Psycho-Social Adjustment of People With Mental Disoders by Suriyawewa Wijayawimala PDF

Other works of the author
Books
Bhavaṅgālaya Vīmaṃsā (An Investigative Study of
Bhavaṅgacitta and Ālayavijñāna) – 2015.
Sarasaviyata Perasaviyak (A guide book for

Advanced Level Students - Buddhism) – 2016.
Some Aspects of Buddhist Philosophy (Reflections

on Western & Buddhist Psychology) – 2017.
Bauddha Dharshanaya Shāstrīya Vimarshana I (Essays
of Buddhist Philosophy I) – 2018.
Editor
‘Prajñāsāra’ Academic Journal - Bhikkhu Union at
University of Kelaniya, 2014.ss
Collection of Research Papers – Junior

Academic Research Symposium (JARS) 2018.
Suriyawewa Wijayawimala
B.A. (Hons), M.A. (Kel’ya), MPhil. (Kel’ya),
Dip. In Eng. (BPU), P.G.D. in Coun. Psy. (UOC),
Dip. in Bud. Psy. & Coun. (Kel’ya), Assistant Lecturer,
Department of Pāli & Buddhist Studies,
University of Kelaniya, Sri Lanka.
First published: 2019
ISBN: 978-955-43988-1-8
Page Setting: Suriyawewa Wijayawimala
Cover Design: Lahiru jayawardhane
printing: Vidyalankara Press, Kelaniya
Publisher: Author
i
Acknowledgment
At first, I would like to pay my gratitude to all members

of the academic staff of the Department of Educational
Psychology to the knowledge, skills, attitudes, and
mindset given in various ways therein my special thank
with gratitude is given to Senior Lecturer, Dr. Samudra
Senarath for the remarkable guidance and kind attention
paid at me by spending her valuable time during this
research was conducting.
I also gratefully acknowledge Senior Professor Udita
Garusinha, Professor venerable Naotunne
Wimalagnana Thera, Dr. Rajitha P. Kumara, Senior
Lecturer Amila S. Kaluarachchi and all the members of
academic staff headed by Senior Professor Makuruppe
Dhammananda Thera in the Department of Pāli and
Buddhist Studies, the University of Kelaniya for giving
me proper advice and showing the importance of the
field of Western Psychology. I am also thankful to
Senior Lecturer Venerable Kumbukandana Rewatha
Thera from the Department of Philosophy, Faculty of
Social Sciences, University of Kelaniya, and Senior
Lecturer, Dr. Samudra Senarath for providing two
postscripts appreciating my little effort. I kindly
remember Senior Lecturer Lagumdeniye Piyaratana
Thera who supported and encouraged me in difficult
occasions in many ways.
ii
Special thanks and gratitude are also given to Iresha
Samarasinghe for being a valuable resource person to
me with kind-hearted words, support, and advice in
gathering information for the present work. Honestly, I
should mention here that without her cooperation, this
research would not have been possible.
Furthermore, I would like to extend my gratitude to the
non-academic staff of the Department of Educational
Psychology at the University of Colombo for the
support that they gave me during the study period.
Eventually, including Venerable Pahiyangala
Sumangala, Deyyandara Pannananda, Udagaladeniye
Dhammawimala, and all my friends are kindly
remembered.
Sri Bodhiraja Viharaya
Wekanda, Withanage Mw
Colombo 02
Sri Lanka.
2020-03-23.
iii
Dedication
To all the cured people with mental
disorders in the world!
iv
Content of Tables
Table 2.1.: Ages of people with mental disorders in the
sample
Table 2.2.: Sex identity of people with mental disorders

in the sample
Table 2.3.: Marital status of people with mental disorders
Table 3.1.: Mental disorders faced by people in the

sample
Table 3.2.: Affinity between mental disorders and life
experiences of people with mental disorders
Table 3.3: Types of family include people with mental

disorders
Table 3.4: Enrolled jobs of people with mental disorders
Table 4.1: Nature of the support people with mental
disorders are given by their family
v
Contents
Acknowledgment
Dedication
Content of Tables
Preface I
Foreword iii
Abbreviations V
Chapter I — Introduction 01
The First Phase 02
The Second Phase 02
The Third Phase 03
Aim of the present study 04
Key terms 08
The process of socialization 17
Studies Related to People with-
Mental Disorders 20
Chapter II—Background of the Study 23
Chapter III — Different Mental

Issues of People 29
The Impact of Mental Disorders 41
Physical Difficulties 42
Mental Difficulties 43
Other Difficulties 43
Chapter IV—Conditions Confront People

With Mental Disorders 49
Chapter V — Conclusion and Summary 53
Questionnaire 55
Bibliography 59
Index 63
vi
Psychology:
“(Gr. psyche, mind or soul - logos,
law). The science of the mind, its functions,
structure and behavioral effects.”
(Dictionary of Philosophy, p. 258.)
vii
Preface
Research has confirmed that the prevalence of mental
illness in Sri Lanka is high at present. Analysts believe
that the reason behind this situation is due to the open
economic policy. It is well-known that in 1977, the first
Executive President of Sri Lanka, J. R. Jayawardhane
introduced this open economic policy to Sri Lanka.
However, it is worth noting that this new economic plan
has produced positive and degrading results in traditional
Sinhala economic, political, cultural, and social sectors.
This has created a highly disturbed environment not only
within the family unit but also across various institutions.
It is in this context that a person’s mental freedom is
severely deteriorated, which can be attributed to the
rapid escalation of psychological problems. Against this
backdrop, psychological counseling services are being
set up in the West to provide psychological guidance for
people suffering from mental illnesses.
Over the years, the Department of Educational
Psychology of the University of Colombo has
successfully conducted a Postgraduate Diploma in
Counselors training to identify the people with mental
disorders and to provide them with the necessary
psychosocial treatment or referral to an appropriate
i
place. At the end of the Postgraduate Diploma Program,
the title I have chosen for my research dissertation
submitted to the university is the theme of the present
study.
Here, I have attempted to conduct my research with
selected people with mental disorders in today's society,
who have already cured after receiving the right
treatment, are being faced with problems in socializing.
It is clear from the reports at present that our society has
a very backward attitude towards people with mental
illnesses. Therefore, sometimes, they are stigmatized or
labeled as ‘mad men’, etc. concerning these types of
issues, we attempt to provide a little knowledge to the
field on behalf of people with mental disorders so as to
get succeeded the process of socialization in Sri Lanka.
At Greens reading hall
University of Colombo
Sri Lanka.
2020-01-18.
ii
Foreword
History shows us that in the time when Western
psychology was not so advanced, the people with mental
disorders faced very unfortunate experiences. However,
with the development of medical treatments over time,
there has been some relief for them. But until psychology
has been introduced and advanced as a proper way to
treat people with mental disorders, they may have faced
various misfortunes.
It is in fact true that with the complexity of the society,
mental issues faced by people seem to have increased.
Accordingly, the intensity of those issues has caused to
arise in mental disorders. In such contexts, the
intervention or psychological support of professionals
seems to have been more important to get rid of their
mental issues. In fact, modern psychologists have
identified reasons for increasing the prevalence of mental
disorders; population structure, wars, migration, alcohol
abuses, mental stresses, etc. It is recently exposed that not
only the psychological reasons but also the formal social
network of people with mental disorders support to
prevail the mental disorders.
iii
Therefore, in brief, psychologists have concerned
psycho-social intervention for such people with mental
disorders. It is indeed considered an essential part of the
process of treatment to cure these mental issues. Indeed,
the author of the present study illustrates practical issues
and related challenges faced by cured people, who had
mental disorders, in the process of socialization. Further,
the author suggests some essential steps to take
counselors to escape several weak points that appeared
in the present methodology in the process of
socialization. Further, this research would be an essential
reference for not only students but also other parties of
social works in Sri Lanka to gain adequate knowledge to
regulate people with mental disorders.
Mrs. B.G.I.M. Samarasinghe
Training Officer – II
Psychological Counselor
National Institute of Social Development (NISD)
B.A. (Hons.), M.Phil. in Sociology (UOC)
P.G.D. in Coun. Psy. (UOC).
iv
Abbreviations
DSM 5. = Diagnostic and Statistical Manual of Mental
Health Disorders
ICD 10. = International Classification of Diseases
APA. = American Psychological Association
v
Psychology
“Because the soul (psyche) is officially defined as
the form of a body with the potentiality for life,
psychology is a subfield of
natural science.”
(Cambridge Dictionary of Philosophy, p. 47.)
vi
Psycho-Social Adjustment
Chapter I
Introduction
It has been changed negative attitudes of people with
mental disorders existed at the very beginning of the
history of human civilization. Although this was, in
some cases, identified as a social issue, at present it is
conceived that the nature of people with mental disorders
is a mental condition. It had also been existed idea to
isolate these patients in some cases. Owing to the
situation, they were institutionalized in asylums. In some
periods they were categorized and institutionalized as an
alienated group. In fact, as a result of this condition, they
were stigmatized and discriminated from the mainstream
of the society.
It is not a task which begun recently that the people with

