Suppose you were told that because of some characteristic you had or some characteristic others assumed you had that you are somehow deficient as a human being and as such not entitled to the rights or opportunities afforded to others. What if you were told that the fundamental reality of you was the label someone placed on you, the social or cultural group you belong. to, your religious faith, your race, your gender, your disability, your sexual orientation, your physical appearance or any of countless other characteristics or attributes? What if there really no “you”, that your identity was strictly limited to being nothing more than “one of them”, a member of some category or group you were placed in?
What if this “identity” was in some way spoiled leaving in some sense a mark or tag on you saying you were not as able as others and that because of that you should be treated differently than others? What if this treatment was unfair, unjust, and hurtful and still justified as appropriate and deserved regardless of what you thought about it? What if any argument you have, any complaint you make, any refusal on your part to accept this identity is defined by those who would control you as proof that you are indeed what they say you are and in fact need the control they say you need?
What if this “identity” had very real life consequences for you? What if it had real economic consequences for you? What if it influenced the kind of jobs you would be considered for and the likelihood of success in those jobs? What if it affected your health or access to health care? What if it affected whether or not you had a home or what kind of home you had? What if it affected your interactions with police or other authority figures? What if it affected your social standing or status? What if it affected your ability to make friends and be accepted by others? What if it made life harder, much harder and seemed to close off most paths to a better life?
For many people all these things are true. They are identified as different, as alien, as outsiders in their own world. And as outsiders they find that the wider culture habitually and chronically exercises power over them in a fundamentally unjust and hurtful manner.
Too often to be poor means to be treated in this fashion.
Too often to be black or brown or yellow means to be treated in this fashion.
Too often to be a woman means to be treated in this fashion.
Too often to be disabled means to be treated in this fashion.
Too often to be anything other than heterosexual means to be treated in this fashion.
Too often to be an immigrant or anything other than native born to this country means to be treated in this fashion.
All of these things are commonly recognized and in some way, to some degree some kind of fight is being fought to try to change these things. Some of these fights have made some progress. Some have made little. For some people things are getting worse, not better and their struggle is long term.
But there is another group that is not commonly recognized as falling into this narrative. For thousands of people, maybe millions to be given a psychiatric diagnosis (to be called crazy however polite the terminology) means to be treated in this fashion.
Even really good people sometimes don’t recognize this. They assume that diagnosis is a morally neutral act and an objective expression of medical science. Some people see it as a kindness done to poor suffering people to help find them relief. They do not see it as a social act with multiple consequences that are hurtful and unfair. They don’t see that it is an act with real life consequences different than any other kind of diagnosis. They don’t see it as being a question of human rights.
They don’t see the arbitrary and artificial nature of many diagnosis. They don’t understand they are more constructed than discovered. They assume a reliability and diagnosis that just doesn’t exist. They don’t understand how the assumption of a discrete biological entity is more a simple minded prejudice than it is a scientific fact. And they don’t understand how that assumption that problems in living are a symptom of illness helps to excuse and hide very real trauma and injury in the lives of so many.
They don’t understand the danger of many “treatments”. I read one person a list of the side effects of psychiatric medication and asked him what would happen if this was a list of the side effects of heart medication. He responded quickly, “A revolution in health care…”
They don’t understand how many things don’t work very well. We just do them because we are used to doing them. And they don’t understand how an approach that is so naive about the effects of adverse circumstances in our life is so often useless if not harmful.
Rather the fault be in our ability to explain or in the ability of others to hear and understand a lot of people just don’t buy the narrative. They don’t see or understand the idea of mental health advocacy having anything to do with human rights. It is a tragedy of major proportions.
I have heard all kinds of explanations as to why. Some point to the splits and divisions amongst advocates and say that people who don’t stand together give at best mixed messages about what they stand for. I have heard others say the problem is language. How do you translate your experience into terms that resonate and move someone who does not share that experience. I have heard we are far too negative. It is easier to understand what people are against if you understand clearly what they are for. I have heard that we are perceived as trivializing or minimizing the very real misery that so many people live with. We, I have been told, have nothing for people in serious distress. I don’t know the answer but I am sure of the problem. For too many people it has little or nothing to do with human rights, stigma and prejudice, or people being hurt by what is supposed to help them. It is about making sure that people who need medical care get it.
There is a great conversation going on about national mental health reform laws. No one really knows what if anything will happen. Perhaps nothing. But……
One of the outcomes possible with something like the Murphy Bill is that one mental health narrative…. the medical model…. will actually acquire not just medical standing but legal standing. It will become, particularly in time, the legal way to treat people with mental health issues. Anything contradicting it will be seen, in one of Murphys terms, as reprehensible and irresponsible.
The results of this battle may be substantial and long standing. Everyone should matter. Everyone does matter. The task before us is to craft a narrative that people will buy into that takes us closer and closer to the day that is true and better life is a real possibility for everyone who struggles with life.