Reversing the stigmatization of mental illness?
Note: My server is acting kind of temperamental today. Apologies to anyone who has trouble with the blog.
The treatment and care of the mentally ill in Canada has gone through two distinct phases: the institutionalization phase (1850’s through until the 1970’s) and the de-institutionalization phase which has followed.
It is worth noting that the two phases have more in common than they differ. Both involved the infantilization and stigmatization of the mentally ill; and while social attitudes have changed as our knowledge of the brain has advanced, the prevailing notions of “illness” that we have today are still very much akin to the “retardation” conceptualization of the Victorian era… the only real difference is that we decided to start turfing the “harmless” ones in the 70’s and 80’s so that the sidewalk could ‘take care of them.’
The dilemma that has challenged mental-health activists in all this time is how to best go about improving care and treatment: do you work to end the stigmatization of the mentally ill and create a social environment which would be more tolerant of progressive treatment plans; or do you work aggressively to improve treatment and hope that as the quality of care improves the stigma is reversed?
Apparently Paul Garfinkle is attempting the latter.
But the most challenging and controversial aspect of the CAMH makeover is the plan to open the hospital’s grounds to the neighbourhood while integrating the neighbourhood into the grounds. It will be the first large-scale “urban village” mental-health facility in the world.
Being marketed with the slogan “Transforming lives here,” the $380-million-plus CAMH renovation aims to transform the site’s institutional character in order to make patients’ experience closer to “normal” life in the city. The scheme involves criss-crossing the 27-acre property with public streets, constructing a home-like environment for those the CAMH now calls clients instead of patients, and leasing out street-level retail space to restaurants and other businesses. It’s envisioned that clients, staff and neighbours will mingle naturally on sidewalks, parks and cafes.
To be entirely honest I have no idea if this sort of plan could work; but it is an earnest and honest effort to improve on the status quo, and that is certainly worth applauding.
I wanted to point out the similarities between what you call institutionalization and the American term medicalization. This is when the medical profession takes custody over certain issues, like mental illness. In the past, in America, people showing symptoms of mental illness were regarded as deviant. There was a stigma attached to being deviant, but the medicalization of mental illness took away that stigma. You argue that stigma is a main concern when dealing with mental illness and I agree with Paul Garfinkle that working to improve treatment will help reverse stigma. For example, if a child has a mental illness that causes social awkwardness he acquires a stigma. But put that child on medication where he can function normally and that stigma disappears. However, it is important to consider that mental illness is a social construction. A great example of this is from Peter Conrad and his study on hyperkinesias, or ADHD. He shows through his study that the disease was not diagnosed until after Ritalin was discovered. Prior to the cure, hyperkinesias defined children who were deviant, not displaying characteristics of a mental illness. But when push comes to shove, I think more research on treatments would be beneficial.
Comment by CSB — February 26, 2007 @ 2:58 am