mental disorders are institutionalized. In fact, it seems to
have begun several years ago. In discussing the
institutionalization based on Western European history,
the process can be severed into three phases.
The First Phase
At the beginning of the 19th century, a particular

requirement manifested with respect to being looked
after by both special needs people and people who were
1
excluded from society. In rich countries of Europe,

between periods of 1950 and 1980, as a positive
tendency of institutionalization, analysis of asylums was
concerned in contemporary societies. Although
institutions were established with the positive objective
of looking after special needs people, the outcome of the
task of institutionalization appeared as that these people
were stigmatized, excluded, and labeled from the
mainstream of the society. It seems that, in this manner,
institutionalization was begun not only for
institutionalizing special needs people, beggars,
refugees, people with commonable diseases but also
people with mental disorders. Institutionalization seems
to have spread with the industrialization to get the urban
cleared.
The Second Phase
In the era 1950, the concept of asylums is collapsed in

economically developed countries. In the Second World
War, these asylums were employed to admit patients and
solders. Since the situation, the people who were kept in
the asylums seemed to have an issue for society.
Therefore, some of the inmates with mental disorders in
the asylums were massacred and the rest of the inmates
with mental disorders were released to society. The
situation was led to the collapse of the project of
asylums. Many of them were socialized out of the
inmates with mental disorders who were released to
society. Through the process instead, the institutional
collaborative care was come to manifest.
2
The Third Phase
It should tersely be noted that notions of

institutionalization were strictly fallen in this period. The
concept of community care has come to appear thanks to
the community-based system. As an effect of this new
concept, the community care concept was advanced to
provide proper caring for people with mental disorders.
However, after introduced the concept of welfare
society, these people with mental disorders were looked
at from the sympathetic perspective. Hence, they seemed
like a group that should have to be looked after.
However, the negative perspective was paid at them and
it was begun to change as a result of the beginning of the
professional intervention. In fact, through these methods,
these people with mental disorders were empowered by
recognizing their strengths and potentialities. Through
this process, these people were given further attention
with the newly introduced community-based care
system around the world.
In this background, instead of the concept of

institutionalization, the concept of deinstitutionalization
was initiated. This condition has continued to Sri Lanka
and many other countries with differentiations. In
contemporary Sri Lankan society, it has been identified
the importance of establishing the concept of
community-based care system for such patients.
Therefore, in the present study, major attention hopes to
pay at the process of socialization of people with mental
disorders from the academic perspective.
3
Aim of the present study
In the wider topic of psychological issues, the present

study aims to focus on the various issues that people with
mental problems face when they socialize after their
treatments. In other words, this study will reveal the
psycho-social adjustment of people with mental
disorders in the process of socializing.
The issue noted above seems requisite to overlook from

both psychological and sociological perspectives. It
intends that when these two aspects of individual life are
collapsed, their day to day life patterns go out of the
regular system. Thereby, the psychological,
physiological, and sociological changes are manifested
within their lives. Owing to this situation, it is difficult to
adjust to normal life pattern as usual. For the adjustment
of such people, it needs to have close relationships and
professional psychological interventions or supports.
Further, at present, mental disorders are begun to

professionally view and discuss. However, there remain
negative views of these people with mental disorders in
common sense, therein still such people are being
stigmatized and discriminated. Henceforth, it seems the
necessity to have a micro and macro-level intervention
for such people.
At the micro-level, people with mental disorders, and

attitudes of them in the society should be examined.
Based on each individuals’ positive attitudes, the
4
positive social attitude of these people with mental

disorders built up. Through such methods, we can make
their respect or recognition in the society. It is next to
find out what is the macro level condition? Thereby the
community level background should be created to
socialize such people with mental disorders, therein on
this background the professional intervention should be
carried out.
An interdisciplinary approach and discussion should be

made with the support of sociologists, psychologists,
psychiatrists, social workers, and counselors to assist
people with mental disorders. Through this process of
professional intervention, such people can get rid of
mental disorders and to establish their regular lives in the
society.
Further, in the common society, there should be a

method to re-socialize these people with mental
disorders. For the purpose, positive social awareness of
these people needs to inculcate in the community and
that social awareness should also be cultivated in the
society. The responsibility of making such awareness
apparently goes to professionals. Hence, in the present
work, existing conditions and necessary changes of
people, and the task of socializing required to be
concerned. It is not an inherent characteristic of Sri Lanka
itself. Indeed, this challenge of increasing the number of
people with mental disorders is being faced by developed
and developing countries in the world. Mental disorders
5
are also termed as mental health disorders due to its

negative effects on mental health.
It should be noted that the mental conditions and moods

of ordinary people are not stable. But, mental conditions
and moods of such people are changed in terms of
stimuli that they experience in daily life. However, when
these people get experienced disturbing thoughts for a
long time, that condition is pressured for people to arise
mental issues and it breaks their integrity in daily life.
Mental disorders are harmful to every aspect of an
individual life. Such one of the harmful aspects of an
individual can badly be affected not only for his life but
also for other people in the society. For instance, such a
problematic situation of people with mental disorders
affects their physical conditions as well. And also, a
number of issues are manifested in relation to these
mental disorders; substance abuse, suicide, emotional
problems, educational issues, sexual problems, and
relationship problems.
Both the individual factors and social factors also lead to

manifest these issues. Hence, conditions lead to make
such mental disorders should be included in the present
study. Biological and environmental factors should be
studied therein. Biological factors such as inherited traits
and brain chemistry should also be studied. It is also
equally important to concern the social influence and
condition that people with mental disorders confront in
6
the process of socialization concerning the existing

situation of the society.
In the present complex societal background, an

individual endures numerous duties and responsibilities.
When the pressure is high, cognate mental disorders can
be manifested among people. This clearly emphasizes
that this situation leads to make mental disorders when
their capacity is exceeded. It should be noted that
although such pressure can anyhow be eradicated, the
mental turbulence made by the mental disorder would
further persist. Therefore, in order to cure such mental
issues, a strong prevention process has to be
implemented. In fact, for the purpose, a professional
intervention requires to carry out. It is, therefore,
significant to make an awareness of negative
consequences in society through the research. On the
other hand, professionals of various fields should
concern such mental disorders for getting success in their
fields. We believe that through the present study,
professionals will allow to gain little knowledge on the
subject in which we hope to reveal the roots and
consequences of mental disorders.
Different settings in different professional areas can be

added new set up knowledge about psychological
disorders and which allows different perspectives to look
at psychological disorders. And also, by the study,
intervention and the role of professionals can adequately
be identified and it assists to protect their professional
status. Further, the present study aids us to distribute
7
challenges, their real or exact conditions, etc. among

people in the society and the study can be assisted to
decide that what sort of support is required for them to
be cured of their mental difficulties. Therefore, findings
of the present study would definitively be a concise
manual for professionals as well as ordinary people who
deal with such people with mental disorders.
Eventually, the mental health field can also acquire some

extent of knowledge through the present study, and also
the research will suggest necessary steps to be taken in
socializing such cured people with mental disorders.
Therefore, this study also seems to have significant
importance for mental health fields.
Key terms
In this study, there are several key terms such as people

with mental disorders, Psycho-social adjustment, and
Socialization process. It seems a prerequisite to be got
defined these concepts in the study. According to a
definition, a mental disorder is defined as follows:
“Mental disorder is a significant deviation from a

person’s past behaviors, thought processes, and
emotions that result from an abnormal disturbance
in his or her mental state” (Cockerham, 2017, p. 05).
Therefore, those who suffer from such mental conditions

