Sanism
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Sanism, saneism, mentalism, or psychophobia refers to the systemic
, and other cognitive impairments.Mentalism may cause harm through a combination of
Mentalism does not only describe how individuals are treated by the
The term "sanism" was coined by Morton Birnbaum, a physician, lawyer, and mental health advocate. Judi Chamberlin coined the term "mentalism" in a chapter of the book Women Look at Psychiatry.
Definition
The terms mentalism, from "mental", and sanism, from "sane", have become established in some contexts, although concepts such as social stigma, and in some cases ableism, may be used in similar but not identical ways. While mentalism and sanism are used interchangeably, sanism is becoming predominant in certain circles, such as academics. Those who identify as mad, mad advocates, and in a socio-political context where sanism is gaining ground as a movement.[1] The movement of sanism is an act of resistance among those who identify as mad, consumer survivors, and mental health advocates.[1][2][3] In academia evidence of this movement can be found in the number of recent publications about sanism and social work practice.[3][2][1]
Etymologies
The term "sanism" was coined by Morton Birnbaum during his work representing Edward Stephens, a mental health patient, in a legal case in the 1960s.[4] Birnbaum was a physician, lawyer and mental health advocate who helped establish a constitutional right to treatment for psychiatric patients along with safeguards against involuntary commitment. Since first noticing the term in 1980, New York legal professor Michael L. Perlin subsequently continued its use.[5]
In 1975
As of 1998 these terms have been adopted by some consumers/survivors in the
There is also the umbrella term ableism, referring to discrimination against those who are (perceived as) disabled. In terms of the brain, there is the movement for the recognition of neurodiversity. The term 'psychophobia' (from psyche and phobia) has occasionally been used with a similar meaning.
Social division
Mentalism at one extreme can lead to a categorical dividing of people into an empowered group assumed to be normal, healthy, reliable, and capable, and a powerless group assumed to be sick, disabled, crazy, unpredictable, and violent. This divide can justify inconsiderate treatment of the latter group and expectations of poorer standards of living for them, for which they may be expected to express gratitude. Further discrimination may involve labeling some as "high functioning" and some as "low-functioning"; while this may enable the targeting of resources, in both categories human behaviors are recast in pathological terms.[15]According to Coni Kalinowski (a psychiatrist at the University of Nevada and Director of Mojave Community Services[16]) and Pat Risser (a mental health consultant and self-described former recipient of mental health services[17]).
The discrimination can be so fundamental and unquestioned that it can stop people truly empathizing (although they may think they are) or genuinely seeing the other point of view with respect. Some mental conditions can impair awareness and understanding in certain ways at certain times, but mentalist assumptions may lead others to erroneously believe that they necessarily understand the person's situation and needs better than they do themselves.[15]
Reportedly even within the disability rights movement internationally, "there is a lot of sanism", and "disability organisations don't always 'get' mental health and don't want to be seen as mentally defective." Conversely, those coming from the mental health side may not view such conditions as disabilities in the same way.[18]
Some national government-funded charities view the issue as primarily a matter of stigmatizing attitudes within the general public, perhaps due to people not having enough contact with those (diagnosed with) mental illness, and one head of a schizophrenia charity has compared mentalism to the way racism may be more prevalent when people don't spend time together throughout life.[19] A psychologist who runs The Living Museum facilitating current or former psychiatric patients to exhibit artwork, has referred to the attitude of the general public as psychophobia.[20]
Clinical terminology
Mentalism may be codified in clinical terminology in subtle ways, including in the basic
Some oppose the entire process as labeling and some have responded to justifications for it – for example that it is necessary for clinical or administrative purposes. Others argue that most aspects could easily be expressed in a more accurate and less offensive manner.[15]
Some clinical terms may be used far beyond the usual narrowly defined meanings, in a way that can obscure the regular human and social context of people's experiences. For example, having a bad time may be assumed to be
The former director of a US-based psychiatric survivors organization focused on rights and freedoms,
British writer Clare Allen argues that even reclaimed slang terms such as "mad" are just not accurate.[citation needed] In addition, she sees the commonplace mis-use of concepts relating to mental health problems – including for example jokes about people hearing voices as if that automatically undermines their credibility – as equivalent to racist or sexist phrases that would be considered obviously discriminatory. She characterises such usage as indicating an underlying psychophobia and contempt.[23]
Blame
This section needs additional citations for verification. (September 2022) |
Interpretations of behaviors, and applications of treatments, may be done in an judgmental way because of an underlying mentalism, according to critics of psychiatry. If a recipient of mental health services disagrees with treatment or diagnosis, or does not change, they may be labeled as non-compliant, uncooperative, or treatment-resistant. This is despite the fact that the issue may be healthcare provider's inadequate understanding of the person or their problems, adverse medication effects, a poor match between the treatment and the person, stigma associated with the treatment, difficulty with access, cultural unacceptability, or many other issues.[15]
Mentalism may lead people to assume that someone is not aware of what they are doing and that there is no point trying to communicate with them, despite the fact that they may well have a level of awareness and desire to connect even if they are acting in a seemingly irrational or
Clinicians may blame clients for not being sufficiently motivated to work on treatment goals or recovery, and as
Neglect
Mentalism has been linked to
In addition, mentalism can lead to "poor" or "guarded" predictions of the future for a person, which could be an overly pessimistic view skewed by a narrow clinical experience. It could also be made impervious to contrary evidence because those who succeed can be discounted as having been
Institutional discrimination
This may be apparent in physical separation, including separate facilities or accommodation, or in lower standards for some than others. Mental health professionals may find themselves drawn into systems based on bureaucratic and financial imperatives and social control, resulting in alienation from their original values,[clarification needed] disappointment in "the system", and adoption of the cynical, mentalist beliefs that may pervade an organization. However, just as employees can be dismissed for disparaging sexual or ethnic remarks, it is argued[by whom?] that staff who are entrenched in negative stereotypes, attitudes, and beliefs about those labeled with mental disorders need to be removed from service organizations.[15] A related theoretical approach, known as expressed emotion, has also focused on negative interpersonal dynamics relating to care givers, especially within families.[citation needed] However, the point is also made[by whom?] in such views that institutional and group environments can be challenging from all sides, and that clear boundaries and rights are required for everyone.[clarification needed]
The
In the
The
On a society-wide level, mentalism has been linked to people being kept in
Law
With regard to legal protections against discrimination, mentalism may only be covered under general frameworks such as the disability discrimination acts that are in force in some countries, and which require a person to say that they have a disability and to prove that they meet the criteria.
