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Community homogeneity and exclusion of the mentally ill: rejection versus consensus about deviance.

This study investigates the relationship for communities between extent of common culture and hospitalized mental disorders. Common culture is measured by indices of (1) political consensus, (2) homogeneity of income, and (3) racial and ethnic similarity. Homogeneous communities tend to have a higher incidence of hospitalized mental disorders than heterogeneous communities. Data on community psychopathology, measured independently of mental hospital statistics, suggest that propensity to hospitalize may account for the observed differences in hospital admission rates between communities. Data on the circumstances surrounding admissions further suggest that hospitalized mental illness is higher in culturally homogeneous communities because of greater consensus as to what constitutes normal and abnormal behavior rather than because of rejection of the mentally ill. The influence of community structure on institutionalization of the mentally ill appears to operate chiefly for the less debilitating forms of mental illness.