Chrystal Ocean wrote:
>Leah, you need to look at the book our group put out. It's title is below.
>The book includes the first-person stories of 21 women living in poverty
>in
>a typical Canadian rural community. The stories are extremely revealing of
>the link between poverty and mental illness. They show that no matter the
>starting point of a person's mental health, it inevitably deteriorates as
>one slides deeper into poverty.

it really disturbs me that in an otherwise critical
environment, the term mental health is being used
as if it is not completely problematic. I don't understand
this.

About the link described  poverty and mental health,
I want to ask, is it mental illness that is getting talked
about (which by definition has genetic roots), or is it
the lived experience of poverty (and/or oppression)?
If mental illness is produced by poverty and mental
illness is genetically produced, wouldn't that imply
that there are genes for poverty? (I'm stretching the
point here but this is the absurdity that is implied).

Naming something mental illness/health implies a very
different solution from calling it the distress produced
by poverty. Naming has huge implications. Consider the
work of Horovitz, a psychiatrist who rejects the widespread
overuse of the mental illness(health) construct model
and argues that what we look at and refer to as
mental illness is mostly 'socially induced distress.'

Where are the critical voices on this issue in the SDOH
community?

The relationship of poverty and educational level to
depression (and inverse relationship with optimism)
in women has been understood for forever. And this
is horrifying because very little has been done with
the knowledge other than note the relationship and
then conveniently placed poverty and educational
attainment in the category of social risk factor in a
biopsychosocial risk model of depression. And then
go ahead and prescribe antidepressants. Or the
more enlightened (supposedly) provide treatment
to correct the faulty cognitions that are argued to
produce and maintain depression. It's important to
remember in this context that women and the poor
have historically been considered to exemplify
irrationality. Psychiatry and psychology perpetuate
this stigmatization in their conceptualizations of
mental health/illness. Others in psychology have
studied the poor and argued a link between
poverty and poor coping skills. Psychology and
psychiatry have done little with the knowledge
of a link betweeen social factors and depression
other than to produce a market for their own
interventions. And in my view when we support
the naming of distress mental health/illness
we perpetuate this. Feminists resisted all this for
a while but their resistance has gotten quite thin.

Horovitz wrote a book called Creating Mental Illness
that was published in 2002. He considers the
widespread labelling of severe distress mental illness
(or alternatively mental healthissues ) that we are
witnessing today is nothing more than the conflation
of socially produced distress with mental illness.  It's
an important read but at the same time a dangerous
one because to accept or adopt Horovitz' arguments
means you will be out of step with the prevaling mental
health ideology supported by Health Canada and by
health promotion agendas and it would seem by those
working in the area of social determinants of health.
Reader be warned!

Where is the discussion of these issues in the SDOH
community? Please direct me to the critical thinkers
on these issues if there is any discussion of them
in work on SDOH.
Linda

____________________________
Linda Green, OISE/UT
Counselling for Community Settings
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