Depression in a depressed area: Deservingness, mental illness, and treatment in the contemporary rural U.S.

Publication date: Available online 17 October 2018Source: Social Science & MedicineAuthor(s): Claire Snell-Rood, Elizabeth Carpenter-SongAbstractPeople with mental illness face public scrutiny that provokes questions about their ability to cope, membership in society, and entitlement to state support. Less attention has been focused on how such scrutiny occurs at the community level, particularly when shared economic distress has generated a high burden of poor mental health. We employ theorizations of health-related deservingness to examine the local moral economies through which residents of an economically depressed area question who deserves to be depressed, how those with depression should cope, and what forms of treatment are sincere. Drawing on a multi-phase study (2014–2016) in Appalachian Kentucky, we analyze interviews conducted with women with depression and the health practitioners who work with them. In the rural U.S., the dim economy and scarce healthcare resources are attributed to exclusion from broader society. Naturalized as a moral response for enduring dead-end jobs and poverty, participants described how depression coping can positively demonstrate individuals’ commitment to providing for their families and mobility. However, when individuals are perceived to use depression diagnoses to access state entitlements or obtain medication as a “quick fix” that facilitates substance use, area residents question the veracity of symptoms and argue that tre...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research