TheMHS 2014 S054: Symposium – Diversity & Power in Mental Health Services

By August 28, 2014 No Comments

The abstract from this session can be found here.

This Symposium panel members were Morgan Carpenter, Fayez Nour, Cath Roper and Sam Stott. The symposium was addressing structural violence in the mental health system. What is structural violence? Structural violence (put simply) is systemic ways that social structures maintain the status quo, constraining an individuals’ agency and putting them in harm’s way. It is often invisible or subtle and that is why we as society do not recognise its workings.

Morgan Carpenter spoke passionately about the structural violence experienced by people who are intersex. They are pathologised, their biology is deemed atypical. It is argued that there has been an “imbalance of their hormones” and are often forced or coerced into conforming into the binary gender identities. They face stigma and shame. Children are often told they need surgery to protect them from the psychological and physiological trauma and ridicule they may experience in their lives. Medicine even says there is merit to eliminate intersex from the gene pool by treating foetuses with hormone therapy. People who are intersex are forced into gender conformity for ‘their own good’, without evidence that this is beneficial or necessary. This is structural violence.

Morgan left us with a intriguing thought: “Why operate on the child’s body when the problem is in the mind of the adult?”.

Cath Roper presented the audience with two propositions:

  1. Mental health legislation is a form of structural violence.

It is a separate law, that subjugates, that only operates on one group of people. It is discriminatory in the fact that it is separate from physical health decision making. It is used in a health frame and you are told it is for your own good. There is physical coercion to put medicines into your body, bodily integrity is violated through involuntary treatment. Cath emphasised that we must count how many times this happens, and how many people actually leave hospital well?

   2. The legislation creates categories of people that are invisible.

It is difficult for people to create an identity when they are invisible, when their voices are not heard. Cath spoke about people having to assume a spoiled identity, only have negative aspects associated with it.

Intersectionality was a way to render the invisible visible. Intersectionality is the intersection between systems of oppression between the domains of ethnicity, sex, gender, class, sexuality, and ability, that contribute to social injustice. It’s a way to examine structural violence, explaining how different oppressions (racism, homophobia, or sexist) interrelate.

Structural violence is a barrier to mental health recovery. The intersectionality framework offers a way forward a way for services to achieve principles that address structure violence.

The symposium closed with 5 questions:

1. What power do you have?

2. Who gave you that power?

3. In whose interests do you exercise it?

4. To whom are you accountable?

5. How can we get rid of you?