#BellLetsTalk About The Problem With Anti-Stigma Campaigns

By Maxine Kozak, Writer for RU Student Life

Illustrated by Mahtab Abghari

Last year, I wrote about my experience with mental health treatment and critiqued the popular “recovery narrative” promoted by anti-stigma campaigns like #BellLetsTalk. To summarize, I wrote, “here’s what I’d like to see more of from #BellLetsTalk: rather than promoting a “recovery narrative”, whereby some spokespeople for the campaign portray a “clean” image of mental health (where recovery is the final destination), could we talk about the nuance of recovery as a process? My mental illnesses probably do not have an expiry date and I’m not the only one. Can we talk about the intersectionality of mental illness — its relationship with poverty, sexual orientation, gender, race, and ability?” This year, I’d like to continue the conversation.

Since then, I’ve started taking a mad studies course at Ryerson (DST500). The term “mad” is used as a means of reclaiming a term that has been historically used against us. Mad studies is an emerging field pioneered here in Toronto by mad survivors, activists and educators. The field positions survivor knowledge as core curriculum and utilizes academia to back up this community knowledge and lived experience. It provides an open definition of madness as over time and in different spaces, meaning shifts and changes constantly.

Take the subject of mad studies itself. It has roots in two other mental health movements in particular: the psychiatric survivor and anti-psychiatry constituencies. Psych-survivors came to being out of the civil rights movement of the late 1960s. The movement was a means of pushing back against personal histories of psychiatric abuse. In the Mad Matters text, psychologist Shaindl Diamond writes that psych-survivors “prioritized connecting people who have experienced the system and improving the conditions of their lives, alleviating suffering and meeting needs”. Mad studies can be considered an extension of the psych-survivors movement.

On the other hand, the term “anti-psychiatry” also began making its rounds in the 60s. According to Diamond, the primary goal of which was to “abolish institutional psychiatry or at least undermine its power and authority.” Diamond articulates that the main differences between mad and psych-survivor movements and the anti-psych constituency is that the former would “reform current institutions to ease immediate pain and suffering” while the ladder would “transform society to meet needs in alternative ways that intrinsically respect the dignity and welfare of all.” While these constituencies present radically different courses of action when it comes to mental health movements, they can be considered two sides of the same coin. They all understand that there is something wrong with the ways we think about and respond to quandaries of the mind.

In the first DST500 lecture, we were introduced to the concept of mental health literacy. That is, the way in which we are educated and socialized to identify common signs of a mental disorder, to share beliefs of causes of mental disorder as well as share an understanding of treatment options. Through efforts of mental health literacy, understanding mental health through the “medical model” has become the norm. The medical model is characterized by a number of inherently flawed assumptions. For example, the medical model upholds the idea that mental illness is something that resides in the individual. Thus, the solution is to “fix” the individual. However, working on treating individual experience does not eliminate the problem from the structures and institutions that often cause or exacerbate them. This is where a mad studies approach comes in. As academic Rachel Gorman writes in Mad Matters, mad studies “takes social, relational, identity-based and anti-oppression approaches to questions of psychological difference and is articulated in part against an analytic of mental illness.”

We are told that mental health literacy efforts are social justice programs that are improving the lives of individuals with mental health issues. However, social justice unpacks power imbalances. #BellLetsTalk does not do this. Instead, as activist and academic Jenna Reid pointed out in lecture, “it promotes top-down expert driven knowledge that comes from powerful white elites. They develop a set of cultural practices through which we are taught socially and institutionally to identify and manage madness. We take this expert driven knowledge in order to develop one story about madness, that is, the medical model. The medical model is always validated because it comes from the elite, from the people who are in power.”

The medical model holds that if we promote this one clear story, the more successful we will be at prevention and treatment because we will have destroyed the stigma. Ultimately, this linear logic evades social justice issues. Understanding madness in terms of one clearly defined narrative is deeply problematic. There is not one story to be told. Sure, there are patterns of thought because there are patterns of human behaviour. Regardless, the ways in which we understand ourselves and the world around us is largely determined by our own unique collection of experiences.

As Shaindl Diamond writes,essentializing both mad discourse and psychiatric discourse has the potential to obscure how processes of racialization, gender, class, disability, sexuality and other processes shape and define madness. The experiences and narratives of many marginalized mad people demonstrate how madness is shaped by a complex system of power relations and narratives that fail to address this reality.” It is clear that the medical model is not intersectional. We ignore real issues and never solve anything because of this emphasis on individual. There is this dominant recovery narrative despite the fact that our different experiences of the world have us experience institutions differently. In failing to consider intersectionality and individuality, the medical model as well as anti-stigma campaigns like #BellLetsTalk fail us. We must continue to demand better and so, this year, these are the conversations I’d like to be having.