can be termed as ‘people with mental disorders.’ In
defining the term in which it seems to have triad as
“Psycho,” “Social” and ‘Adjustment.’ However, first,
8
two terms of the triad are together called ‘psycho-social’

to mean, according to APA College Dictionary of
Psychology, “psychosocial” - describing the
intersection and interaction of social and cultural
influences on mental health, personality development,
and behavior” (APA College Dictionary of Psychology,
2009, p. 334.).
‘Adjustment’ and ‘Adaptation’ occur in some cases in a

similar sense. The other term, ‘adjustment,’ is defined in
the same reference thus:
“A change in attitude, behavior, or both by an

individual based on some recognized need or desire
to change, particularly to account for the current
environment or changing, a typical, or unexpected
conditions. It may be assessed via a type of survey
called an adjustment inventory, which compares a
person’s emotional and social adjustment with a
representative sample of other individuals. A well-
adjusted person is one who satisfies his or her needs
in a healthy, beneficial manner and demonstrates
appropriate social and psychological responses to
situations and demands modification to match a
standard.” (APA College Dictionary of Psychology,
2009, p. 08).
The term ‘Psychosocial’ is explained: “Of or relating to

both the mind and interaction with other people”
(Cambridge Dictionary of Psychology, 2009, p. 413).
Further, ‘Adjustment’ is defined thus: “Adaptation to
function better in a particular environment. Changing
9
thoughts or actions to interact in more satisfying ways

with one’s physical, social, and cultural environment.
Adjustment, in the discipline of psychology, is generally
conceived of as learning to deal better with changes in
life” (Cambridge Dictionary of Psychology, 2009, p.
17). ‘Adaptation’ is also thus explained:: “Similar to
Adaptation, especially in a social context, but usually
implies a greater purposiveness and Awareness on the
part of the individual faced with environmental
demands” (The Concise Dictionary of Psychology,
1998, p. 03). Further, it explains Adaptation thus: “(in
psychology) especially behavioral adaptation to a
particular environment or set of circumstances.” (Oxford
Dictionary of Psychology, 2009, p. 39).
According to the above definitions related “Psycho-
social Adjustment,” we can define the concept, in terse,
that the ability of an individual to deal successfully with
his mind and other people in the society.
Psychological changes are looked at in the task of
psychological adjustment. It also studied the moods and
mental conditions of people within their socialization
process. As well as, social changes of the people looked
in the process of social adjustment. The social conditions
of people such as social status, social relationships, social
roles, etc. are also studied in the socialization process.
There exist positive and negative aspects in the

discussion of mental health, in which positive aspects
intends maintaining the mental health in a good manner,
10
and the negative aspect is the opposition of positive

aspect. Based on multifarious rules and regulations,
normal and abnormal mental health conditions are
severed. A behavior is defined as normal or abnormal
based on social indications. The behavior which is
accepted by the majority of the society is called ‘normal’
and the opposition of it is called ‘abnormal.’ These
criteria can be changed in accordance with time, society,
and so forth. Therefore, something which is accepted in
a society can be rejected in another social context.
Ex: The sex industry, Homosexuality
In the seventeenth century, people with mental issues

were labeled as people with ‘madness’. The madness
was come to mean those who deviated from the mass
society. Therefore, they are constantly given a negative
social response. In various fields, mental issues are
variously defined. This is identified as an illness from a
medical perspective. Therefore, they provide medical
treatments to control abnormal behaviors. It is not
adequate to give medical treatments for mental
disorders. For the purpose of getting rid of the mental
issue, psycho-social intervention should be given to get
cured such mental disorders.
In the discussion of mental disorders, it is important to

posit definitions with regard to defining mental
disorders. In fact, the International Encyclopedia of
Social and Behavioral Sciences includes a definition for
getting defined what mental disorder is thus:
11
“A particular mental disorder is determined by

three research approaches: family, twin, and
adoption studies. Family studies identify people
with the disorder through questions (probands); the
rates of disorder are identified in other family
members and relatives and are then compared with
the rates in the general population. From these
figures, it is possible to compute the numbers of
people likely to develop the condition at some time
in the future (the expectancy rate or morbid risk). A
higher rate in immediate relatives compared with
others and greater rates than the general population
indicate a genetic contribution to the disorder”
(International Encyclopedia of Social and
Behavioral Sciences, 2015, p. 204).
Besides, it is important to take existing ideologies into a

discussion in which the WHO defines ‘a disorder’ as
follows.
“‘Disorder’ is not an exact term, but it is used here

to imply the existence of a clinically recognizable
set of symptoms or behavior associated in most
cases with distress and with interference with
personal functions. Social deviance or conflict
alone, without personal dysfunction, should not be
included in mental disorder as defined here”
(WHO, 2017, p. 11).
This explains the importance of identifying mental

disorders from other dysfunctions. According to the
Australian Government Department of Health, mental
Disorders can be defined as follows:
12
“A mental illness is a health problem that

significantly affects how a person feels, thinks,
behaves, and interacts with other people. It is
diagnosed according to standardized criteria. The
term ‘Mental Disorder’ is also used to refer to these
health problems” (Australian Government
Department of Health, 2015, p. 01).
At the very beginning, the exposition of mental disorders

was mainly classified into two categories in concert with
the intensity of those mental disorders. They are well-
known to us as psychotic and neurotic disorders in which
psychotic disorders were explained as severe disorders
such as Schizophrenia, Bipolar disorders, Schizotypal
personal disorders, Catatonia. Further, hallucination
and delusion had been considered as primitive
characteristics of psychotic disorders. The other was
explained as simple mental disorders such as: stress,
obsessive-compulsive disorders (OCD), obsessive-
compulsive personality disorders, hysteria. The distress
is the main characteristic of neurotic disorders therein
hallucination and delusions are not consisted of.
According to this, it is precise that the mental disorders

are evaluated based on standardized criteria in which at
present Sri Lanka, professionals of mental disorders can
use two criteria to judge the mental disorders as follows:
1. DSM 5
2. ICD 10
13
By these criteria, it precisely denotes mental puzzles and

characteristics related to people with mental disorders.
Further, thereby individuals are allowed to determine
mental disorders properly and evaluate them.
Mental disorders can be categorized under several major

respects. Australian Government Department of Health
provides the following six facts under mental disorders.
1. Depression
2. Anxiety
3. Schizophrenia
4. Bipolar Mood Disorder
5. Personality Disorders
6. Eating Disorders (Australian Government
Department of Health, 2015, p. 01).
People who have suffered from such mental disorders

can be termed “People with Mental Disorders” in the
medical view. Indeed, causes led to originate such sort
of conditions within ordinary people can be noted as
follows:
1. Inherited traits
2. The environmental condition of a mother while
the infant in her womb.
3. Brain chemistry
4. Social factors
Risk factors related to arising mental disorders can also
be described as follows:
14
1. A history of mental illness in a blood relative,

such as a parent or sibling
2. Stressful life situations, such as financial
problems, a loved one’s separation
3. An ongoing (chronic) pathological condition,
such as diabetes
4. Brain damage as a result of a serious injury
(traumatic brain injury), such as a violent blow to
the head
5. Traumatic experiences, such as military combat
or assault
6. Use of alcohol or recreational drugs
7. A childhood history of abuse or neglect
8. Poor interpersonal relationships
9. A previous mental illness
Issues confronted by these people with mental disorders

can be clarified as follows:
1. Unhappiness and decreased enjoyment of life

2. Family conflicts
3. Relationship difficulties
4. Social isolation
5. Problems with tobacco, alcohol and other drugs
6. Missed work or school, or other problems related
to work or school
7. Legal and financial problems
8. Poverty and homelessness
15
9. Self-harm and harm to others, including suicide

or homicide
10. The weakened immune system, time resisting
Infections
11. Heart diseases and other medical conditions
(https://www.mayoclininc.org).
When defining the concept of socialization, it can be

defined as follows:
“The process by which children or other new

members of society learn the way of life of their
society” (Giddens, 2001, p. 26).
Further, it also defines the same factor in International

Encyclopedia of The Social & Behavioral Sciences as
follows:
“Socialization is the process by which skills,

knowledge, values, and habits prevalent in a
particular social group are conveyed to newcomers
who become part of that group, either as the next
generation or as new members. Parents are
responsible for the socialization processes of early
childhood, whereas school and peer groups gain
importance as the child grows older. In adulthood,
socialization processes continue, e.g., in friendship
networks, in partner relationships, and at the
workplace” (International Encyclopedia of The
Social & Behavioral Sciences, 2015, p. 07).
16
Although many definitions of socialization that have

been posited based on childhood, today psychologists
have distinguished that the socialization of an individual
is built up through his all across the life span. Therefore,
it seems his socialization process is improved with all
knowledge and experiences that he is given in his entire
life. As a matter of fact, the Developmental Psychology
insists that prenatal experiences of an individual are
caused to appear mental disorders, personality errors,
maladaptive behaviors, and so forth. In such a context, it
is more important to have concerned these facts when
such people are socialized.
The process of socialization
The process of socialization has occurred in two different

ways. They are noted thus:
1. Primary socialization
2. Secondary socialization
Primary socialization is given by their family
background. Therefore, the family unit can be
recognized as the primitive socialization agent. People
are also given secondary socialization when he moves to
the outward society. The secondary socialization process
can be listed as follows;
1. Education
2. Political institution
3. Economic institution
4. Religion
17
An Individual’s life is influenced by all these agents.

