Caught in the Psychiatric Net: Meanings and Experiences of ADHD, Pediatric Bipolar Disorder and Mental Health Treatment Among a Diverse Group of Families in the United States

Abstract

Based on a 13-month ethnographic meaning-centered study of the lived experience of behavioral and emotional disorders among children and families living in the United States, this article highlights the range of orientations to mental health problems and treatment among families from diverse backgrounds. Detailed case portraits of three families are presented to illustrate the various meanings that psychiatric diagnoses and mental health treatments take on within families, with medicalized perspectives holding less salience among African-American families relative to Euro-Americans in the study. The diverse orientations to problems among families in the study suggest that, despite the dominance of biochemical and neurological explanations for behavioral and emotional distress in contemporary U.S. culture, and especially U.S. psychiatry, nonpathological interpretations have not been wholly eclipsed by broad trends toward biologization and medicalization. Families' experiences are positioned to reveal the allure, as well as the limitations, of biopsychiatric approaches to behavioral and emotional problems.

Parents’ Perceived Treatment Match and Treatment Retention Over 12 Months Among Youths in the LAMS Study

“…Prior work has found racial/ethnic group differences in attitudes towards pharmacotherapy, psychotherapy, and whether particular emotions and behaviors in children require professional intervention (22,34,35). Additionally, previous research has indicated that racial and ethnic minority parents may be more likely to feel stigmatized by using mental health services (36) and that minority youth are less likely to receive adequate mental health care (7), which could increase the likelihood of dropping out of treatment.…”

“Learning how to deal with feelings differently”: Psychotropic medications as vehicles of socialization in adolescence

“…A dilemma for parents, doctors, youth and educators inherent in this social construction of adolescence is whether an adolescent's emotional or behavioral issues are developmentaldsomething they will outgrowdor pathological, and needing psychiatric treatment to resolve. Moreover, young people are engaged in the developmental task of reaching a reliable conception of what it is to feel "like themselves," (Sharpe, 2012;Carpenter-Song, 2009), and psychiatric medication consumption will be implicated in this process and may provoke intense self-scrutiny.…”

“…Carpenter-Song, 2009;Ecks, 2010;Oldani, 2009;Singh, 2004;Floersch et al, 2009;Timimi and Taylor, 2004;McKinney and Greenfield, 2010;Weinberg, 1997;Barnett, 2012b). Psychiatric medications are both material and discursive agents As such, the use of medications is part of local processes of identity construction and positioning that are inscribed within larger discourses, institutional structures, and political-economies of psychiatry and psychopharmacology (Blackman, 2007).…”

Putting meaning into medicine: why context matters in psychiatry

“…Anthropological research has demonstrated that psychiatric conceptualisations of mental health problems often do not resonate with how individuals, families and communities understand problems (Jenkins, 1988;Carpenter-Song, 2009b, Carpenter-Song et al 2010. We have learned from urban, low-income participants from racial and ethnic minority backgrounds that mental illnesses are understood and experienced in relation to daily lives marked by the threat of violence, histories of trauma and the stresses of financial insecurity.…”