The concept of abnormality-Who needs treatment?

Before we can begin to describe and evaluate the different types of treatment that are available for mental disorder, it is essential to consider first what exactly we mean by ‘mental disorder’ or ‘abnormality’. Despite the fact that most cultures have acknowledged the existence of mental problems in some form, there are considerable discrepancies between cultures regarding what is considered to be unacceptable behaviour. The Yoruba of Nigeria, for example, are much less likely than the average American to consider that someone showing the symptoms of paranoid schizophrenia is mentally ill (Erinosho and Ayonrinde 1981). What is unacceptable can also change within a society over time, as can be seen in the case of homosexuality (which used to be classed as a mental illness). In an attempt to standardise the way that societies respond to such individuals, and to remove any possible subjective bias that a particular clinician might have, efforts have been made to draw up criteria which will provide an agreed definition of abnormality. The legal and social consequences for an individual categorised as abnormal are considerable, ranging from compulsory treatment and loss of freedom to social rejection. Therefore it is essential to develop criteria that can be universally and unambiguously applied.

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