Therefore, the present study our attention hopes to pay
in this regard as well. Eventually, outcomes of
socialization can be comprised as follows.
1. Socialization evolves the biological human into

social beings.
2. Personality development is occurred by
socialization.
3. Socialization adjusts human being for both social
system and social order.
4. Different roles develop a phenomenological
aspect of a person through the socialization.
5. Awareness of good and bad is given by
socialization.
6. The problem-solving skill of a person is
developed by socialization.
7. Improving overall growth and development of an
individual through the socialization.
8. Integrity is created among individuals by
socialization.
9. An awareness of a person himself is made by
socialization.
10. The self-image of an individual is built up by
socialization.
According to these facts, it is precise that the driving

force of human life is the socialization. Further, it should
be noted that if the socialization of a person is built up in
a positive social background, the person will be socially
accepted person. In contrast, if it is not so built up the
18
personality, the person will socially be formed many

maladaptive behaviors. Therefore, it can be inferred
through the discussion that even psychological issues or
mental disorders can be made on account of the error
socialization process.
19
Studies Related to People with Mental

Disorders
In the course of the study, it could be identified that the

following studies have been done in relation to the
concept. They can tersely be noted as follows:
 —2013. “Diagnostic and Statistical Manual of Mental
Disorders (DSM-5).” American Psychiatric
Association, American Psychiatric Publishing,
Arlington.
 Kessler, R.C., 2011. “Childhood socioeconomic
status and the onset, persistence, and severity of DSM-
IV mental disorders in a U.S. national sample.” Social
Science & Medicine 73, 1088–1096.
 Stein hausen, H.C., 2011. “The size and burden of
mental disorders and other disorders of the brain in
Europe 2010,” European Neuropsychopharmacology
21, 655–679.
 Vögele, C., Von Leupoldt, A, 2008. “Mental
disorders in chronic obstructive pulmonary disease.”
Respiratory Medicine 102, 764–773.
 Lamberti, J.S., Weisman, R.L., 2004. “Persons with
severe mental disorders in the criminal justice system:
challenges and opportunities.” Psychiatric Quarterly
75 (2), 151–164.
20
 —2000. “Diagnostic and Statistical Manual of Mental

Disorders,” Text Revision.” (4th Ed.). American
Psychiatric Association, Washington, DC.
Therefore, in the present study, our primitive attention

hopes to pay at the difficulties confronted by the cured
people with mental disorders in the process of their
socialization in Sri Lanka.
21
Culture
“Culture implies heritage, transmission of modes of
acting. Feeling and thinking from generation to
generation. There are the material as well as the non-
material aspects of culture. There are the physical
objects like the houses. Tools, machines and so on
which form part of culture. There are also the
attitudes, beliefs, knowledge and skills which form
part culture. But a division of culture on this basis is
hardly satisfactory since objects have no meaning
apart from the thought and action patterns..
Consequently, it may be asserted that the essence of
culture is the attitudes and beliefs transmitted from
generation to generation rather than the mere
physical objects.”
(An Introduction to Social Psychology, p. 39).
22
Chapter II
Background of the Study

The main intention of this research is to identify psycho-
social adjustment of people with mental disorders in the
process of socialization. Besides, the following specific
objectives are also based on this research.
1. To identify the different mental issues that have

been suffered by people.
2. To study on the psycho-social adjustment of
people with mental disorders.
3. To examine people with mental disorders how
far showed the psycho-social adjustment in the
process of socialization.
It aims to investigate under the first specific objective,
causes led to arise mental disorders and consequences of
it. Under the second specific objective, psychological
and sociological adjustments of cured people with
mental disorders are studied. In the third specific
objective, necessary changes of the family and the close
environment of such people with mental disorders are to
be studied.
23
Selected people with mental disorders who have

institutionalized based on a specific mental disorder and
after treatments who have returned to their familiar
environment are the sample for the present study.
Therefore, the research field of the present study is
carried out with the help of several government
institutions and private mental health institutions in
which thirty cured people with mental disorders who
have left those institutions have been selected for the
purpose. It should be noted that this sample is selected
under the purposive sampling method based on reports
preserved in these institutions. Further, the sample was
selected by considering the duration of those people. It
should remember that the support and assistance of the
community-based care officers given in gathering
information of people with mental disorders in the
sample are highly appreciated. Here, people, who left
after having cured, have been selected from an institution
established by the government, and five people, who left
after having cured, have been selected from a private
institution for the study. In fact, the present study is
basically done by collecting qualitative data in which the
following methods are used in gathering data for the
study.
1. Direct observation
2. Questionnaire
Direct observation assists to conceive the behavior

patterns, mental schemas of clients, and for the success
of the object of the research. The other method;
24
questionnaire is used to gather information. The

narrative analysis method is used to analyze the collected
data. Further, the ages of the selected people with mental
disorders in the sample can appear as follows.
Table 2.1: Ages of people with mental disorders in the
sample
Age Category Number of People with

Mental Disorders
20-30 3
31-40 2
41-50 8
51-60 8
61-70 12
71-80 2
This shows us that at any age of people can be

suffered from mental disorders. The study sample can
be divided as follows under their sex identity.
Table 2.2.: Sex identity of people with mental disorders in
the sample
Sex Identity Number of People with

Mental Disorders
Male 17
Female 13
25
When we further investigate the selected sample, the

marital status of these people can be found as follows:
Table 2.3.: Marital status of people with mental
disorders
Married Unmarried Widow Separated

15 6 4 5
According to the above study sample, people with

mental disorders can be found without distinction
between males and females. Further, this shows us that
although such mental disorders are increasingly found
among married people, it reveals that these people with
mental disorders can be found among other statuses as
well. Furthermore, though there exist some differences
among these people with mental disorders, it is an
obvious fact that each patient with mental disorders in
the study sample has a responsible family.
Some limitations indeed have to be followed when

dealing with people with mental disorders. As the
present study reveals the people who have already cured
and socialized, it was a big challenge to find out real
details of them as they have given imprecise details.
Therefore, we had to spend much more time in revealing
accurate details of people with mental disorders.
It should also be noted that there are some unavoidable

challenges to a researcher in gathering information for
this type of study. The reason for this can be explained
26
that some cured people with mental disorders are

uninterested in revealing their past experiences. This
situation can be seen because several reasons such as;
 The risk of re-spring the same illness within them

again in consequence of recollecting their strident
past.
 Some relatives are not willing to provide their
information for a number of sub reasons.
 Fear of stigma etc.
Another limitation of the study can here be highlighted

that family members or relatives of these people who got
fully cured their issue do not seem to allow researchers
to build up discussion with such people.
27
Memory:
“(Lat. memoria) Non-inferential knowledge of past
perceptual objects (perceptual memory) or of past
emotions, feelings and states of consciousness of the
remembering subject (introspective memory).
Memory is psychologically analyzable into three
functions: (a) revival or reproduction of the memory
image, (b) recognition of the image as belonging to
the past of the remembering subject, and (c) temporal
localization of the remembered object by reference to
a psychological or physical time-scheme.”
(Dictionary of Philosophy, p. 195).
28
Chapter III
Different Mental Issues of People

