Linda Green wrote:

>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),
>
There is no hard evidence to support a genetic basis for what gets
labeled 'mental illness' no matter what the context. Psychiatric
diagnoses of any kind are merely subjective value judgments.

> 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.
>
Not necessarily. It boils down to a case of psychiatric diagnoses being
inherently subjective and biased, in combination with the inherent bias
directed against poor people. It comes as no surprise that a
discriminated-against population is more likely to be subjected to a set
of 'diagnoses' that is inherently discriminatory. It's just one more way
of suppressing and invalidating certain peoples' voices.

>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.'
>
>
Amen to that, but I would take it one step further. To my mind *any use*
of the 'mental illness/health' construct is overuse. Peoples' emotional
or mental distress is always circumstantial/environmental in nature. It
does not occur in a social vacuum. Attributing it to abnormal pathology
is merely using one more 'personal deficit' model, which in this case is
all the more insidious because it is a practice cloaked in
pseudo-science and false compassion.

>Where are the critical voices on this issue in the SDOH
>community?
>
>
This lack of analysis is a serious problem among supposedly progressive
individuals in general. Folks all over have fallen prey to the myth that
psychiatry is in any way based upon compassion or real science. It is
(in truth) merely one more sophisticated mechanism of oppression and
social control.

>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!
>
>
All Health Canada does is to promote the existing medical/pharmaceutical
agenda. It was never intended to serve as a critical voice or to
challenge the existing medical status quo. To my mind anything that
causes people to take a hard second look at Health Canada's position on
these issues can only be beneficial.

More good reading on this subject is anything by Dr. Peter Breggin.
Breggin is a dissident psychiatrist based in Bethesda, MD. who has
written extensively (and critically) about the practices of his own
field of medical specialty. He has a website as well (www.breggin.com).

What really needs to happen is for people to stop treating doctors
(including psychiatrists) as if they were some form of infallible
demigods and recognize them for what they are - human beings like the
rest of us, who have pursued a particular course of learning (which
itself may well require challenge); who are imperfect (as is everyone),
and who frequently have personal agendas. Psychiatrists in particular
have enormous power since they represent the only medical specialty that
is legally entitled to deprive people of their liberty and treat them
even over their clear objections as a matter of course. They are also
the one medical specialty whose area of practice has not been
scientifically validated.  Psychiatry is inherently subjective and
biased. Is it any surprise it would be wielded disproportionately
towards marginalized groups?

Graeme

>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
>[log in to unmask]
>
>
>



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