Page:  [ 1 | 2 | 3 | 4 | 5 | 6 | 7 ]

S ome people who have experienced what it is like to be a psychiatric patient say that it is not possible for them to feel safe within the mainstream mental health system. Others say they were empowered to recover their mental health with the support of progressive services and individual mental health professionals. These cases herald a more enlightened system in the future but the economic interests of highly paid professionals and drug company profits, along with an imperative to maintain the status quo, hobbles meaningful reform.

Instilling fear is a method of control both in the psychiatric system and out in the general public. Portrayals in the media of stereotypical 'dangerous' mental patients and the passing on of terrifying myths about mental illness create fear and aversion in the general public. Fear can also be felt from the danger of being seen as 'mad' or 'crazy' when one gives public expression to ideas or experiences which are not part of an acceptable or 'normal' discourse. Psychiatric diagnosis or being 'taken away' in a straight jacket if one's behavior is 'extreme' violates social norms and bothers others around us. After receiving a diagnosis, people report an ever-present fear of the loss of freedom and rights under the committal process because of the use of three-point restraint, isolation, enforced medication and electro shock treatments in hospitals.

The psychiatrization of mental patients begins with their diagnosis. The diagnosis involves the psychiatrist, a person trained to look for pathology, who examines behavior which is often taken out the context of people's actual lives, their possible histories of trauma as well as the stresses in their present environment. The ideology which states that difficult life situations trigger an already present defect in the brain allows biological psychiatry to minimize the importance of outside causes. This ideology helps to maintain the patriarchal status quo and silence potential disruption to social structures and institutions. Many feminists and their allies see psychiatry as an agent for the preservation of patriarchal and capitalist systems.

Once psychiatized, a person experiences the hallmarks of oppression: domination and subordination; fear; the withholding and control of information; the silencing of expression; the loss of dignity and rights; discrimination and internalized stigma; low self-esteem; self-deprecation and, most importantly, resistance. Oppression is considered by some as necessary to control people who are seen as irrational, 'lost' in delusion, potentially dangerous and/or in need of protection from self-destructive behaviors. The resistance that occurs is often pathologized as a symptom of and a lack of insight into one's 'mental illness', enabling many legitimate complaints and concerns to be dismissed.

Psychiatrization is a cycle of disempowerment where people learn to become "helpless" mental patients. This reinforces the idea that those with serious mental illness need to be controlled and taken care of. People are given a life sentence to a limited future, lose control of their lives, and are medicated with energy-draining and potentially damaging drugs. The aspects of social control are hidden behind reassuring statements that psychiatric professionals are compassionate and have their patients' best interests at heart.

The consumer/survivor/ex-patient movement resists psychiatrization and oppression with advocacy and lobbying against the abuses found in mental health systems. One former psychiatric patient said that it was only as she began to recover that she was able to see how unsafe her life had been as a client of mainstream mental health services. There is no physical, psychological and emotional safety when stigmatization is felt both externally, by being oppressed, dismissed as defective, damaged goods, then relegated to poverty and marginalization; and internally, when stigma transforms a person's identity to one that is powerless, ineffective, ashamed (self-blaming) and insecure. Psychiatrized people can become so marginalized that they don't see that they have any choice or that there is any other alternative but to place themselves under 'professional' care. People who have lived on the 'edge' of psychosis for a while also have a hard time moving away from it. Whatever positive self-esteem they have may be founded on the 'specialness' of their own alternative reality which may be the only place where they find self-validation though at the price of ostracism and isolation.

Safety is definitely missing when people with mental health issues leave the system, drop through the cracks of the safety net and end up homeless or living in unsafe housing. People self medicate with alcohol and street drugs to ease the pain, wander the streets or become victims to predators. People often find themselves in the prison system by default. There are many women and men, with traumas from neglect and abuse, who develop multiple problems. Their great pain and suffering is not addressed appropriately in the mainstream system of care. Traumatized people find it difficult to disclose their abuse and find the trust they need for healing in institutions where power and coercion are aspects of the treatments.

The antidote to psychiatrization is the hope and reality of recovery. Recovery of mental health can happen when people are supported in their environment to achieve whatever they desire, and where their diversity and differences is celebrated, not discriminated against. The rediscovery of mental health requires safe spaces: places where people have freedom of expression without fear of repercussion; where they can be themselves emotionally without the risk of being 'shut down', taken away or medicated; where they can tell their stories free from the stigma of being viewed as 'abnormal'; and where they can develop a greater awareness of the social, economic and political factors behind their marginalization and stigmatization.

A safe space is not a place that uses people as guinea pigs in experiments with new wonder drugs, or test tubes, adding this or that dosage of drug to find the most effective control. A safe space is one where people are treated with respect and dignity as human beings with full citizenship, their rights and privacy honored. It is a place where people are able to take full control and responsibility for themselves and are meaningfully involved in all the decisions which affect their lives. A safe space for people with mental health issues is where fear, control and domination is replaced by love, compassion and cooperation.

Self-help groups and consumer/survivor-run programs are safe places where people find mutual aid, peer support and role models for recovery. Here, people share their stories and break the cycle of disempowerment and despair. Self help groups provide understanding and supportive environments were people can reconstruct lost identities and carry on with the discovery of their spiritual, physical and mental health.

Joanna is an active member of the Vancouver Richmond Mental Health Network.
She was recently awarded her Masters of Social Work from the University of BC.