When discussing conditions of ‘normal’ vs. ‘abnormal,’
an exact definition cannot be given. In fact, the
discussion of ‘normal’ vs. ‘abnormal’ differs by time,
cultural context, social context, etc. Hence, acceptance
of normal in accord with a period can be changed from
another period of time. As well as, a thing which is
normal in a society can be changed in tallying with
another society. Therefore, the way of looking for people
is determined based on these indications. Indeed, the
social order makes considerable influence on this matter.
Durkheim observes that the social order comes to
manifest through the social norm. There cannot be seen
in many societies that a positive perspective of such
people with mental disorders and such people are not
looked at by social norms taught by Durkheim.
The state of ‘normal’ is probably known to have

recognized actions that advocate Social order and the
state of ‘abnormal’ advocates deviation of social order.
In fact, from the very old era, these two terms; ‘normal’
and ‘abnormal’ have been defined with the help of
several kinds of perspectives such as:
29
(1) Supernatural tradition

(2) Biological tradition and
(3) Psychological tradition (Barlow, H. David, and
Durand V. Mark, Abnormal Psychology: An
Interrogative Approach, p. 06).
In the early period of human civilization, the
manifestation of mental disorders was considered as a
condition of supernatural forces such as demons, devils,
spirits, or the influences of the moon, planets, and stars,
etc. Henceforth, this approach is termed in two names
(1) Supernatural Tradition and (2) Demonological
Method. In the process of treatment of abnormal
behaviors, some people inclined to believe such sorts of
mental issues could be removed through the ritualistic
approaches.
The belief of supernatural forces is a common

characteristic for both western and eastern traditions, is
built up from the outset of the human civilization.
Durkheim, in one of his criticism of religion, has
observed two concepts (1) Beliefs and (2) Magic
(Durkheim, 1912, p. 44). The belief system is of
supernatural forces. The healing methods related to them
are called magic. This concept of magic is severed into
two such as (1) Black magic and (2) White magic
(Malinovsky 1978, p.) People with mental disorders are
classified under black magic. In addition to this, by
quoting Raymond Perth, Dissanayake mentions that
there are three cardinal magic such as:
30
(1) Productive magic

(2) Protective magic
(3) Destructive magic (Dissanayake, 2004, p. 178).
Out of the trio the protective magic was used to heal both
mental issues and mental difficulties.
Traditional healing methods failed to cure mental issues

that require medical treatments. Therefore, in
consequence of using these traditional methods to
overcome them, the issues of such people were severe.
So that, the supernatural tradition was collapsed and the
biological tradition comes to manifest. However,
although it was collapsed the supernatural tradition, it
was not totally removed from the beliefs of society.
From the Biological perspective, it was explained that
mental issues come to manifest since the biological
factors. Few of them are noted thus:
 Genetic factors
 Nervous factors
 Damages of the brain
 Imbalance of the body
 Using drugs and alcohol
 Malnourishment in childhood
 Physical appearance
In fact, later on, it was found that in addition to the
biological reasons, mental issues are come to be
appeared by means of psychological reasons, therein it
was evidently believed that mental issues of people have
31
arisen as a result of the imbalance of psychological

factors such as moods, feelings, emotions,
phenomenological factors, cognition, and personality.
Barlow, H. David, Durand V. Mark, say in this
connection thus:
“In conclusion, it is difficult to define “normal” and
“abnormal” (Lilienfeld & Marino, 1995, 1999)—and
the debate continues (Clark, 1999; Houts, 2001;
Klein, 1999; Spitzer, 1999; Wakefield, 2003, 2009).
The most widely accepted definition used in DSM-
IV-TR (and drafts of DSM-5) describes behavioral,
psychological, or biological dysfunctions that are
unexpected in their cultural context and associated
with present distress and impairment in functioning,
or increased risk of suffering, death, pain, or
impairment. This definition can be useful across
cultures and subcultures if we pay careful attention to
what is functional or dysfunctional (or out of control)
in a given society. But it is never easy to decide what
represents dysfunction, and some scholars have
argued persuasively that the health professions will
never be able to satisfactorily define disease or
disorder (see, for example, Lilienfeld & Marino,
1995, 1999). The best we may be able to do is to
consider how the apparent disease or disorder
matches a “typical” profile of a disorder—for
example, major depression or schizophrenia—when
most or all symptoms that experts would agree are
part of the disorder is present. We call this typical
profile a prototype, and, as described in Chapter 3, the
diagnostic criteria from DSM-IV-TR as well as the
emerging criteria for DSM-5 found throughout this
32
book are all prototypes. This means that the patient

may have only some features or symptoms of the
disorder (a minimum number) and still meet criteria
for the disorder because his or her set of symptoms is
close to the prototype.” (Barlow, H. David, Durand
V. Mark, Abnormal Psychology: An Interrogative
Approach, p. 4).
The Cambridge Dictionary of Psychology explicates the

term ‘abnormal’ in a wider sense as follows.
“The study of persons whose behavior causes
significant distress to them or others; the behavior’s
cause is believed to be the pathological functioning
of the mind. This field includes the development,
classification, diagnosis, treatment, and prevention of
mental disorders. The term abnormal psychology is
not applied in a statistical sense to both the highest
and lowest functioning persons but only to the lowest
functioning ones, and so the term is usually used in a
pejorative sense rather than a statistical one, causing
significant confusion among laypersons.”
(Matsumoto, David, The Cambridge Dictionary of
Psychology, p. 01).
The above Cambridge Dictionary of Psychology

provides us to follow steps in the process of healing their
mental issues that led to arise ‘abnormal behavior’ such
as development, classification, diagnosis, treatment, and
prevention of mental disorders. This classification is
very famous among professionals in the process of
treatment for people with mental disorders.
33
“Abnormal psychology the branch of psychology

devoted to the study, prevention, assessment, and
treatment of maladaptive behavior.” (APA College
Dictionary of Psychology, p. 01).
This interpretation shows us clearly that Abnormal

Psychology assigns to provide perfect guidance for
getting cured mental disorders of people. The Concise
Dictionary of Psychology includes a worthful definition
to clarify the term ‘abnormal’ as follows.
“Abnormal can only be defined in relation to the term

normal, about which there is probably more
disagreement than anything else in Psychology. In
whatever sense, it is used abnormal implies
divergence from what is normal. It is generally used
to describe someone’s behavior when it disturbs the
regular course of his everyday life, or that of other
people.” (Statt, David A. The Concise Dictionary of
Psychology, p. 01).
The interpretation extracted above seems to have

highlighted the main characteristic of the term
‘abnormal.’ Accordingly, what is deferred from
‘normal’ is called ‘abnormal.’ Further, our attention is
compulsory to pay at APA College Dictionary of
Psychology in which the term that we defined above is
further clarified thus:
“Abnormal’ relating to any deviation from what is

considered typical, usual, or healthy, particularly if
the deviation is considered harmful or maladaptive.
In statistics, for example, abnormal scores are those
34
that are outside the usual or expected range. The

term, however, is most often applied to behavior that
differs from a culturally accepted norm, especially
when indicative of a mental disorder.” (APA College
Dictionary of Psychology, p. 01.)
Furthermore, the term defines in ‘Cambridge Dictionary

of Psychology’ as follows.
“Differing from the usual, expected, or mean. In

psychology, this term is used both in the statistical
sense of deviation from the central tendency of a
distribution and in the sense of behavioral deviation
from the social norm. Confusion often arises as a
result of failing to specify which use of the term is
meant. So, a person with a very high IQ is abnormal
in the statistical sense but not the pathological one”
(Matsumoto, David, The Cambridge Dictionary of
Psychology, p. 01).
Eventually, in considering all these opinions, four criteria

can be suggested to determine the distinction between
Normal and Abnormal as follows:
(1) It does not exist as a common behavior.

