If I used phrases like "wog", "paki", "yid", "bit of skirt", or "cunt", you would feel rightly offended and outraged,. Yet service workers use words like "mental health", "mental illness", "mental distress", "sick", and "chronic" without a second thought.
Diagnostic labels have been replaced by euphemisms like "mental health problems". Chronic and "long-term" have been replaced by "Continued Care Client". Professionals talk in these terms often interchanging them in the same sentence for example; saying "mental distress and mental illness" on the one hand, then "people who have mental health problems" on the other. Do you know what they mean and how it feels to be called by these terms? Probably not. So you need to think about it. You also need to leave your preconceived ideas and training outside of this building. That will be quite difficult for you as your training will have disabled you. Disabled your ability to perceive. Most service workers, particularly the medical and nursing disciplines are taught to see certain kinds of pictures. Every person you see is compared to the set of pictures you have been taught. You don't see different pictures with different interpretations. This process leads to treating people as homogeneous groups, and it is unhelpful and damaging to group together peoples distress.
PEOPLE are not studied by psychiatry and psychology CATEGORIES are. In categorising distress the distress itself is not acknowledged. The individuals right to OWN the experience has been stolen.
I looked up several words in the dictionary - mental, health, illness, mind, insane, mad, crazy, and lunatic. Many of these words are self-referential. Under LUNATIC it said, "an informal or archaic word for insane". Under CRAZY it said "Insane". Under MAD it said "mentally deranged and insane". Under INSANE it said "mentally deranged, crazy of unsound mind". These words exist only in relation to each other. So what is the mind? The dictionary defines it as; "the entity in an individual RESPONSIBLE for thought, feelings, and speech". ENTITY is defined as "something having or distinct existence". Well we all know what we are talking about now! There are no exact, tangible meanings. I am particularly interested in the use of the word RESPONSIBLE in the definition of MIND. According to the Mental Health Act people deemed to be "mentally ill" may not be responsible for anything - least of all their thoughts, feelings, and speech.
It is common amongst people who have used or been used by the mental health services to feel that they are not responsible because they are incompetent and inadequate. Where do these feelings of incompetence come from? It would be easy to say that they are inherent. Certainly low self esteem and confidence fosters these feelings, but it doesn't start and end there. People become dependant and helpless with treatments and labels. The fight to retain yourself is harder when your body and will is weakened by chemicals. When your choice is crushed with assertions such as "If you want to stay out there, you MUST stay on your injections". When you are given options not choice and your whole identity is defined by their label. Then we only see what people CAN'T do - not what people CAN do. Low expectations are lived down to. Forced and amended "normalisation" is also a recipe for incompetency. What do "expertise" and "professionalism" do to help people retain personal power? Yet again unidentifiable words - but these words command immense power. The professional is there as an "expert" to find a way of solving or curing the distress. The recipient receives. There is no understanding on the subjective level. There is no acceptance of the persons reality. No common language. Even on surviving the services I had to look long and hard to find my OWN words - as I had been so saturated with the language of labels and categories. The language of objectification and MENTALISM. This is probably a new term for you. It isn't difficult to understand. If you understand racism and sexism then you can understand mentalism. "ism" merely means to "indicate an action, process or result".
Mentalism is a process of not allowing people to express themselves. Society allows a very narrow range of expression. On boarding a tour of the mental health services one discovers that the range is narrowed. Not only that but every inch of the range is defined in negative terms. A persons behaviour is never labelled in a positive way, it is always negative. Illness equals unwanted, bad, and abnormal. Something that should be eradicated or cured. However "normal" is not defined, so how can "abnormal" be determined?
Can anyone tell me when the whole population were tested and how, to determine, for example the normal amount of grief to express on the death of your mother?
Some people would say that "mental health" is the absence of "mental illness". About as logical as saying that happiness is the absence of sadness!!! This does not hold up as something scientific, something that should be taken seriously. Sadly our society does take the unquantified, flimsy, notions of "mental health/mental illness", and diagnostic labels seriously. These terms devalue and demean people on a fundamental level which is hard to rid oneself of. Once past the "relief response" to learning a name for the described distress - the label itself does not alleviate pain. The acceptance of the label is often borne out of desperation. It does not help the worker or the individual to understand what is happening or what is needed to assist the individual. Most importantly it stops the individual from being able to find their own language and acceptable meaning. It stops the individual from owning the experience. Ownership goes to the worker and case-notes. Disempowerment of this kind drives people crazy. It causes people to BE and STAY "mentally ill". If people accept their labels - and I don't condemn this - I feel sad that this acceptance prevents an individual from discovering their own description. The description is paragraph 8, page 2, as dictated by the expert. Along with labels comes myth and stereotypes which are perpetuated by the services and continued in society. So-called "Schizophrenics" are supposed to not be able to make a decision. So-called "Personality-disordered" are not meant to be able to hold "normal" social relationships. These stereotypes mean that the labelled people are seen as inferior, less competent. In the same way that stereotypes of Afro-Caribbean and Asian people equal inferiority. There is legislation to address racism and sexism, but not mentalism. Equal Opportunities Policies rarely include mentalism. It's as though it doesn't matter. Mentalism hurts just as much as racism and sexism. I would like to see Equal Opportunity Policies to include mentalist language - for "mental illness" to be on a par with "nigger, and wog". It is often said to me that it all depends on what meaning you attach to these words. I don't accept that. If a worker calls me a "person with mental health problems" in a nice, right-on, radical way - it still feels the same, as I haven't chosen the term or meaning. You may attach your meanings to words but society as a whole may attach others; I will give you three examples; Phil Cool recently sang a song on his comedy show about the split personality of the schizophrenic; The tabloid press have attached the Loony to left-wing for at least the last ten years. Can you imagine if this was cripple or spastic instead?? Does the word Psychopath make you think of the patient shuffling around or the crazy behind your shower curtain with the knife a la Hitchcock??
I refer to myself as a survivor of the mental health services, an ex-binliner, and a loony. These words I have chosen and have my meaning which is not derogatory but empowering. Whereas "mental illness", or "schizophrenic" merely make me feel sub-human. It's quite simple - drop the expertise and let everybody draw their own pictures.
Louise Roxanne Penbroke, User Involvement Course, Kings Fund Centre 1991. April.
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