In terms of the legal system itself, the law is traditionally based on technical definitions of sanity and insanity, and so the term "sanism" may be used in response. The concept is well known in the US legal community, being referred to in nearly 300 law review articles between 1992 and 2013, though is less well known in the medical community.[29]
Michael Perlin, Professor of Law at
Perlin notes that sanism affects the theory and practice of law in largely invisible and socially acceptable ways, based mainly on "
Sanist attitudes are prevalent in the teaching of law students, both overtly and covertly, according to Perlin. He notes that this impacts on the skills at the heart of lawyering such as "interviewing, investigating, counseling and negotiating", and on every critical moment of clinical experience: "the initial interview, case preparation, case conferences, planning litigation (or negotiation) strategy, trial preparation, trial and appeal."[32]
There is also widespread discrimination by jurors, who Perlin characterizes as demonstrating "irrational brutality, prejudice, hostility, and hatred" towards defendants where there is an
Perlin has suggested that the international Convention on the Rights of Persons with Disabilities is a revolutionary human rights document which has the potential to be the best tool to challenge sanist discrimination.[33]
He has also addressed the topic of sanism as it affects which sexual freedoms or protections are afforded to psychiatric patients, especially in forensic facilities.[34]
Sanism in the legal profession can affect many people in communities who at some point in their life struggle with some degree of mental health problems, according to Perlin. This may unjustly limit their ability to legally resolve issues in their communities such as: "contract problems, property problems, domestic relations problems, and trusts and estates problems."[35]
Susan Fraser, a lawyer in Canada who specializes in advocating for vulnerable people, argues that sanism is based on fear of the unknown, reinforced by stereotypes that
Education
Similar issues have been identified by Perlin in how children are dealt with in regard to
Oppression
A spiral of oppression experienced by some groups in society has been identified.[
People suffering such oppression within society may be drawn to more radical political action, but sanist structures and attitudes have also been identified in
See also
- Disability flag
- Franco Basaglia
- List of disability-related terms with negative connotations
- Mental health stigma
- Rankism (umbrella term for all forms of hierarchical discrimination)
- Social Darwinism
- Social model of disability
- Supremacism
- Violent behavior in autistic people
References
- ^ a b c Poole, Jennifer M.; Ward, Jennifer (2013). ""Breaking open the bone": Storying, Sanism, and Mad Grief". In LeFrancois, B.; Menzies, R.; Reaume, G. (eds.). Mad Matters: A Critical Reader in Canadian Mad Studies. Toronto: Canadian Scholars Press.
- ^ a b Poole, Jennifer M.; Jivraj, Tania; Arslanian, Araxi; Bellows, Kristen; Chiasson, Sheila; Hakimy, Husnia; Pasini, Jessica; Reid, Jenna (2012). "Sanism, 'Mental Health', and Social Work/Education: A Review and Call to Action". Intersectionalities: A Global Journal of Social Work Analysis, Research, Polity, and Practice. 1.
- ^ a b Poole, 2011[full citation needed]
- ^ Ingram, Richard (May 2011). Sanism in Theory and Practice (PDF). Second Annual Critical Inquiries Workshop. Vancouver, Canada: Centre for the Study of Gender, Social Inequities and Mental Health. Simon Fraser University.
- ^ Perlin, Michael L. (1993). "ADA and Persons with Mental Disabilities: Can Sanist Attitudes Be Undone?". Journal of Law and Health. 8 (1): 15–45.
- ISBN 978-0889740006.
- ^ Hevesi, Denis (30 January 2010). "Judi Chamberlin, 65, Advocate for Mental Health Patients". The New York Times. Retrieved 1 March 2011.