(2) It also contrasts with moral systems.
(3) This does not support people to be balanced
in the gradual life pattern.
(4) The mental well-being of an individual is
negatively affected by this behavior.
Various actions are taken to prevent these abnormal

behaviors. These actions are formal and informal.
35
Among informal actions, rituals, and so forth are

important. Although some psychological-relaxation has
received by these informal rituals, those practices are not
strong enough to cure severe disorders like this.
Therefore, at the outset, these informal rituals inspired to
accelerate the rate of severe disorders of individuals.
However, owing to the situation, consistent scientific
intervention seems to require. Mental disorders that had
been faced by the individual of the sample can be
categorized as follows.
Table 3.1.: Mental disorders faced by people in the

sample
Individuals of the
Number of individuals in
sample faced mental
the sample
disorders
Anxiety 09
Depression 06
Bi-polar disorders 03
Schizophrenia 08
Borderline personality
disorder 01
Somatoform disorders 03
Totality 30
This shows us that all people in the study indicated above

are suffering from a severe level of mental disorder. The
main characteristic of the study found that although these
people have already cured and socialized, till they
continue their drug treatments. Reason can be identified
36
concerning with respect to this fact that if these people

do not take continuous medical treatment symptoms can
again be manifested.
Further, it is also an identified characteristic that all these

people have known the mental disorders that they were
suffered. In studying the sample related to this study, it
was precise that various causes have led to the rise of
mental disorders. It also most expounded that some
biological factors as well as life challenges that they face,
unexpected incidents, etc. have been led to these mental
disorders. The attention can be paid at life history and
also family history in order to conceive the biological
causes of these different mental issues.
Therein it was proved that various family members

belong to several generations have suffered from mental
disorders that have been suffered by patients in the study
sample. It was found that these people have been
stimulated by lack of attention, carelessness, lack of
knowledge of the mental issues, etc. of their family
backgrounds for suffering from these sorts of mental
disorders. The mental disorders that they have been
inherited by their previous generations as follows;
1. Schizophrenia
2. Depression
3. Bipolar disorder
Here, it was found that 03 people out of 08 have been

suffered from schizophrenia, 02 depression people of 06,
37
01 bi-polar people of 03 mentioned the above sample.

This reveals that genetic factors can be affected for
arising mental disorders among people with mental
disorders.
Further, it also was crystal clear that based on their

present life experiences and unexpected and unpleasant
incidents have been causing to make mental disorders.
24 people from the study sample were related to this
genetic factor mentioned above. According to the
sample, the life experiences of the people have been led
to mental disorders.
Table 3.2.: Affinity between mental disorders and life

experiences of people with mental disorders
Family Issues Number of members in the
study sample
Life struggles 08
Breaking interpersonal 10
relationships
Frustration 02
Economic difficulties 04
Totality 24
It is in fact true that the people face different kinds of

difficulties and challenges in their usual lives and they
balance those issues in accordance with their capacities.
Nevertheless, when these issues are beyond their
capacities, they have to face many psychological issues
such as mental disorders. Some of these mental disorders
can be affected to arise long term harmful consequences
for individuals.
38
The family is the primitive factor of building up one’s

whole life. Therefore, thus the family is termed as
‘primary socialization agent’. Thus, it can be said that the
family makes a considerable impact to build up the
whole life of an individual. Therefore, family issues of
people with mental disorders are highly affected for
family members.
Disorganization and breaking family relationships are

also made mental imbalance of family members. This
situation seems to enable for originating puzzle mental
state and mental disorders of family members. The
following statement is extracted here from a member of
the study sample.
“After going abroad my father and mother, I was alone

in Sri Lanka. My relatives are also in foreign countries.
I lived in hostels continuously. Therefore, I did not
receive love. Hence, I think I was more aggressive.
Finally, I became a patient who takes medicine” (A 38-
year-old boy who suffered from a mental disorder,
2019).
Further, mental disorders can be found among

individuals as a result of existing disputes among family
members, relatives and also breaking love affairs. In fact,
the intensity of these mental disorders totally depends on
the value of those relationships attributed to them.
Further, the mental balance of an individual can be

broken as a result of breaking their needs and wishes
related to both their mental and physical states such as
39
marriage, love, employment, economic improvements,

children, and so forth. They have actually been pressured
with the inability of achieving these expectations.
Therein, we can apparently note that those who cannot

bear up economic difficulties, and other problems that
they confront in daily life and potentials of people are in
some cases not strong enough to reconcile those
challenges that can cause them to make their situation
more confusing. Although we sever these two factors,
biological factors, and life experiences, based on the
approximate cause of making mental disorders, it was
evident from some incidents that these causes are
interconnected, or in other words, they cannot be
separated from one another.
“I was crazy because of confronted unbearable

problems, social insult after having left me by
my husband. But both grandmother and father
and also step-mother have depression. This is a
common illness to our entire family” (A 37-
year-old woman who suffered from mental
disorders, 2019).
This shows us that although biological factors create

mental disorders of people, they apparently manifest
owing to negative individual experiences.
Further, this explicates that individuals can be protected

from mental disorders, although they have genetic
factors, by making the composed mental and physical
environment in the society. On the other hand, it is also
40
precise that although it does not exist biological factors

behind mental issues of individuals, their day to day life
experiences can lead to arise such a state of mind.
Now, it is crystal clear that the personality, individuals’

mental state, nature of mind, the bearing-ability, etc. are
also significant factors in relation to get rid of these
issues.
The Impact of Mental Disorders

People with mental disorders face many difficulties
within the period of suffering from mental issues. Such
kind of mental difficulties can affect every aspect of an
individual’s life. Further, it also affects negatively for
other individuals of society. Indeed, some difficulties
that these patients suffer can be listed as follow:
Physical Difficulties
 Anoxia of foods
 Obesity (as a result of feeling hungry always)
 Feeling in whole the day sleepy (as a result of
using medical treatment)
 Laziness and loss of energy to do anything
 Infection of skin illnesses easily
Mental Difficulties
 Loss of attention
 Hallucinations
 Delusions
41
 Loss of memory
 Breaking the link in between thoughts and
behavior
Other Difficulties
 Breaking social relationships

 Isolation
 Loss of employment
 Loss of social status
 Discrimination
 Social stigma
It was revealed that the difficulties tersely noted above

harmfully affect their day to day life pattern. Further, it
is also found that their normal life pattern has been
damaged and they have used to new life patterns. Their
life patterns have changed after the institutionalization,
therein they have to spend their time with a regular time
table which is unfamiliar for them. As a result, in the
period they are living in the institution, their expectations
have been limited. This was exposed to the following
expression.
“When I was staying (in the institution) I was got
a bath according to the wishes of people worked
there. I was not allowed to do what I wish to do.
Therefore, I felt my freedom has been limited” (A
36-year-old man who suffered from a mental
disorder, 2019).
42
In paying attention to all clients, it is precise that in some

considerable extent of time they have institutionalized to
cure mental disorders. Experiences obtained from the
institution have been important in the process of
socialization. It should also be noted that although they
have puzzled their marital life, family relationships,
social relationships, employment, and so forth, they have
indeed trained to socialize within the period of time that
they stayed there. These instances show us that people
with mental disorders, who have institutionalized, have
cured. Further, the training given in the institution has
been more important in the process of socialization.
Here, the rehabilitation process is done by trained
professionals. The positive differences appeared after the
training given in the institution can be noted as follows:
 gaining again the favour of food

 appeared the need of getting cured
 physical wellbeing
 mental wellbeing
 arising the need of socializing
 feeling inner differences
 thinking of preventing medical treatments
 feeling better as before
 looking at others differed from him
In the present context of Sri Lanka, it has been an issue

that a large number of people with mental disorders have
lost their guardianship. In such a context, all issues that
43
came to have appeared can be settled through

introducing ‘a community-based care system.’ Thereby
the process of socializing would be able to maintain
accurately. Further, sometimes, the details of people
with mental disorders, given by guardians in
institutionalizing their patients, are inaccurate and it is
revealed when they check the details. Therefore, the
officers of the institutions have to face many obstacles in
the process of socializing these people with mental
disorders after cured their mental issues.
Consequently, this situation leads cure people with

mental disorders to institutionalize repeatedly or may
bring about to intensify their negative mental states. On
the other hand, this situation inspired responsible groups
to begin institutions such as halfway homes, therein in
the process of maintenance of such people with mental
disorders is too high and the government has to allocate
a vast amount of money for the process of maintenance
those institutions. Although this can be considered as a
weakness of the institutionalization of Sri Lanka, on the
one hand, it can also be identified as a positive tendency
at present.
The study sample confirms that people with mental

disorders belong to three kinds of families as follows:
44
Table 3.3: Types of family include people with mental

disorders
Type of family Number of people with
mental disorders
Entering their own 21
biological family
Entering their own relative 06
family
Entering their close family 06
Totality 30
It is in fact true that many of the sample belong to the

