Archives of Psychiatric Nursing
Volume 21, Issue 1 , Page 1, February 2007

Tipping Points in the Mental Health World

Article Outline

 

I MIGHT BE the last person to have read Gladwell's (2002) book on the rise and spread of social epidemics; but having done so, I have found myself intermittently reflecting on his perspectives and challenging my previous views on mental health. Most of what I previously held to be true stemmed from perspectives of individual psychology—meanings of behavior derived from growth and development. Of course, families and social groups are acknowledged throughout the field, but the study of social epidemics ala Gladwell reinforces understandings of social power and influence. In fact, Gladwell presents many examples that could otherwise also be explained in behavioral health terms. The increase in suicide rates among adolescent males in Micronesia is a case in point. Although the imitation theory or suicide, referred to in the literature as the Werther effect, is not new (Wasserman, 1984), placing the behavior in the context of contagion attributes even more emphasis to social factors, influences, and power.

Whether or not one accepts the premise of social epidemics, there are important lessons that can be learned from this perspective. I found myself wondering about the most recent school-based violence from this social psychologic perspective. Of course, the aberrant behavior of public figures, politicians, and sports stars, for example, also could be easily explained by this theoretical perspective. Knowing how easy it is to focus on the negative, I purposely have tried to identify positive tipping points in the field of mental health. The spread of alternative approaches to mental health care, such as the culturally based healing arts, might best be understood as social epidemics. Although the use of alternative therapies for mental health treatment may depend on one's culture and geographic location, there is certainly evidence that overall use has increased, both within the United States and globally. The increased influence and power of grassroots consumer groups are additional positive social epidemics in our field. Since its founding in 1979, the National Alliance on Mental Illness, an organization focused on improving mental health services and reducing stigmatization of mentally ill individuals, has grown in size: from 1 to more than 1,000 local chapters. More importantly, social change has occurred, as families no longer have to hide members who have a mental illness.

Gladwell offers tips on how to increase the results of social epidemics and attributes the initial change effect to key individuals with charisma and connections—those whom he calls the mavens, or those who accumulate knowledge. It will be important for the future of mental health treatment if we identify the mavens among us and nurture their connections. Positive social epidemics in mental health could be just around the corner, and this should give us hope.

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References 

  1. Gladwell M. The tipping point: How little things can make a big difference. Brown, NY: Little; 2002;
  2. Wasserman IM. Imitation and suicide: A reexamination of the “Werther effect”. American Sociological Review. 1984;49(3):427–436

PII: S0883-9417(06)00228-7

doi:10.1016/j.apnu.2006.10.001

Archives of Psychiatric Nursing
Volume 21, Issue 1 , Page 1, February 2007