Psychiatric Survivors Research Articles

The Joker’s Shifting Face: Eighty Years of Mad History in Batman and American Culture

That “grim jester with a twisted brain,” Batman supervillain the Joker reflects shifting social constructions of mental difference in the US across eight decades. The article reads Batman serial comics, graphic novels, and film against four key moments in Mad History: eugenics, psychiatric survivor activism in the 1960s and 1970s, the trauma discourses of 1980s popular culture, and the criminalization of mental difference in the twenty-first century. Out of this complex conversation four models of madness are derived: toxic reproduction, liberation, mad genius, and the conflation of madness with violent crime. These models work intersectionally: Joker’s madness, queerness, and exceptionally white masculinity engender each other. Because of his distinctive qualities as a visual icon, he makes Mad History more visible, too.

Moving Beyond "Recovery": Exposing and Disrupting the Eating Dis/Order Industrial Complex

In this article, we begin by discussing the historical ideologies and practices that have evolved into the prevailing understandings of ‘eating disorders’ (EDs) and their association with mental illness, psychiatric treatment, and recovery. We argue that psychiatry’s authoritarian control over so-called EDs and the circular reasoning that justifies its questionable efficacy present a paradoxical trap for those labelled as ED. While scholarly critiques of the psychiatric ED monopoly have expanded clinical framings of ED recovery, it is the psychiatric survivor movement that has exposed psychiatry itself as something to recover from. In line with this movement, and moving with Mad Studies, we call for a more radical scholarship that resists prevalent notions of ‘recovery’ and expresses Mad outrage in response to the systemic violence that is perpetuated by psychiatry’s totalitarian control of treatment and recovery. Toward this end, we began the process of curating radical imaginations for a transdisciplinary project to include alternative analyses of ED-related phenomena that expose what we have come to understand as the eating dis/order industrial complex. We conclude by pointing to alternative analyses that we suggest can inform critical eating dis/order studies, drawing from: economics, communication and technology studies, public health, radical dietetics, practitioners, activists, artists, survivors, peace studies, and multi-species studies.

Role Identities of Activists with Mental Disorders in South Korea: A Qualitative Descriptive Study

Purpose: The psychiatric survivors movement, which represents people with mental disorders (PWMD), recognizes the autonomy of PWMD activists and emphasizes peer support and advocacy. However, in South Korea, where this movement is still in its early stages, the activities associated with it are not clearly defined. This paper aims to explore the role identities of PWMD activists and examine their significance.Methods: We conducted one or two in-depth interviews with 12 PWMD activists to gather data. The interviews were designed to uncover the participants’ perspectives on their roles as PWMD activists and their understanding of these roles. Thematic analysis was used to identify common themes.Results: The overall theme that emerged from the role identities of PWMD activists was “one who publicly advocates for the rights of the group while leading colleagues towards personal growth and societal change.” Within this overarching theme, three sub-themes were identified: intrapersonal, interpersonal, and socio-political aspects. In total, we identified 10 sub-themes.Conclusion: Our findings can inform the development of various activities that support the recovery of PWMD, enabling them to assist their peers and advocate for their future interests, while also ensuring that their roles are reflected in policies.

The Publishing Dilemmas of Authors Who Have Lived Experience With Mental Illness.

This column details some of the ways in which psychiatric survivors or those writing about their lived experience with mental illness are disadvantaged and devalued in mainstream academic publishing. This devaluation stems from structural issues involving various organizations, persons, and practices. Breaking the constraints of this structure is extremely difficult, but the author proposes some ways of doing so.

‘Informed consent is a bit of a joke to me’: lived experiences of insight, coercion, and capabilities in mental health care settings

AbstractThe Independent Review of the Mental Health Act 1983 found that people’s experiences and self-knowledge were mislabelled as a ‘lack of insight’. Insight, a psychiatric concept, is defined as an ability to recognise one’s mental illness, awareness of one’s symptoms and compliance with treatment. Across different jurisdictions, legal scholars have raised concerns about the influence of insight on legal provisions for psychiatric care and mental capacity assessments, given its prevalent use in psychiatry and its absence from statutory criteria. However, outside of these findings, little is known about people’s lived experiences of ‘insight’ and the law. This article draws on narrative and photo-elicitation interviews with psychiatric survivors to argue that insight is an extra-legislative proxy for regulating involuntary detention and other coercion masked as consent. Finally, this article draws on the capabilities approach to deliver a justice argument for creating real opportunities to provide informed consent in mental health settings.

