Currently, mental health is a hot topic in Ontario. Countless media stories along with governmental and professional groups have highlighted the importance of reducing stigma, identifying folks who need support and connecting folks in need of support to clinical services. There are aspects of this that are awesome. Many of us do suffer from some form of mental distress at one point or another and/or love someone who has/does. It is important that we do not feel embarrassment or shame about the behaviours, thoughts and feelings we are told are not “normal.” It is also important that we challenge all the stigma and oppression associated with being labeled with a mental illness (e.g., loss of employment, loss of housing).
But if Shameless (and feminism in general) has taught us anything, it is that language is important and we need to critically examine understandings and norms, including those around mental health. Since the 1970s there has been a Mad Movement of folks labeled as “mentally ill” and while it has not received the same acknowledgement as other social change movements, mad organizing has been instrumental in challenging the concept of mental illness, as well as the oppression and violence experienced by those of us labeled “ill.” Feminists have been directly and indirectly involved in this movement (e.g., Bonnie Burstow, Kate Millet, Paula Caplan, Phyllis Chesler) and I want to very broadly introduce mad politics and how mental health is a feminist issue.
Mental illness and mental disorders are two terms that do not sit well with me. Illness and disorder are medical terms for pathology that are connected to a disease model of health. If we understand mental health according to a disease model, we believe that the root of mental health issues is biological, much like other illnesses in the body. This can restrict someone’s ability to heal or imagine a non-medicalized future. For example, when I was labeled with a mental illness at the age of twelve, I was told that my brain chemistry was abnormal and I would have to take medication for the rest of my life. Such a statement was terrifying and really affected my self-esteem, sense of self and ability to imagine a successful future.
The other problem with a disease-model of mental illness is that no one knows what exactly “mental disorders” are, how they develop or how best treat them. There are many theories, but theories are just theories. So when we are told that mental health issues are caused by chemical imbalances, it is important to be aware that that is only one possibility. This is not to say that there are not biological aspects to our mental health, but that our social environments play an important role.
One reason that feminists have been so critical of the way we understand and diagnose mental illness is that women are overrepresented within many disorders. For example, women are diagnosed with depression at three to four times the rates of men, with low-income women and women of colour being diagnosed at twice the rate of middle-class white women (Belle & Doucet, 2003). Thus, depression is not only gendered, it is shaped by race and class. As a result, women are more commonly medicated with psychiatric drugs or treated with electroshock therapy (ECT). In Canada, ECT is primarily administered to elderly women and is regarded by the Coalition Against Psychiatric Assault as a form of violence against women. Conflicting with popular beliefs, feminist psychologists argue that psychiatric diagnosis is largely unscientific and subjective, reflecting gender, race and class biases (Caplan, 1995; see articles by Association for Women in Psychology Bias in Diagnosis Committee).
By rooting mental health issues in the body and treating individual symptoms, we do not look at the external social factors that are also impacting how an individual is thinking, acting and feeling. Feminists have argued that many individuals labeled with mental illness are survivors of gender-based oppression and/or violence (e.g., Jane Ussher, Phyllis Chesler, Bonnie Burstow, Janet Stoppard). Given that many people labeled with mental health issues are also survivors of violence, mainstream focus on stigma reduction and strategies to identify people who need support and connect them with treatment individualizes mental health. When I say individualize, I mean that we focus on what is wrong with the individual and how to treat/fix them. A feminist perspective would recognize individuals’ thoughts, behaviours and feelings as normal reactions to their life experiences and work with them from an anti-oppressive, strengths-based approach of healing and empowerment. What would happen if for the majority of us who are mad and survivors were told that something bad happened to us, instead of being told that we were sick? What if the government invested in changing social systems that create, produce and maintain mental distress? I would like to see a mental health strategy that works to eradicate violence against women and children, poverty, colonialism, and other oppressive aspects of society.
Jenna MacKay is a community worker/activist who is currently completing an MA in psychology and dreams of starting a vegetarian catering company.