A note on terminology: people who suffer from mental illness sometimes refer to themselves as patients, clients, service users, sufferers or survivors. We use these terms interchangeably though we recognize the limitations and some of the reasons behind rejecting each of them. The term “mental illness” itself is problematic but for now we use it here for lack of a better way to refer to these states of being which undoubtedly exist as a category, if not yet conclusively a medical one.
The A Project recognizes that mental illness represents one of the most pervasive burdens of our time. The already immeasurable suffering it causes in and of itself is severely amplified by the social stigma which surrounds it, as well as the state-sanctioned impunity of the mental health practitioners and their blatant abuse of power.
While we recognize the suffering that exists, we are highly critical of the mental health industry which includes pharmaceutical companies, psychiatrists, psychologists, researchers and others. The industry holds the power of pathologizing and diagnosing people by defining what the norm is and what deviates from it and deciding what is healthy and what is harmful.
Diagnoses like hysteria, (now replaced with the equally sexist and unfounded histrionic personality disorder), homosexuality (now removed from the list of disorders), gender dysphoria (which in 2013 replaced gender identity disorder), schizophrenia and others have deeply entrenched political histories and continue to serve as tools of subjugation of women, homosexuals, gender non-conforming people, marginalized communities and people who challenge the normative structures of the family or the state. Gender, race and class bias in diagnosis has been proven repeatedly for several disorders and indicates, at the very least, the highly subjective nature of an industry which markets itself as scientific.
That being said, we are equally critical of conspiratorial deniers of the very existence of all types of mental illnesses as some of these are well-documented patterns of emotional suffering which predate the mental health industry and all its abuses.
We also reject the severely reductionist medical model towards mental health insofar as it depoliticizes and individualizes the problem. By asserting that the cause of mental illness lies solely within the individual’s biology, the medical model presents medical solutions, which place the individual at the center of their own healing. Instead, we recognize the social, economic and political determinants of mental health as being at least equally important to the underlying biological determinants. As such, we firmly hold that any real effort to better the condition of sufferers should prioritize tackling the social, economic and political determinants, all three of which have been conveniently overlooked by the industry.
Mental health warrants much more attention than it is currently receiving but this attention should be of a fundamentally different nature than it is today. Indeed, today’s reality is that those who provide mental health services are the same people who are raising awareness on mental health, conducting the locally relevant research and spearheading national strategies. In the best cases where the people involved are well-intentioned and truly care about the plight of mental health sufferers, this still represents a problematic conflict of interest where the general direction is towards more and more treatment, without any critical appraisal of the nature and quality of this treatment.
We believe that the current efforts poured into promoting treatment (of any nature) and waving the slogan of “fighting stigma” distract from tackling the more dangerous and systemic problems like the blind reliance on highly political diagnostic manuals, the lack of accountability mechanisms for mental health professionals and the legal protection of mental health patients’ agency, autonomy and rights.