This chapter describes the development of social concepts within psychiatry and the mental services between 1960 and 2010. This occurred against the backdrop of the emergence of new social theories concerned with psychiatry, medicine, science and other institutions of liberal democracy from the very beginning of the period. Attacks on the legitimacy of psychiatry came from postmodernists on the left and neoliberals on the right and coincided with a distancing between psychiatry and sociology. Organised psychiatry reacted defensively to most, but not all, of its critics and had difficulty assimilating even those new social theories that appeared neutral with regard to the professional and scientific status of psychiatrists. In the last decade of the period, empirical evidence regarding social determinants of mental health, together with the failure of biomedical technology to deliver on promises of better treatments, led to the beginnings of a revival of interest in social factors within academic psychiatry.

This chapter draws on the works of key labelling theorists Howard Becker, Edward Lemert and Stanley Cohen to explore how individuals come to be labelled as deviant or criminal, the subsequent impact that labelling and stigmatisation can have on behaviour, and the need to carefully consider interventions to social issues that go beyond ‘law and order’ responses. First, the theoretical underpinnings of labelling theory, which are found within the sociological perspectives of social constructionism and symbolic interactionism, are discussed.