This document examines the differences and similarities between the women's movement and the service user/survivor movement relating to mental health. It discusses how they originated from different contexts, with the women's movement growing out of feminism and focusing on gender issues, while the user movement emphasized disability and poverty issues. Some key differences included views on medicalization, violence, and identities. However, there were also overlaps in seeking more holistic, person-centered services and challenging traditional power dynamics. The document considers implications for developing a social model of distress and building coalitions while recognizing both common and differentiated experiences.

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: lydia.lewis@wlv.ac.uk

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. 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. 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. 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. 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. Ideologies: points of divergence
and conflict

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. 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. 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. 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. 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. ‘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. Identities
• Negotiating stigmatised identities
• Negotiating multiple identities
• Identities and internal politics

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. ‘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. 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?