Journal of Ethics in Mental Health- some thoughts about the special issue

Finally the special issue of the Journal of Ethics in Mental Health (JEMH) is released by the McMaster University in Canada. The whole process has lasted over two years, for we began in April 2017- when I was still in the midst of collecting my empirical data- narratives of people with lived experiences of mental ‘illness’. Here is a link to the open access issue. My article is number 13, of the total 14 pieces. Now that I recall, it was in April 2017 that the abstract was accepted- perhaps the whole story started in Feb 2017 then!

The editors of the special issue- Lucy and Jiji were supportive from the beginning. It is amazing to see how considerate people can be. After my abstract was accepted we had to submit in August. The whole scorching summer, partly because earlier I would take a longer time in thinking things before putting them down on paper, and partly because it was still the beginning of my PhD (not yet a year) I was unsure how to begin, I delayed in my writing. And suddenly papa was diagnosed with a severe blockage in the heart and had to undergo a massive surgery, involving four blocks and a valve replacement. I could not write the article at the last minute- the last month when I had to write was when he went into the surgery, not that I was doing much for him, but I could not bring myself to anything as serious as the first journal article from my PhD struggles with the mental chaos that such a big event brings into a family.

Photo by Micheile Henderson on Unsplash

I did not send in my submission at the appointed time and in a few days I got a letter of inquiry, after the last submission date was over, and I was feeling so crestfallen that I could not keep upto my initial plan. I explained to them my position and surprisingly…they gave me a whole month extra! (I needed a fortnight only). And that helpfulness became the stance from the beginning itself. Until the end they remained supportive, even though Jiji took on the task of being in touch with me, for how else would they have divided the work up? So anyways, that is a peek into the behind the scenes bit for now.

But I am troubled!

Having seen the full issue, and notwithstanding its excellent, thoughtful and thorough pieces of writing, I am troubled; perhaps the more appropriate expression would be anguished. And that sense of trouble is the subject of this blog post. My trouble does not stem from anything except the fact that there is not much contribution from the Global South, or should I say that apart from me there is none?! It is NOT something to be happy about. And this is not an exclusion by the editors- it seems the voices are just not there! Or even if they are there, they do not organize themselves enough to be heard.

My article is about the prejudice I faced as an ex-patient attempting PhD research in India, in the same field that had once made a patient out of me. It is a reflection on the deep stigmas around mental health- among people who are themselves suffering at present- whether they are family caregivers or ‘patients’, NGOs and further. To say the word stigma reduction and to actually work towards its reduction are two different things. But that apart my article is an ex-patient’s encounters with the dominance of psychiatry’s biomedical knowledge at so many levels.

I am troubled because people do not know that something is the matter with psychiatry, and they do not question it, thinking is as a medical field and the doctor knows what is best for them. To expect that the medical field is going to know everything about oneself and also DO THE BEST is to additionally project a great deal of ethical, humanistic and egalitarian values to psychiatrists and those they lead (the other psy-professions). People do not wish to take responsibility for their own lives, but leave that agency to others- like doctors, to help them manage their lives. It is a great tragedy that with docility, an unquestioning submission to a totalizing perspective a verdict on one’s sanity is accepted and nobody flinches! (That is a little exaggerated perhaps, people DO flinch, but not enough that its ripples spread much, and they flinch within safe spaces. And tragically sooner or later everyone is subsumed under the biomedical umbrella, because they do not flinch together!)

How will anything change?

For things to change either at a personal or social level the first thing is that people have to question something or someone who is in a position of power. Just imagine if the British had not been questioned about how they were managing India, would we have gained independence? If people do not question their doctors about their treatments- will the doctors benevolently treat them to the best possible and shortest treatment? Had that been the case why would there be patients taking psychiatric medication for 10-2- 30 years? This is the issue I am concerned about.

Seeing the special issue of the JEMH this concern has surfaced again in my head that there is not enough scholarship going around in the Global South, or say the ‘developing’ countries. Whatever questioning is happening here is limited and contained within minuscule pockets. But more than that people who are offering the critique are unable to talk to others and draw them into the fold of the critique. And that is a sign of the same systemic failure due to which we do not have successful mass movements in India- a lack of cohesion and ability for collaborative action (I think the British also saw this about India, for how the princely states kept fighting among one another). So now I know this is not limited to India, but has a footprint in other parts of the world as well.

Until such a time when we learn to understand our strugles- not only at our localized social levels but how they are connected to the global stirrings, on most fronts we will have to contend with scholarship of the West, where they are raising their voices, asking their questions and challenging their status quo. We here are simply mimicking their tools, their categories and their tactics- which is unlikely to succeed easily, given the other social issues in our parts of the world! It is about time that the Global South starts looking into its own problems more intuitively and thoroughly. And that I why I desist from calling myself MAD or taking pride in that as an identity. More of that soon.

Photo by Joel Burgess on Unsplash

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