Symbolic interactionism
Herbert Blumer coined the term symbolic interactionism (Griffin, 2009). Craig and
Muller (2007) assert that symbolic interactionism is the study of “how communication
shapes individual identities, making both individuality and social community possible”.
Blumer states three core principles of symbolic interactionism that deal with meaning,
language and thought. These premises lead to conclusions about the creation of a
person’s self and socialization into a larger community.
First, Blumer bases symbolic interactionism on the premise that humans act
towards people or things on the basis of the meanings they assign to those people or
things (Griffin, 2009; Lindlof & Taylor, 2011). Meaning is seen as the construction
of social reality. Pragmatism viewed reality as indeterminate: the world that we
perceive and act in consists of multiple, emergent realities that are always in the
process of changing. These realities are formed in negotiations conducted between
the self and various people, objects, and events (Mead, 1934). This theory was used
in this study to explain that people’s knowledge, attitudes and responses towards
mental illnesses and the mentally ill are as a result of the meanings they have
assigned to them. A society in which people have little or no knowledge of mental
health issues will assign wrong meanings to mental illnesses and the mentally ill.
Based on this social reality, people will have discriminatory attitudes and responses
towards mental illnesses and the mentally ill. Mental illnesses and the mentally ill
will be stigmatized. On the other hand, a society where people have knowledge of
mental health will not stigmatize mental illnesses and the mentally ill. This is
because people will assign correct meanings to mental illnesses and the mentally ill.
In such a society, people will have understanding and caring attitudes and responses
towards mental illnesses and the mentally ill since their social reality is constructed
on knowledge.
Blumer’s second premise is that meaning arises out of the social interaction that
people have with each other (Griffin, 2009). Griffin explains that meaning is not
inherent in objects or preexistent in a state of nature. It is negotiated through the use
of language- hence the term symbolic interactionism. In this study, it is argued that
the meanings that individuals give mental health issues are as a result of social
interactions. The stigma that individuals have towards mental health problems is as
a result of their interactions with other individuals in society.
Symbolic naming is the basis for human society (Griffin, 2009). Symbolic
interactionism is used to explain that people’s knowledge of mental illnesses and
attitudes towards the mentally ill are shaped by the names they have given them.
These names influence their perceptions and attitudes towards mental illnesses and
the mentally ill. Furthermore, these attitudes and perceptions are influenced by
people’s interactions with each other through language. This study argues that if
people are exposed to adequate knowledge of what mental illnesses are and what
causes them, they will change their attitudes and perceptions towards the mentally
ill and stop using discriminatory and condemnatory language towards them
(Kweyu, 2012).
Blumer’s third premise is that an individual’s interpretation of symbols is modified by
his or her own thought processes. Symbolic interactionists describe thinking as an inner
conversation, a process called inner dialogue minding (Griffin, 2009). Griffin (2009)
says that minding is the pause that is reflective. It’s the two -second delay while we
mentally rehearse our next move, test alternatives and anticipate others’ reactions. To
do this we need language. Language is the software that activates the mind (Griffin,
2009).
Symbolic interactionism was used in this study to argue that people’s knowledge of
mental illnesses and attitudes towards the mentally ill are shaped and determined by
their thought processes. Consequently, people’s attitudes are influenced by those of
others when faced with similar circumstances. They imagine how others would
behave in the same situation and do exactly that. This study therefore argues that if
communication campaigns on mental health are effectively designed to change
people’s attitudes towards mental health issues, people’s thoughts and language
will change and they will also influence other people to behave exactly that way.
After understanding that meaning, language and thought are tightly interconnected,
the concept of the self becomes clear (Griffin, 2009). People paint their self-
portraits with ideas that come from taking the role of the other- imagining how we
look to another person. During interaction, participants ascertain each other’s
intentions through the use of significant symbols (Lindlof & Taylor, 2011).
Significant symbols are verbal or nonverbal gestures that implicitly arouse in an
individual the response which they explicitly arouse, or are supposed to arouse, in
the individuals whom they are addressing (Mead, 1934). Using significant symbols
involves more than signaling our internal state to others; it also evokes in us the
anticipated response of the other. We momentarily imagine how we are seen.
The concept of the self is important in this study as people’s knowledge of mental
illnesses and attitudes towards mental health and the mentally ill are socially
constructed. If others have profound knowledge of mental health and their attitude
towards the mentally ill is nondiscriminatory, then one will equally seek more
knowledge and be nondiscriminatory towards the mentally ill in order to fit in that
society.
The last concept in symbolic interactionism is that of community. Community is
the generalized other. This is the composite mental image a person has of his or her
‘self’ based on community expectations and responses (Griffin, 2009). This study
argues that people’s knowledge of mental health and attitudes towards the mentally
ill are based on their communities’ expectations and responses. If the community
expects individuals not to stigmatize mental illnesses or discriminate against the
mentally ill, then the individuals will respond by having positive and non-
discriminatory attitudes towards mental illnesses and the mentally ill.
The health belief model
The Health Belief Model is one of the most commonly used models of health
behavior change. It was developed by Becker (1974) from the work of Rosenstock
(1966) as an overarching framework on how to promote preventive behaviours. The
model enables the examination of health beliefs and perceptions and encourages the
assessment of their influence on preventive health behavior (Hester & Macrina,
1985). It can therefore be used as a pattern to evaluate or influence individual
behavioural change (Corcoran, 2007).
The Health Belief Model includes six constructs to help predict whether people will
take action to prevent, screen for, and control illness (WHO, 2012). These
constructs are: perceived susceptibility, perceived severity, perceived benefits,
perceived barriers, cues to action and self-efficacy (Corcoran, 2007).
Overall, perceived barriers have been the strongest predictor for whether or not
individuals engage in health protective behavior, followed by perceived
susceptibility (Janz & Becker, 1984). Janz and Becker (1984) found that the
perceived severity was the weakest predictor across studies employing the Health
Belief Model. The combination of perceived susceptibility and severity provides
the motivation for action, and the comparison of perceived benefits to perceived
barriers provides the means or pathway to action. Thus the stronger the perception
of susceptibility, severity, and benefits and the weaker the perception of barriers,
the greater the likelihood that health protective actions would be taken (Janz &
Becker, 1984).
The HBM also considers ‘modifying factors’ important to behavior change. These
include demographic variables, socio-psychological variables and structural
variables that influence how a person perceives the disease severity, threats and
susceptibility. Factors such as age, gender, peer pressure or prior contact with the
disease also impact on the decision-making process (Corcoran, 2007).
Since its development, the model has been empirically tested as the basis for
educational campaigns on a number of health behaviours including contraceptive
behaviors (Hester & Macrina, 1985), cervical cancer screening (Burak & Meyer,
1997), and healthy eating habits (Deshpande, Basil & Basil, 2009).
Health belief model was used in this study to argue that if people are exposed to
mental health promotion campaign messages that inform them about their
susceptibility to mental illnesses, the severity of mental illnesses, the benefits of
taking action to reduce risk or seriousness, the barriers involved such as stigma,
factors that activate change, and confidence in one’s ability to take action, then they
will embrace behaviours to ensure their own and others’ mental health.
Communication campaigns for mental health were analysed for evidence of these
concepts.
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