A new article published in Social Psychiatry and Psychiatric Epidemiology offers a framework for shifting the psy-disciplines towards a fuller understanding of the role social environments play in “mental illness”. Author Laurence Kirmayer of McGill University argues that current models place too much emphasis on the individual and often blame people unfairly for hardships created by the environment. This undercuts the psy-disciplines’ ability to advocate for societal changes that could improve public health.
While recent research has pointed to the role of inequality, trauma, racism, poverty, and global issues in causing “mental illness”, the current work argues that dominant cultural institutions, such as the psy-disciplnes, often overlook and contribute to long-standing norms that cause inequity. The author writes:
“Crucially, the cultural construction of social identities and institutions goes along with particular ideologies that rationalize, normalize, naturalize and hide arrangements that cause inequities… One implication is that effort to understand the social determinants must include critical analyses that look past the taken-for-granted to call into question the structures of disadvantage.”
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My unhappiness is my life which is society. Therefore there is no division between my unhappiness, my life, my society. They are three words for one thing, and this one thing is the disease – the way we actually live.
Do you think psychiatry is going to rescue us from this disease? It expresses this disease articulately, perfectly, actually. It is this disease.
Until and unless one black princess or one black prince rises up amongst you and announces all this, our lives are a pittance, an insult, a pitch black swollen cist.
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Good article, but I think it overlooks the impact of family dynamics and family culture, as these usually determine the course of one’s emotional/psychological development and journey through life more than anything else. So, it’s not a matter of blame, it’s a matter of understanding what’s inevitable.
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…this isn’t meant to suggest that parents and caregivers themselves aren’t shaped by social/cultural/environmental forces. It’s meant to point out that there’s no greater influence on a baby’s/child’s/adolescent’s life than the quality of the nurturing (or lack thereof) they receive from their parents/caregivers.
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Thank you Professor Gallagher, I really appreciate this article. Some in psychiatry have proven they are all about victim blaming. In 2009 I was given a cancer diagnosis and informed I had little chance to survive even if I took the 3 standard chemo drugs. The oncologist wanted me to add a trial drug to the 3 chemo drugs. I am in Canada and if I agreed he would get the prestige/perks of being named as an ‘Associate Doctor’ on the California clinical trial. But the trial drug meant I had to sign consent to ‘side effects’ of heart attack, stroke, blindness etc. There were very valid reasons that made this ‘dire diagnosis’ appear overblown so I declined the trial. The oncologist flew into a rage, threw his pen across the room and stormed out. After I started the standard drugs he was very abusive. The drugs had horrible effects, causing permanent tinnitus and vertigo, also nausea, painful swallowing, multiple profuse daily nosebleeds and dizziness which led to a fall and head injury. I laid unconscious and bleeding from a deep head laceration that needed stitches and CT scan. When the chemo and steroids began to cause insomnia I was prescribed Imovane but after 1 or 2 months it quit working and made the insomnia worse. I was sent to a young female psychiatrist under the pretense it was for “help with sleep medications”. Instead she treated me with disdain and blamed me for the difficult circumstances I faced. I ended up quitting chemo halfway through hoping the harmful effects would not be permanent. (the clinical trial was later halted due to too many fatalities) It was approximately 2 years later when it became apparent something very negative must be on my health records as I was being denied other health services and treated badly by any providers I did interact with. I would finally see a ‘report’ the psychiatrist published to widespread electronic records that contained many outright fabrications and 4 damaging psychiatric labels. I have tried relentlessly to get my records corrected without success. Even with having many supportive letters from psychologists, plus another psychiatrist who is Director at the same clinic, and my long time family doctor, and others who all disputed the psych labels as erroneous. Psychiatrists can write whatever falsehoods they want, they can defame people with impunity and will never have to correct their lies. They can simply hide behind their victim blaming and fabricated psych labels as being their “opinion” without having to provide any reasons or evidence whatsoever.
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“It was approximately 2 years later when it became apparent something very negative must be on my health records as I was being denied other health services and treated badly by any providers I did interact with. I would finally see a ‘report’ the psychiatrist published to widespread electronic records that contained many outright fabrications and 4 damaging psychiatric labels. I have tried relentlessly to get my records corrected without success. Even with having many supportive letters from psychologists, plus another psychiatrist who is Director at the same clinic, and my long time family doctor, and others who all disputed the psych labels as erroneous. Psychiatrists can write whatever falsehoods they want, they can defame people with impunity and will never have to correct their lies. They can simply hide behind their victim blaming and fabricated psych labels as being their “opinion” without having to provide any reasons or evidence whatsoever.”
Sounds about right. Almost all people who read this will relate. I hope you can find some comfort in that, because I definitely can.
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The animal is a storm in this nothingness that we all are. The animals are a storm in a storm in a storm. The animal is a storm inside the storm of consciousness inside the storm of the social process inside the storm of nature inside the storm of the sky. But I am nothing at all besides it, hence I am nothing. I cannot touch the storm. It cannot touch me. How can you touch nothing? And this nothing is all there is. The storm is an unreachable mystery. And I want the storm to subside.
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Unsure of whether there’s difference in social inequity (e.g., BIPOC populations, psychiatric oppresion, systemic racism as an institution) and what you speak of. They are one and the same when basis and/or framework comes from organizational institutionalism.
One and the same.
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