#MentalHealthAwareness Week: Alana Wilde on “Ending the Stigma: What We Can Learn From ‘Mad Pride’”

As part of our #MentalHealthAwarenessWeek series, centre member and PhD student Alana Wilde talks about practical ways to combat stigma surrounding mental health, both in philosophy and beyond. Alana’s work relates to mental health related disability more broadly, looking both at what disability is, and how we might better understand or accommodate the views of marginalized groups in theorising about this topic.

It’s Mental Health Awareness Week. As philosophers and as citizens, our concern should be with how we can try to make things better. What can we do to remedy the injustices that people face? As such, this brief post will discuss mental health related conditions and stigma with some very short suggestions for practical steps we might take.

The last ten or so years have seen huge steps forwards in relation to mental health and stigma, with BBC research data indicating that there have been some shifting attitudes to the public consensus on mental health and tolerance within society. However, there is still much work to be done. Rethink and Mind both state that mental health conditions are likely to affect 1 in 4 adults in the UK at some point in their lives. That’s 25% of the population. The empirical data further suggests that this 25% of the adult population in the UK are subject to stigma, to mistrust on the basis of having a mental health related condition, and to misperceptions about dangerousness or unpredictability (Angermeyer and Dietrich, 2006).

This isn’t to say that it is only stigma that can cause psychological distress – many of the conditions we’re talking about when we use the term ‘mental health’ seem inherently bound up with some level of distress. But there are groups who argue that we are largely getting it wrong. ‘Mad Pride’, for instance, are a group of mental health service users or ex-service users (sometimes called ‘consumers’ or ‘survivors’) who argue that our attitudes to mental health are inextricably bound up in our desires to pathologise or to control behaviours that we find problematic[1]. This is a radical claim, since psychiatry is built upon the assumption that there is a medical issue at play in mental health symptomatology and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5, for short) lists extensive diagnostic criteria which can help clinicians to identify whether a patient has a mental health condition.

Whilst the broader claims of Mad Pride groups can seem quite jarring – they include calls to end involuntary treatment altogether – I think that they can teach us something about where our attitudes to mental health related conditions might be going awry. First, it might be the case that whilst we think we’re doing better, both in academe and society, at changing attitudes and being more accepting of mental health related conditions or symptoms, we are still failing to make suitable adjustments for many people. These could be work-related adjustments (i.e. more flexible working patterns where possible), or perhaps more broadly social ones (i.e. mental health not being viewed as something ‘scary’ or ‘abnormal’).

What I’m learning from my work in this area is that there is a consensus that society perpetuates many of the difficulties that individuals who experience mental health related distress – often on the basis of having a mental health related condition. There is much empirical data which supports this claim, and that indicates we need to do more. Too many of us continue to view those who have mental health related conditions as ‘other’ and as people to fear; I worry that failing to address this means attitudes will not change.

To take steps towards alleviating this, here are six suggestions that we might consider implementing, not only in philosophy, but more widely. These changes might not change attitudes directly, but might still provoke some useful thought:

  1. In relation to people using mental health ‘terms’ i.e. ‘crazy’, ‘psycho’, ‘Mad’ colloquially, to express distrust or absurdity in an idea, perhaps highlight how the use of these terms perpetuates the stigma surrounding mental health.
  2. Support more flexible working, wherever possible, to allow people to work at times that are easier for them.
  3. Challenge stigma, particularly within philosophy, when it is encountered (this relates to, but also builds on 1.)
  4. Try to avoid talk of ‘normality’, or to draw out how conceptions of ‘normality’ might themselves confuse statistical data and normative considerations which in turn might emphasize the notion that there is such a thing as ‘normal’ and that deviation from that norm is bad in some way.
  5. Be aware and considerate that when discussing complex and emotive issues, that people often do have personal experiences with these and ensure that discussions proceed with the same level of care that you yourself would want if the person with that experience were you.
  6. Respect the testimony of people with any sort of health issue, whether psychological or physical, particularly in relation to people holding affirmational attitudes to their condition(s). You may not always agree with the attitudes of individuals, but try to respect that their stance on their own health is not something to be debated

Angermeyer, M. C. and Dietrich, S. (2006), ‘Public beliefs about and attitudes towards people with mental illness: a review of population studies’. Acta Psychiatrica Scandinavica, vol: 113: pp.163-179.

Rashed, M.A. (2019) Madness and the demand for recognition: a philosophical inquiry into identity and mental health activism. Oxford: Oxford University Press

[1] I won’t talk about these here, but Mohammed Abouelleil Rashed’s ‘Madness and the Demand for Recognition’ (2019) is a great read, for anyone looking for more on the philosophy of Mad Pride