biological family and it can be mentioned that it is a
positive tendency of the society. This reveals in
comparing with other two families.
On the other hand, it is revealed that the intensity of
socializing people of families noted above is high people
in the biological family than relative family and close
family. The reason behind it is that the supportive system
of the biological family is not found in the other two
families. The following parties are the most helpful to
parties for people with mental disorders.
1. parents
2. husband/wife
3. boyfriend/girlfriend
4. sister/brother
5. friends
6. relations
7. neighbors
8. chief monk
45
Of this, it is revealed that both parties, formal and

informal, are supporting in socializing these cured
people with mental disorders. Their supports are also
different and they can be listed as follows:
1. finding a job
2. continuing their education
3. managing their day to day lives
4. emotional supports
5. empowerment
6. economic supports
7. integrating them into social network again
8. remembering their duties of previous time
9. continuing the treatments
10. reestablishment in the society
12 out of the 30 persons in the sample are employing and
the above-mentioned helping parties have assisted them
to find out jobs. They have been doing jobs related to
formal and informal. They can be categorized as follows.
Table 3.4: Enrolled jobs of people with mental
disorders
Jobs Number of people
sewing 04
security jobs 02
Informal cooking and 01
selling foods
handicrafts 01
formal clerical 02
Totality 12
46
The basic skills for doing these jobs have been improved
by trainers and officers in the period of staying at the
institution. Although they have been well-practiced to
continue these jobs, it is a significant fact that they seem
to have not taken any effort to go forward. Further, their
inborn skills have also been important in finding these
jobs. However, it could be revealed an important thing
that the majority of them indeed think that they cannot
do formal jobs that they did previously and therefore,
they do not even like to talk about their previous jobs.
The following expression given by one cured patient

who had a mental disorder is a strong evidence to prove
this fact.
“We cannot do previous jobs and we are not

enrolled in a new job as we had an illness, we don’t
have the previous capacity” (A 42-year-old man
who suffered from a mental disorder, 2019).
This explicates the existing issues related to both parties

in the process of socialization. By overlooking these
issues, professionals can provide proper service to
succeed in the process of socialization. Until responsible
parties do not concern on these issues, the entire social
process puzzles.
47
“Durkheim conceived of human beings as homo

duplex, as leading essentially double existences, one
rooted in the biological organism and one (morally,
intellectually, spiritually superior) in a social. And
while the former was naturally egoistic and selfish
(the individual body with its material senses and
appetites), the latter, accruing from society, effected
by †socialization, was able to be ‘conscientious’:
altruistic and moral. Between the two there was
constant tension, but through inculcation into a
public language and culture, humans became capable
of rising above mean (animal) individuality and
becoming part of a †collective consciousness in
which the (sacred) traditions of a society were
maintained. If people were yet conscious of
themselves as individuals, then this too derived from
their socialization and served a social function.”
(Encyclopedia of Social and Cultural

Anthropology, p. 450.)
48
Chapter IV
Conditions Confront People

with Mental Disorders after
Socialization
An exceptional characteristic of this sample is that these
patients who have left the institution have entered any of
the two families identified such as: receiving proper
support from family and receiving improper support
from family. Therefore, we have to find out what kind
of light or support has been given to them to socialize.
The main intention of family members who well
supported to socialize was to get cured their relative
from the mental disorder which he had been suffered.
Further, it is also a significant fact that family members
of the people with mental disorders have given
considerable support to get rid of the issues in the family
background. Indeed, they have paid special attention to
those people who cured of their mental illness and to
build up their personality again. The following table
shows us the nature of the support given these two
families.
49
Table 4.1: Nature of the support people with mental

disorders are given by their family
Nature of the support people Number of individuals
are given
1. Receiving proper support
22
from family
2. Receiving improper support
08
from family
Totality 30
An individual who suffered exceptional mental disorder

can be given proper assistance for him to adjust with the
society if we establish a strong ‘social unit of the family.’
At the same time, we have to bring down the social
stigma. Indeed, these people are socially stigmatized.
Even in Sri Lanka, this social stigma is usual on such
people with mental disorders. In the colloquial, we can
hear;
“W!g msiaiq yeÈ,d wxf.dv heõjd”
(Uta pissu hadila angoda yawwa) He was sent to
angoda because it was crazy.
“´ld wxf.dv b|,d <`.È f.or wdfõ”
(Oka angoda idala lagadi gedara awe) He came
home recently from Angoda.
“W! msiafila”
(Oka pissek) it’s crazy.
These instances show us that these people with mental

disorders have somewhat been stigmatized negatively.
Although society is forwarding, still it has been difficult
to change this negative perspective that prevailed in the
50
current society. Owing to this social stigma, they

demotivate and the negative social responses can be
broken or disturbed the process of socialization.
However, there is no established supportive system to
help them at the community level in Sri Lanka. After
people with mental disorders have healed and
returned home, one of the biggest problems that they
face is that although their mental illness has healed,
other people are reluctant to associate these people as
before. Often they are labeled and discriminated from
them. Here we should note that even basic human rights
of these people are violated. The following expression is
extracted to identify the nature of issue faced by these
people.
“Our home belongs to me. Mother and father
do not give the authority to me as they said that
I’m crazy” (A 38-year-old man who suffered
from a mental disorder, 2019).
This shows us how it is being happened in the Sri

Lankan context. Sometimes, their parents suspect these
people who have already cured their mental issues.
Therefore, these people are un-sentiently alienated from
the mainstream of society.
This alludes that although they strive to turn to the
normal life, barriers are crossed their turning. Therefore,
the existing system should be reutilized with new
changes. For the purpose, the micro-level and the macro-
level societies should be changed with positive attitudes.
51
Adjustment:
“Adaptation to function better in a particular

environment. Changing thought or actions to interact
in more satisfying ways with one’s physical, social,
and cultural environment. Adjustment, in the
discipline of psychology, is generally conceived of as
learning to deal better with changes in life.”
(Cambridge Dictionary of Psychology, p. 17.)
52
Chapter V
Conclusion and Summary
Although from the earlier perspective of human

civilization abnormalities of people consider as mental
illnesses, at present, the perspective is changed to
consider such abnormalities as mental conditions.
Therefore, these people are looked at from a positive
perspective. In Sri Lanka, people who have already
cured and socialized, have a lack of attention and in
some cases, they are stigmatized and discriminated. This
reveals the requirement of establishing a community-
based care system in Sri Lanka.
It is viewed that patients have been suffering from

physical, mental, social, and spiritual difficulties for a
long time. However, we have observed that this situation
can be brought down through proper psycho-social
intervention of professionals. Indeed, formal and
informal relationships have supported these people to be
reestablished in the society, therein the support of
professionals and the family given is more effective.
However, the socializing process is disturbed in some
cases when their biological, social, and other problems
are come out. This can lead to reappear the previous
mental disorders within them consequently.
53
Whatsoever, socializing is more acceptable, soon after

their mental issues are cured, in agreement with other
social norms such as human rights, free will,
independence, than they are, further, institutionalized.
However, this socialization process should be initiated
under professional guidance. Here, we identify the role
of a social worker, counselor, psychiatric, sociologist, or
psychologist is as a mediator, in which making a potent
combination between people with mental disorders and
their family members is the primitive role of such a
mediator. The mediator can do this by way of
empowering or regulating family members by giving
professional guidance.
Eventually, when socializing these people, it needs to
make a strong positive social notion. For the purpose, as
we discussed in previous chapters, professionals should
aware the society clarifying their mass level
responsibilities. Further, we can also buildup a common
social platform for making professional discourse,
therein we identify that it is badly in need of establishing
a client-centered welfare system through the support of
professionals. Throughout putting such new methods
into practice, the socialization process can be
strengthened for the welfare of people with mental
disorders in Sri Lanka.
54
Questionnaire
1. Name of respondent
………………………………….................................
2. Age of respondent
………………………………………………………
3. Address of respondent
……………………………………………………….
4. Marital status of respondent: married
unmarried widow separated
5. Sex of respondent male female
6. Currently, are you an employer? Yes/No
If ‘Yes’ mention
………………………………………………………
7. How many family members do you have?
………………………………………………………
8. Who they are?
……………………………………………………….
9. In which year did you face to this mental difficulty?
.....................................................................................
10. How long did the mental difficulty exist?
.....................................................................................
55
11. How many times did you suffer from this mental
difficulty?
……………………………………………………….
12. Do you aware of this mental difficulty? Yes/No
If ‘Yes’ explain in brief
………………………………………………………
………...……………………………………………
…………………...…………………………………
…………………………….........................................
.....................................................................................
13. Do you aware of the approximate cause of your
mental difficulty?
Yes/No
If “Yes” please explain the reason in brief.
……………………………………………………….
…….……………………….……………………...…
……………………………………………………….
…………………………………………………….....
14. What are the difficulties that you were suffered since
your mental difficulty?
Physical Mental difficulty Others
difficulty
56
15. How this mental difficulty affected your life?