Psychiatric Advance Directives: A Call for Humanization

Psychiatric Advance Directives: A Call for Humanization

Anton Boisen Reconsidered: Psychiatric Survivor and Mad Prophet.

Anton Boisen was a seminal figure in the psychology of religion and pastoral psychology, but scholars have remained skeptical about his theoretical contributions and have perpetuated the stigma surrounding his psychiatric diagnosis and incarceration. I argue that Boisen was a prophet, ahead of his time, and that the academy has been slow to hear his salient critiques of the psychiatric system, and his contention that "psychosis" and "mystical experience" are overlapping phenomena. Most significantly, scholars have ignored the kernel of prophetic truth in Boisen's own visionary experience, which, remarkably, in 1920, predicted the ecological crisis of our current age. Reclaiming Boisen's unique voice might help us reclaim the uniqueness of the disciplines he helped birth.

Implementation of peer-support services in Asia: A scoping review.

Peer-support services was started in the 1970s psychiatric survivor movement in the United States of America (USA) due to the lack of transitional support for deinstitutionalized psychiatric patients. Delivered by peer-support workers (PSWs) with lived experiences of mental health conditions, peer-support workers use their experiential knowledge to help others with similar conditions. The paradigm shifts in mental health recovery has led to an increase in interest on peer-support services among the Asia countries. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The diversity political and cultural differences in Asia makes it a unique for people to understand the mental health ecosystem that exist within. This review is timely as it provides the insights into the current state of peer-support services for mental health consumers in Asia and the future research on them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: First, this review provided a broad overview on the current types of peer-support services and their implementation in Asia. Second, emphasized the importance and value of peer-support services for individuals with mental health conditions in their journey towards recovery. Third, important to build a more positive image for peer-support workers by assigning more clarity to their roles and systematizing training to hone their skills in providing peer support. Introduction The increasing recognition and need for recovery-oriented services led to the heightened interests of peer-support services globally, including Asia. However, little is known about the peer-support services in Asia as compared to the West, where peer-support services primarily originated from and are well established. Aim To examine available evidence on the implementation of peer-support services for such consumers in Asia. Method This scoping review was based on the Arksey & O'Malley's framework. A comprehensive search was performed across seven electronic databases. The grey literature was also searched through Open Grey and ProQuest Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2000 to December 2021. Results Three main themes were identified to provide an overview on peer-support services for mental health consumers in Asia: the delivery of such services in Asia; Asian consumers' perceptions of them; and factors affecting their implementation. Discussion Given their relative novelty in Asia, findings from this review represent useful insights for organizations and policy administrators when formulating such services. Implications for Practice Future research should also focus on evaluating the effectiveness of such services in Asia and comparing their outcomes with other regions.

Lesbian and bisexual women's experiences of aversion therapy in England

This article presents the findings of a study about the history of aversion therapy as a treatment technique in the English mental health system to convert lesbians and bisexual women into heterosexual women. We explored published psychiatric and psychological literature, as well as lesbian, gay, and bisexual archives and anthologies. We identified 10 examples of young women receiving aversion therapy in England in the 1960s and 1970s. We situate our discussion within the context of post-war British and transnational medical history. As a contribution to a significantly under-researched area, this article adds to a broader transnational history of the psychological treatment of marginalised sexualities and genders. As a consequence, it also contributes to LGBTQIA+ history, the history of medicine, and psychiatric survivor history. We also reflect on the ethical implications of the research for current mental health practice.

The ‘madness’ of accessing justice: legal mobilisation, welfare benefits and empowerment

ABSTRACT This article explores a paradigmatic case of legal mobilisation in the UK: successful litigation taken by RF, an anonymous claimant, against the Department of Work and Pensions’ cuts to disability mobility benefits for those facing ‘psychological distress’. While there is now a flourishing literature on the mobilisation of disability rights around the world, socio-legal scholarship has tended to overlook the mobilisation of law by those experiencing mental ill health or the potential contributions of adoption a social model of madness, mental distress and confusion. In developing a ‘thick description’ of the litigation process in the RF case, the article inductively identifies important lessons for scholars of legal consciousness and legal mobilisation. It showcases how the litigation process has both oppressive and empowering potential for those who are otherwise subject to systemic oppression by mental health and welfare benefit services. Second, it broadens the empirical literature on disability legal mobilisation which has largely overlooked the mobilisation of law by mental health service users and psychiatric survivors beyond issues related to psychiatric interventions, institutionalisation and detention.

