Does society ‘choose’ who must suffer mental health problems? In the early 1990s, Stephen Pattison, an academic in the field of ethics and theology, set out to answer that question. His interest was, of course, religious, but his methods were taken from secular sociology. What he discovered is included in his book Pastoral Care and Liberation Theology (Cambridge University Press, 1994).
Pattison found that social status and background has a lot to do with who goes on to have contact with the mental health services. The lower down you are in society, the more likely you are to be diagnosed as mentally ill. Ethnic minorities, women, and people from ‘working class’ backgrounds are excessively represented among those supposedly suffering psychiatric disorders. Pattison argues that these are all people who can be counted as among the less privileged in Western society. And so he concludes that mental illness is a social/political issue, something that is often ‘given’ to some people by others because of the way our society is ordered.
One of the things my book, Delivered Unto Lions, focuses on is the powerlessness of being a child caught up in the psychiatric services – and Pattison’s work particularly focuses on issues of power and powerlessness in connection with psychiatric health-care provision. Pattison looks to those elements in society that support the privileged against the less privileged. Being a religious studies academic, he especially looks at the role of the churches in this situation.
The chaplain is a particularly visible indication of church involvement in health-care. When I was a patient at Merrifield Children’s Unit in Somerset, I remember the unit often being visited by a Methodist chaplain. Chaplains are usually employed by the health-care provider, but even where churches provide the chaplain’s income, it is still the case that the person offering pastoral care is part of the dominant social structure. He or she (even if unintentionally) is acting on behalf of the powerful.
Pattison says that religion has a ‘conservative function’ in Western society; it isn’t usually politically radical and so, by default, it supports the powers-that-be. The chaplain may well offer kind words to the suffering patient, but these words do not challenge the powers and institutions that placed that person in that ‘care’ environment in the first place.
My own view is that all bodies – whether they be churches, political organisations, charities, voluntary groups, etc. – need to step back and look at what their actual function is in society (something like a Business Classification Scheme analysis might help with that). Once they know their actual function, they can then decide if it is the same as their intended function. For instance, if a church was to find that it did indeed function in support of the powerful against the weak, it could then decide whether it really wanted to be on the side of the powerful, or whether, perhaps, it wanted to take someone else’s side.
Those who are mentally ill – or who are viewed as mentally ill – need more than kind words. They need people on their side.
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Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit www.davidaustin.eu
For more information visit www.davidaustin.eu
My own experience of mental health services is as the partner of someone who has needed to access their services. I have repeatedly found that in order to get the support we need I have had to fight every step of the way using the support mechanisms that I can. I have been fortunate to have the very real support of my family and at times my church, I have also used the carers support network, a MIND advocate and the PALS complaint service. I have often worried about those people within the service who don't have access to a friend, partner of family member to support them in their fight for help. I'm afraid it often feels like a fight.
ReplyDeleteYour last line about people who are mentally ill needing people on their side resonates with me so much with my own experience.
I was a patient in Merrifield Unit in the mid 1960s ----- and I had no visitors! I came from what would probably be described a 'middle class' background, was doing well in my third year at secondary school until my admission, had many friends and family (parents, siblings, aunts, uncles, cousins). I was involved in Church groups in my home town some distance from Somerset, and other clubs and activities. Apart from the occassional letter from my mother and sporadic home visits (which were always cut short and I was returned to the unit prematurely!)there was no contact or support from any of these sources during my time at Merrifield; it was as though everyone had cut themselves off from me --- the only relationships that helped me through that time were friendships that formed within my new environment at Tone Vale. I attended the Hospital Church on a few occassions but that was all I saw of a Minister. My opinion is that there is a stigma / a prejudice even? / regarding those considered mentally ill and it is easier to sever contact. It was the understanding of that concept that helped me to accept that I had to 'go it alone' -- I decided it was not the fault of all those people; it was my own fault for being 'different' and therefore not a uniform part of society. I don't think 'class distinction' comes into the equation. I do think the support of people who really care makes the difference to anyone suffering any illness, whether deemed mental or physical, as the above post shows.
ReplyDeleteSome very interesting observations there, Anonymous. I imagine that Stephen Pattison was writing from his own perspective as a theologian and religious studies academic, and that he was voicing a criticism of his own background (religious and middle class?). Like you, I was from a fairly middle class background (and from a church background), and I too experienced something of that sense of isolation (and possibly of being blamed). It is possible that, by my time (the 1970s) things had improved a little on how they had been for you. I do, however, tend to think that 'class distinction' (of one kind or another) does come into it (at least to some extent), as the number of people from less advantaged backgrounds are disproportionately represented among those receiving mental health care. But that's a case of looking at the whole rather than at real individuals. Those circumstances clearly didn't apply to either you or me. As you say, the support of people who genuinely care is what makes the difference.
ReplyDeleteOf course, Pattison's book was published in 1994, just before 'Care in the Community' took hold. Things have changed since then. I wonder how Pattison views the current situation.
What I forgot to say in my comment above was that the difference between 'child' and 'adult' could be argued to be a kind of 'class distinction', and that might have more significance (in the psychiatric services context) than background social class. Just a thought.
ReplyDeleteThere are some words in the English language (particularly some that have crept into our vocabulary in more modern times) that I do not care for: 'blog' is one of them! However, I have to accept it -- because the 'power' of the language of the day has that four-letter word firmly ensconsed and the 'powerless' (i.e.the likes of me!)can do nothing to change it!
ReplyDeleteHaving read your article on here through again, David, (and thank you for your previous reply) it is that state of the ability to control that stands out. The powerful versus the powerless: a mismatched duo; the outcome of any battle between the two entities so predictable -- apart from in the world of fairy tales!
Armed with the knowledge that there are sectors of society which are vulnerable and that the powers-that-be can have complete control over, how can the voices of the powerless be heard so as to make a difference to the sufferings of these groups?
In your book 'Delivered unto Lions' there is the example that Daniel spoke up to the powers within the establishment, voicing his disapproval and concerns regarding the way his fellow inmates were treated. The result of his daring to apply that courage was for him to be further punished for what was viewed by the carers as audacity.
Don't we see that on a larger scale in society in general? Haven't people lost their jobs as a result of speaking out against malpractice in the work place? Marriages break up because the more powerful in the partnership want things their way and will not compromise the views that this way is not always acceptable to their spouse.
It all sounds quite hopeless, doesn't it?
The only answer is, as you said, for each person to have someone who genuinely cares.........
I have just read my previous post through again and how negative it sounds! (Perhaps I should park my pen!) The problem is that the things I read on here open such avenues of thought and then I get a bit side-tracked in my replies.
ReplyDeleteDaniel was very brave in 'Delivered unto Lions' in the way he spoke out against the injustices that happened to the others in the unit.
ReplyDeleteIt has made me think that I should be braver in my own life about standing up for what I believe in.
I would like to thank you for your novel, it has really made me think about my life.
Your comment about Daniel being brave is quite a coincidence, Anonymous, as I've started to think about posting on the subject of 'living adventurously' (I'll probably do that tomorrow if I get time).
ReplyDelete