- ^ "Disability History Timeline". Rehabilitation Research & Training Center on Independent Living Management. Temple University. 2002. Archived from the original on 20 December 2013.
- ^ Coni Kalinowski and Pat Risser (July 2000). "Identifying and Overcoming Mentalism" (PDF). Retrieved 16 December 2015.
- PMID 12613052.
- ISBN 978-1136159565.
- ^ Chamberlin, Judi (Summer 1990). "The Ex-Patients' Movement: Where We've Been and Where We're Going". The Journal of Mind and Behavior. 11 (3): 323–336.
- PMID 29052478.
- ISBN 0-333-69890-8.
- ^ a b c d e f g h i j k Coni Kalinowski (psychiatrist) and Pat Risser (former recipient of mental health services) Identifying and Overcoming Mentalism InforMed Health Publishing & Training
- ^ "medicinenevada.com". medicinenevada.com. Retrieved 17 December 2015.
- Times-Gazette. Archived from the originalon 11 November 2013. Retrieved 17 December 2015.
- ^ Anglicare Tasmania (2009) Experts by experience: strengthening the mental health consumer voice in Tasmania Archived 15 April 2012 at the Wayback Machine
- ^ Arlen Kasdorf Discrimination against mental illness on the rise June 2011, The Uniter, Vol.16 No.15
- ^ John Clark Art Museum of the Mind Los Angeles Times, 12 July 1998
- ^ David Oaks Let's find language more inclusive than the phrase "mentally ill"! MindFreedom International. Retrieved 12 December 2011, when stating Last Modified 9/9/11
- ^ David Oaks' personal blog
- ^ Allen, Clare (5 December 2007). "Loose-talking psychophobes show nothing but contempt". The Guardian.
- ^ 'Anti-oppressive practice': emancipation or appropriation? A Wilson; P Beresford British Journal of Social Work; Oct 2000; 30, 5; Research Library pg. 553
- ISBN 0-415-22200-1
- ^ Olden, Mark (23 January 2003). "Obituary: Pete Shaughnessey". The Guardian. p. 22.
- ISBN 1-904385-09-5.
- ^ Lindow, V. (1995) "Power and rights: the psychiatric system survivor movement", in Jack, R. Empowerment in Community Care. London: Chapman and Hall. Cited by Kelly, A. Disability and Social Exclusion. University of Canterbury
- PMID 24152781.
- ^ a b c Perlin, M. (2009) 'His Brain Has Been Mismanaged with Great Skill': How Will Jurors Respond to Neuroimaging Testimony in Insanity Defense Cases? Akron Law Review, Vol. 42, No. 2, NYLS Legal Studies Research Paper (free full text)
- ISBN 9780470267905.
- Clinical Law Review. 9: 683–730.
- ^ Michael L. Perlin (2013) 'There Must Be Some Way Out of Here': Why the Convention on the Rights of Persons with Disabilities is Potentially the Best Weapon in the Fight Against Sanism New York Law School, PSYCHIATRY, PSYCHOL. & L. 462 (2013)
- ^ Periln, ML (1994) Hospitalized Patients and the Right to Sexual Interaction: Beyond the Last Frontier 20 N.Y.U. Rev. L. & Soc. Change 517 (1992-1994)
- ^ Perlin, ML. Looking at Non-Institutional Mental Disability Law Through the Sanism Filter NYLS Law Review, Forthcoming
- Law Society of Upper Canada.
- ^ Perlin, Michael L. (Spring 2009). "'Simplify You, Classify You': Stigma, Stereotypes and Civil Rights in Disability Classification Systems". Georgia State University Law Review. 25 (3): 607–639.
- ISBN 978-1-84310-076-8.
- ^ Nair, Roshan das (30 November 2005). Metaminorities and Mental Health: A model of vulnerability for Black and Minority Ethnic Queer Folk (PDF). 2nd Global Conference, Sexualities: Bodies, Desires, Practices.
- ^ "A Libertarian Perspective on Depression And Madness". The Icarus Project. 29 July 2005. Archived from the original on 21 May 2013.
Further reading
- Large, Matthew; Ryan, Christopher (November 2012). "Sanism, stigma and the belief in dangerousness". Australian & New Zealand Journal of Psychiatry. 46 (11): 1099–1100. S2CID 206398076.
- Parry, John Weston (26 September 2013). Mental Disability, Violence, and Future Dangerousness: Myths Behind the Presumption of Guilt. ISBN 978-1-4422-2405-6.
- Risser, Pat (14 May 2008). Overcoming the Language of Oppression: Promoting Cultural Change with Words. 4th Annual Clinical Forum on Mental Health: Turning Knowledge into Practice. (North Dakota Department of Human Services).
- Wienera, Diane; Ribeiro, Rebecca; Warner, Kurt (22 July 2009). "Mentalism, disability rights and modern eugenics in a 'brave new world'". Disability & Society. 24 (5): 599–610. S2CID 146463753.
- Wolframe, PhebeAnn M. (2013). "The Madwoman in the Academy, or, Revealing the Invisible Straightjacket: Theorizing and Teaching Saneism and Sane Privilege". Disability Studies Quarterly. 33 (1).