Feminist precursors of mutual support groups in the mad movement: a historical-critical analysis

Mutual support groups are one of the most important collective actions in the psychiatric survivors movement or mad movement. Among its precursors, different proposals from social movements and community perspectives on collective health have been mainly well-known. In this article we carry out a historical overview of their antecedents, pointing out different actions from the Women's Liberation Movement and the Women's Health Movement. From this, we perform a critical analysis considering three axes to understand the emergence of collective actions in mental health: personal experience in relation to the sociopolitical structure; the construction of political subjects in this field; and power relationships in the management of madness and psychological discomfort. We show how mutual support groups, in the context of the mad movement, give continuity to the trajectories of collective and feminist health actions, and are positioned as tools for the creation of political processes in different sociocultural contexts.

Die Grenzen der Therapie verhandeln

To a large extent, the history of psychiatric therapy is the history of incomplete cures, defeated hopes, and ever enduring chronicity. Yet while the historiography of psychiatry has paid much attention to the therapeutic successes claimed by psychiatrists, it has had only little to say about its failures. This article offers both a framework for analyzing therapeutic failure in the aftermath of the mid-twentieth century psychiatric revolution and an exploration of the ways in which it has been problematized in three corpuses of publications from families of people with mental illness, psychiatric survivors, and nurses, respectively. I suggest that failure should be understood as a situated concept that emerged, historically, from the complex set of transactions among psychiatrists, their clients, and the wider society. Specifically, I highlight three levels of analysis when addressing therapeutic failure. The first relates to the broader system of expectations surrounding medical practices. At the second level, failure emerges in the course of the administration of a given treatment from the observation that a cure or at least some relief has not been obtained for a given patient. At the third and last level, failure refers to the inability of a clinician to perform his prescribed role. The changing dynamics of treatment administration in the wake of the neuroleptic revolution, the evolving dangers of therapy, and the transformations in the relationship between therapists and patients is then highlighted to offer a broad understanding of failure as an experience and a concept for the various protagonists of the psychiatric drama.

Policing in Europe: disability justice and abolitionist intersectional care

Over the last few years, the intersections between mental health and punitive violence have gained more attention within scholarship and activism around race and policing. Disability justice and intersectional approaches have argued that the discourses around and categorisations of various forms of disability are deeply rooted in projects of colonialism and enslavement, and their legacies. These discourses are strongly enacted in contemporary logics and practices of policing, as racialised people who identify or are categorised as mad, neurodiverse, mentally ill, psychiatric survivors and disabled are particularly vulnerable to police harassment and violence. This article discusses how policing is deeply intertwined with discourses around saneism – institutional and systemic oppression of people who identify, have been diagnosed as, or are perceived to be, mentally ill, which has implications for abolitionist intersectional thought and practice. Foregrounding a black feminist abolitionist analysis, in dialogue with intersectional disability justice and mad studies, the author argues that an accountable engagement with the mad analytics of policing of black lives has important implications for intersectional and abolitionist thought and activism as forms of care/ing for black lives.

The Experiences of Migration among Homeless Male and Female Psychiatric Survivors

Globally, individuals with psychiatric disorders experience an increased risk for homelessness and frequent migration. The present qualitative study used intersectionality and thematic analysis to examine how male and female psychiatric survivors experienced the phenomenon of frequent migration in Canada. The study findings underscored aspects of frequent migration, including negative experiences associated with poverty, as well as increased risks for homelessness and mental health, stigma, and discrimination. The present findings call for bespoken services and programs to address male and female psychiatric survivors’ specific needs; thereby alleviating pathways to frequent migrations among psychiatric survivors.

