative stigma: affects family and caregivers, such as families hiding an illness or siblings facing marriage difficulties.
  • Provider stigma: negative attitudes among health professionals, such as dismissing complaints or giving mental health low priority.

Q11. Explain the cognitive perspective and the humanistic-existential view.

Cognitive (Beck, Ellis): emotions and behavior depend on how we interpret events.

• Beck’s cognitive triad in depression is negative views of the self, the world and the future.
• Common distortions are all-or-nothing thinking, catastrophizing, overgeneralization and personalization.
• Ellis’s ABC model is Activating event, Belief, Consequence. Irrational beliefs cause distress.
• Treatments are CBT, REBT and cognitive restructuring.
• Limitation: it cannot always show whether thoughts cause or result from the disorder.

Humanistic-existential (Rogers, Maslow): problems arise from blocked self-actualization. Treatment is client-centered therapy using empathy, genuineness and unconditional positive regard.

Q12. Explain the psychosocial (sociocultural) approach.

It holds that abnormal behavior arises from the interaction of the person with family, culture, environment and society.

• Family: parenting style, attachment, abuse or neglect and conflict. Family systems theory sees the symptomatic member as expressing family dysfunction. High expressed emotion (criticism, hostility) raises relapse in schizophrenia.
• Culture: it shapes what counts as abnormal. Culture-bound syndromes include dhat (South Asia), koro (Southeast Asia) and ataque de nervios (Latin America).
• Environment: crowding, noise, disasters, war, migration, workplace and school stress.
• Social determinants: poverty, unemployment, discrimination and limited healthcare. Social causation means low status leads to illness, and social drift means illness leads to poverty.
• Life events: bereavement, divorce and trauma, with social support as a buffer.

Q16. How does stigma manifest, and what are its consequences?

Manifestations:

• Stereotypes (cognitive): dangerous, unpredictable, incompetent, weak.
• Prejudice (emotional): fear, anger, pity, disgust.
• Discrimination (behavioral): exclusion, denial of jobs, housing, education or marriage, bullying, secrecy.
• Language: derogatory words (“pagal”, “psycho”) and casual misuse such as “I’m so OCD”.
• Help-seeking from faith healers instead of professionals, or hiding symptoms.

Consequences:

• Delayed help-seeking and poor adherence, producing a large treatment gap.
• Shame, low self-esteem, isolation and suicide risk (the “why try” effect).
• Loss of relationships and family conflict.
• Unemployment, poverty and reduced productivity.
• Human rights violations such as chaining, abuse and forced confinement.
• Neglect of physical health and earlier death in severe mental illness.
• Low funding for services and research.

18. Discuss the role of media in shaping public perception of mental illness.

Negative influences:

• Stereotyped depictions of people as violent, bizarre or comic, and schizophrenia wrongly equated with “split personality”.
• Sensational news that mentions mental illness in crime reports and uses terms like “psycho killer”.
• Inaccurate portrayals of ECT as torture and of asylums as frightening.
• Detailed or glamorous suicide reporting, which can lead to imitation (the Werther effect).
• Social media misinformation, self-diagnosis, cyberbullying and trivialization of words like “depressed”.

Positive influences:

• Documentaries, public service announcements and responsible journalism.
• Sensitive portrayals such as Taare Zameen Par (dyslexia), Dear Zindagi (therapy) and A Beautiful Mind (schizophrenia).
• Celebrities sharing their experiences, and recovery stories (the Papageno effect).
• Peer support and helpline information online.
• WHO guidelines on suicide reporting: avoid method details and sensational language, include helplines, and highlight help and recovery.

Q19. Discuss the role of culture in shaping perceptions of mental illness.

• Definition of normal/abnormal: hearing an ancestor’s voice may be spiritual in one culture and a symptom in another.
• Explanatory models: causes attributed to karma, evil eye, sorcery or possession decide whether people see a psychiatrist, a faith healer or no one.
• Expression of distress: many Asian and collectivist cultures express it through somatic complaints such as headaches, fatigue and body pain.
• Stigma and family honor: illness may bring shame on the whole family, causing concealment, especially affecting marriage prospects.
• Gender norms: men are expected to hide emotions (low help-seeking, higher suicide rates), and women’s distress may be dismissed as “hysteria”.
• Traditional and religious healing: it can give comfort and meaning alongside modern treatment, but is harmful when it replaces care or involves abuse.
• Cultural competence: professionals must understand a client’s background, language and beliefs for accurate diagnosis.

Myths versus Facts

Q5. What are the common myths about mental illness? Give the facts that correct them.