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Commentary on identities and ideologies in the women’s and service user/survivor movements by Dr Lydia Lewis


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Commentary on identities and ideologies in the women’s and service user/survivor movements by Dr Lydia Lewis - a presentation from the symposium on social movements and their contributions to sociological knowledge on mental health at the University of Wolverhampton. Held on 13 June 2014.

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Commentary on identities and ideologies in the women’s and service user/survivor movements by Dr Lydia Lewis

  1. 1. Commentary on identities and ideologies in the women’s and service user/survivor movements Lydia Lewis Centre for Developmental & Applied Research in Education Faculty of Education, Health and Wellbeing University of Wolverhampton E-mail:
  2. 2. Reference: Lewis, L. (2009), Mental health and human rights: a common agenda for service user/survivor and women’s groups? Policy and Politics, 37 (1): 75-92.
  3. 3. The women’s groups and services relating to ‘mental health’ • Grew out of the second wave of feminism in the 1960s • Not always thematised according to ‘mental health’ • Feminist organising as part of the survivor movement • Separatist stance
  4. 4. Distance between the movements • Different origins • Influence of ‘user involvement’ • Points of departure, tension and opposition • Service user/survivor movement tended to emphasise links to organising of disability rights, anti-poverty and black and minority groups
  5. 5. Aims: • to examine why issues of gender and links with feminism may tend to be overlooked by mental health service user groups and action in the recent context; • to explore the points of convergence as well as divergence and conflict between service user/survivor and feminist politics in the mental health sphere; and • to draw out implications for future strategies.
  6. 6. Ideologies: overlaps • Shifting the ideological base of mental health services away from medicalised perspectives and practices and towards holistic, person- centred ones grounded in an understanding of wider socio- political relations. • moving away from traditional power relationships in service provision • self-help alternatives to professionalism
  7. 7. Ideologies: points of divergence and conflict
  8. 8. Understandings of mental health and distress • difficulty of mounting a critique of the dominance of the ‘medical model’ while identifying and operating within its terms • while the organising of the user and community groups at times tried to challenge the dominance of medicalised conceptions and responses, it simultaneously reinforced these • the identity of the service user/survivor movement has led to a priority on the influencing of mental health policy, services and legislation over wider civil rights and social inequalities issues
  9. 9. R: ‘I mean those [social inequality] things are almost sort of subsumed into the greater issues and it’s almost, I mean, I think you know, maybe when, once the greater issues are dealt with I would imagine that sort of thing would start coming up.’ I: ‘Right, and the greater issues being?’ R: ‘User involvement in decision making and in their own treatment.’ (Discussion with Carol)
  10. 10. My concern is that if we are to understand gender factors in user representation, we must first understand the fundamental dynamics at work in the system. This we have not yet done sufficiently well even to drive necessary change, so I wonder if we are yet ready to realistically establish gender influences. (Simon)
  11. 11. Understandings of mental health and distress (cont.) • Feminist organising around gender and other social-structural dimensions of power immediately constitutes a social model of mental health • A basis for establishing services afresh and other forms political action • Enables alignments between service users and practitioners.
  12. 12. Violence • Association of mental health service users with violence has been a key concern for the service user/survivor movement (has sought to downplay this as an issue). • In contrast, feminist perspectives have sought to expose violence and its gendered nature, including in the context of mental health services. • Sexual harassment/abuse and women-only spaces.
  13. 13. ‘I used to attend a drop-in, … and they wanted to start a women’s group. Fine, great, … [but] it escalated, and we actually nearly demonstrated, to the whole facility being closed to men for a whole day, so ... we got really angry about this.… And they tried to make it right by saying, “well you men can have your men’s only group”; we said, “we don’t want that”. Because that’s another issue, [for] anyone with mental illness, the lack of relationships ... and any sort of seclusion; we wanted it to be as normal as possible, men and women mixed.…’ (John)
  14. 14. Identities • Negotiating stigmatised identities • Negotiating multiple identities • Identities and internal politics
  15. 15. ‘Because you have this revolving door syndrome, people become ill again and again and again, it’s difficult enough to get enough service users to attend things, so there’s maybe sort of subconsciously I suppose, a feeling that if we start looking at like um, minor interest issues, it’s going to start fragmenting and it’s already difficult enough to get people together.’ (Carol)
  16. 16. ‘To be honest, my own observation is that it’s generally more women on the committees and things because ... most people involved in mental health care, professionals I’m talking about, are women. So think it through, if anything, ... generally the services I would say, are biased towards women.’ (John)
  17. 17. Implications for future strategies • Do structural inequalities of gender mean that the interests of women and men in relation to mental health cannot be aligned? • What is the potential for developing a consensual social model of distress? • Is the medicalisation of violence an important area of commonality? • Can recognition of the commonalities with women’s organisations help combat the stigma and de-authorisation experienced by those of mental health service users/survivors and aid coalition building with those in positions of more power? • How can we recognise common and differentiated identities and experiences? • How can we widen the social base for action and ensure that social movements in mental health can draw strength from the wider political context? • Is a human rights framework helpful?