When Madness Meets Madness: Insider Reflections on Doing Mental Health Research

Insider–outsider relations in qualitative research have been heavily studied. Yet there is a dearth in the literature exploring how people who have experienced madness produce knowledge and overcome trying circumstances when they do qualitative mental health research with other survivors. This article fills this gap through a critical reflection on my experiences with psychosis and involuntary hospitalization and how they shaped dialogue with my participants. Situated within a narrative framework of inquiry, I reveal how self-disclosure and critical forms of relationality during interviews with 10 psychiatric survivors produced a survivor-centered knowledge that nuances biomedical understandings of mental illness and the mental health system. Practices of self-disclosure revealed how survivors and I had to navigate familial expectations as we recovered and tried to regain a sense of identity. Doing insider research also helped me overcome the periods of embarrassment and stigma in my psychosis, as I learned through critical dialogue how traumatic events can provide unique avenues for intense self-reflection and the development of greater empathy for mental health survivors. I also discuss some of the ethical concerns and limitations of having an insider status in qualitative mental health research, and how self-disclosure may present certain epistemological challenges in the research process.

Territorial Stigmatization and Territorial Destigmatization: A Cultural Sociology of Symbolic Strategy in the Gentrification of Parkdale (Toronto)

AbstractTerritorial stigmatization is one of the most powerful concepts for understanding how social, spatial and symbolic processes are intertwined in producing contemporary urban inequality. Through a detailed case study of Parkdale, a Toronto neighbourhood that has been profoundly shaped by its long association with poverty, single room occupancy housing and psychiatric survivors, this article works at the points of intersection between the rapidly expanding literature on territorial stigmatization and wider social scientific interest in gentrification‐led displacement. Drawing on archival research, participant observation and interviews with residents, it demonstrates how territorial stigmatization, and a new allied concept, territorial destigmatization, operate in Parkdale. Territorial stigmatization and destigmatization work across three dimensions: legal, material and discursive. Using conceptual tools from cultural sociology to foreground symbolic elements of these three dimensions, two strategies of territorial destigmatization are delineated: one that operates in concert with gentrification‐led displacement, and the other that works to symbolically reinscribe stigmatized persons and housing forms. To complement and sharpen territorial stigmatization research, recent findings from studies of stigma are integrated to show how psychiatric survivors and housing advocates in Parkdale use territorial destigmatization to offset gentrification‐led displacement.

Freedom of Opinion and Expression: From the Perspective of Psychosocial Disability and Madness

This article argues that civil mental health laws operate to constrict how people think, understand, and speak about psychosocial disability, madness, and mental distress. It does so with reference to views and experiences of mental health service users and psychiatric survivors (users and survivors) and their/our accounts of disability, madness, and distress, such as those articulated by the emerging field of Mad studies. The analysis considers the application of the rights to freedom of opinion and expression that are enshrined in the International Covenant on Civil and Political Rights and other international human rights instruments to the mental health context. The article explores the suppression of freedom of opinion and expression that is effected through the symbolic violence of psychiatry and the mental health paradigm. Focusing on Australian legal frameworks, the article discusses how the material violence and coercion characterising mental health laws compound this process. It is further argued that civil mental health laws, by codifying the tenets of psychiatry and the mental health paradigm so as to render them largely unassailable, validate the ontological nullification of users and survivors. The foregoing analysis exposes dangers of adopting a functional test of mental capacity as the pre-eminent legal standard for authorising involuntary mental health interventions. It is suggested that considering freedom of opinion and expression from the perspective of psychosocial disability and madness reinforces the Committee on the Rights of Persons with Disabilities’ interpretation that such interventions are incompatible with international human rights standards.

Failure to Comply: Madness and/as Testimony

Self-harm, suicide attempts, disordered eating, addiction, and other forms of “acting out” are associated with the trauma of surviving violence. While these behaviours are pathologized as symptoms of mental illness, they can be understood, instead, as strategies of resistance against violence. When violence is ignored or normalized, the “acting out” associated with trauma can be a means of sounding an alarm that something is very wrong. This “acting out” can be understood as an embodied form of testimony. When direct resistance to violence, such as fighting back or escaping, is thwarted or impossible, traumatic “acting out” can be a way to draw attention to and resist violence. Psychiatry, instead of answering the call of trauma by addressing the underlying violence, works to silence that call. Through incarceration, sexual violence, enforced isolation, restricted motion, threats, coercive drugging, gaslighting, and other abusive tactics, psychiatry works to undermine the embodied testimony of trauma by producing compliance. The source of the problem is shifted from the original violence and located instead in the body of the traumatized person. Successful treatment is understood as the reduction or elimination of the very “symptoms” which are in reality acts of resistance to violence. Therefore, successful treatment essentially means submission. The carceral space of psychiatry continues the work of producing compliance even after the patient has left its enclosures, extending the space of the psych ward into the everyday lives of psychiatric survivors.