.....................................................................................
.....................................................................................
.....................................................................................
16. When this mental difficulty was cured?
………………………………………………………
17. Do you remember how your mental difficulty was
overcome? Yes/No
If “Yes” explain it briefly
………………………………………………………
………………………………………………………
………………………………………………………
…………………………………………………….
18. What did you feel when your mental difficulty is
being overcome?
……………….............................................................
……………….............................................................
19. Where did you go after having cured the mental
difficulty?
……………….............................................................
……………….............................................................
i. What kind of support you were given therein?
……………….............................................................
....……………….........................................................
20. What kind of responses you were given after having

cured your mental difficulty?
……………….............................................................
……………….............................................................
57
21. What kind of challenges were faced while you are

turning back to day life?
……………….............................................................
22. Who are the supported parties you when you back to
the normal day to day life?
……………….............................................................
……………….............................................................
……………….............................................................
……………….............................................................
23. Explain in brief that what kind of support you were
given by them?
……………….............................................................
……………….............................................................
……………….............................................................
……………….............................................................
24. Explain in brief what kind of changes are to be done
for another person like you when he comes back to
the society.
……………….............................................................
……………….............................................................
58
Bibliography
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Anthropology, Routledge 11 New Fetter Lane,
London.
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Diagnostic and Statistical Manual of Mental
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Published by Oxford University Press, Great
Clarendon Street, Oxford OX2 6DP.
— [2009]. APA College Dictionary of

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— [2009]. The Cambridge Dictionary of

Psychology, Published in the United States of
America by Cambridge University Press, New
York.
59
— [2013]. American Psychiatric Association,

Diagnostic and Statistical Manual of Mental
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David A. Leeming, Kathryn Madden, Stanton

Marlan, [2010]. Encyclopedia of Psychology and
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Geddes, John, Price, Jonathan, and McKnight

Rebecca, [1990]. Psychiatry, Oxford University
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Kessler, R.C., [2011]. Childhood socioeconomic

status and the onset, persistence, and severity of
DSM-IV mental disorders in a U.S. national
sample. Social Science & Medicine 73, 1088–
1096.
Kuppuswamy, B. [1961]. An Introduction to Social

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Lamberti, J. S., Weisman, R. L. [2004]. Persons

with severe mental disorders in the criminal
60
justice system: challenges and opportunities.

Psychiatric Quarterly 75 (2), 151–164.
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San Francisco.
Rosenthal, H. [2008]. Encyclopedia of

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61
Adjustment disorder:
“An unusually strong reaction to a specific
external source of stress that impairs functioning
in one or more areas of life in a usually normal
person. Symptoms can include almost any
emotional and behavioral ones that affect
personal, social, marital, or vocational
functioning as long as they arise as a reaction to a
specific source of stress and endure less than 6
months longer than the stressor itself, which may
persist for any length of time. This is one of the
most commonly used diagnostic categories in the
DSM-IV-TR as it encompasses a wide variety of
symptoms, bears little social stigma, and can be
used to obtain insurance payments for
psychotherapy.”
62
Index
Abnormal behavior —11, 28, 31, 33.
Adaptation — 9, 10.
Adjustment — 4, 8, 9, 10, 21.
Anoxia of foods — 39.
Anxiety — 13, 34.
Biological family — 42.
Biological tradition — 28, 29.
Bipolar disorder — 13, 34, 35.
Black magic — 28.
Borderline personality disorder — 34.
Boyfriend/girlfriend — 42.
Breaking interpersonal relationships — 36.
Breaking social relationships — 39.
Chief Monk — 43.
Close family — 42.
Damages of the brain — 29.
Deinstitutionalization — 03.
Delusions — 13, 39.
Depression — 30, 34, 35, 38.
Destructive magic — 28.
Discrimination — 39.
Durkheim — 27.
63
Economic difficulties — 36, 37.

Economic institution — 37, 36.
Education — 6, 17, 43.
Feeling in whole the day sleepy — 39.
Friends — 16, 43.
Frustration — 36.
Genetic factors — 29, 35, 38.
Hallucinations — 39.
Homosexuality — 11.
Husband/wife — 43.
Imbalance of the body — 29,
Infection of skin illnesses easily — 39.
Institutionalization — 01, 02, 03, 39, 41.
Isolation —39
Laziness and loss of energy — 39
Life struggles — 36.
Loss of attention — 39
Loss of employment — 39
Loss of memory — 39
Loss of social status — 39
Magic — 28, 29.
Malnourishment in childhood — 29.
Negative social response — 11, 48.
Neighbors — 43.
Nervous factors — 29.
Normal vs. abnormal — 27.
Obesity — 39.
Parents — 16, 42, 49.
Physical appearance — 29.
64
Physical appearance — 29.

Political institution — 17.
Primary socialization — 16, 36.
Productive magic — 28.
Psychological tradition — 28.
Psychosocial — i, iii, 9, 21,
Relations — 43.
Relative family — 42.
Religion — 17.
Schizophrenia — 13, 30, 34, 35.
Secondary socialization — 16, 17.
Sex industry — 11.
Sister/brother — 42.
Social stigma — 39, 48.
Somatoform disorders — 34.
Supernatural tradition — 28, 29.
Thoughts and behavior — 39.
Using drugs and alcohol — 29.
White magic — 28.
65
Adjustment Method:
An experimental method used in psychophysics
to determine perceptual thresholds, in which a
subject is given a set of stimuli and asked to
adjust each stimulus to match a standard stimulus.
The differences between the adjustments and the
original standard are used to estimate the
sensitivity of perception.
66

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Other works of the author

Sarasaviyata Perasaviyak (A guide book for

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Collection of Research Papers – Junior

At first, I would like to pay my gratitude to all members

Table 2.2.: Sex identity of people with mental disorders

Table 2.3.: Marital status of people with mental disorders

Table 3.1.: Mental disorders faced by people in the

Table 3.3: Types of family include people with mental

Chapter II—Background of the Study 23

Chapter III — Different Mental

Chapter IV—Conditions Confront People

(Cambridge Dictionary of Philosophy, p. 47.)

It is not a task which begun recently that the people with

The First Phase

At the beginning of the 19th century, a particular

excluded from society. In rich countries of Europe,

The Second Phase

In the era 1950, the concept of asylums is collapsed in

The Third Phase

It should tersely be noted that notions of

In this background, instead of the concept of

Aim of the present study

In the wider topic of psychological issues, the present

The issue noted above seems requisite to overlook from

Further, at present, mental disorders are begun to

At the micro-level, people with mental disorders, and

positive social attitude of these people with mental

An interdisciplinary approach and discussion should be

Further, in the common society, there should be a

are also termed as mental health disorders due to its

It should be noted that the mental conditions and moods

Both the individual factors and social factors also lead to

the process of socialization concerning the existing

In the present complex societal background, an

Different settings in different professional areas can be

challenges, their real or exact conditions, etc. among

Eventually, the mental health field can also acquire some

In this study, there are several key terms such as people

“Mental disorder is a significant deviation from a

Therefore, those who suffer from such mental conditions

two terms of the triad are together called ‘psycho-social’

‘Adjustment’ and ‘Adaptation’ occur in some cases in a

“A change in attitude, behavior, or both by an

The term ‘Psychosocial’ is explained: “Of or relating to

thoughts or actions to interact in more satisfying ways

There exist positive and negative aspects in the

and the negative aspect is the opposition of positive

Ex: The sex industry, Homosexuality

In the seventeenth century, people with mental issues

In the discussion of mental disorders, it is important to

“A particular mental disorder is determined by

Besides, it is important to take existing ideologies into a

“‘Disorder’ is not an exact term, but it is used here

This explains the importance of identifying mental

“A mental illness is a health problem that

At the very beginning, the exposition of mental disorders

According to this, it is precise that the mental disorders

By these criteria, it precisely denotes mental puzzles and

Mental disorders can be categorized under several major

People who have suffered from such mental disorders

1. A history of mental illness in a blood relative,