Reflections on the first year of a critical psychotherapy supervision collective

ABSTRACTThis article is a report on the experiences of members of a Critical Psychotherapy Supervision Collective following our first anniversary. The supervision group comprises psychiatrists, psychologists, a general practitioner and ‘psychiatric survivors’ as well as counsellors and psychotherapists from different modalities. It arose out of a conference based on the book Critical Psychotherapy, Psychoanalysis and Counselling: Implications for Practice (Loewenthal 2015). We are particularly concerned with detrimental influences on the psychotherapeutic project brought about by policies such as manualisation, ‘prevent’ and ‘safeguarding’, which we consider threaten confidentiality, water down the psychological therapist’s abilities, and introduce an inappropriate ideological use of the talking therapies. The article explores eight group members’ experiences of what we are doing and the processes during our first year.

Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency by Neely Laurenzo Myers

Neely Laurenzo Myers, Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency. Nashville: Vanderbilt University Press, 2015. 208 pp.Recovery has been a dominant paradigm shaping mental health policy in United States since turn of millennium. A treatment philosophy that emerged from disaster of deinstitutionalization and disappointment of psychopharmaceutical revolution, it draws on sources eclectic as antipsychiatry, psychiatric survivors and consumer rights movements, and psychosocial rehabilitation (Braslow 2013). Recovery advocates envision a new system of care that produces citizens no longer doomed by hopelessness of biological reductionism, nor dependent on social services. The central precepts of have been summarized as: renewing a sense of possibility, regaining competencies, reconnecting and finding a place in society, and repairing disruptions in self and career (Hopper 2007). The role of people with lived experience of mental illness, or peers is central to this approach at every level, from research, policy-making, and advocacy to frontline care provision. The movement's ostensibly radical core concepts of empowerment, self-determination, and freedom of (Myers 2015:7) were enshrined in George W. Bush's Presidential New Freedom Commission of 2003, an unfunded set of recommendations that many states have subsequently tried to implement. Critics see this embrace of by neoliberal reformers as a move to withdraw care and services from chronically mentally ill by declaring them recovered and substituting care with choice (Braslow 2013, Myers 2015:8).This is point of departure of Neely Myers's powerful book, in which she ethnographically documents how one community mental health agency in urban US, called Horizons, navigated shift from mental health services to recovery-oriented care through creation of a peer-led treatment program. Myers documents her own intimate journey as she developed relationships with staff and clients, or members, of agency. She provides a contextualized account of stark realities of living with severe, chronic mental illness and poverty in urban US, revealing promises, pitfalls, complexities, and contradictions of contemporary mental health reform and social abandonment members and staff worked against. Her detailed observations, poignant reflections, and incisive critique create a compelling account and an important contribution to medical anthropology and community psychiatry. Recovery's Edge is a story of relationships, therapeutic and traumatic, personal and professional, ruptured and repaired, lost and longed for, and often tragically unattainable.Myers's central thesis is that moral agency, the ability to be recognized as a 'good' person in a way that makes possible intimate connections with others, is oft-overlooked driver of recovery (13). Mental health crisis results in an initial loss of moral agency. This loss is perpetuated by ways people with mental illness are treated, both by society in general and by traditional mental health programs in particular. As a result, those with chronic, severe mental illness remain isolated and marginalized.Chapter 2, No Direction Home, establishes context with an account of history of deinstitutionalization and never-delivered promise of community-based care. A major theme introduced here is contradictions and double binds members faced as they sought to rebuild their lives despite recurring mental health crisis. One classic trap they faced was a dependence on Social Security insurance and Medicaid to pay for their high healthcare costs, yet full time, competitive employment would disqualify them of these benefits without providing a viable alternative. Members cycled through institutional circuit, including hospitals, jails, prisons, shelters, nursing homes, outpatient day programs, and streets. …