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Challenging ideas in mental health
Challenging ideas in mental health

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1.2 Ways of viewing mental distress

The first point to note is that there are two key competing ways of viewing mental illness or distress: physical and social. One of the functions of this course is to draw together aspects of these accounts in order to cross the boundaries that they create and maintain. Our aim in this respect is to devise a third way, a more rounded and holistic approach that brings together the best of both worlds. In the meantime, though, the physical and social explanations predominate. Physical explanations are based on, for example, notions of brain dysfunction or genetic predisposition. Mental distress, in those terms, is a disorder of the mind, akin to a physical illness. Social explanations, on the other hand, are based on an understanding of difference and discrimination: on structural factors in society that separate people and may come to oppress them. Another way of understanding mental distress – and this links with our ‘third way’, the holistic (whole person) approach – is to view it from the standpoint of those who have experienced it. This is an important vantage point. The next activity invites you to read, and reflect on, the personal experiences of one woman who has experienced mental distress.

Activity 4: Personal experiences of mental distress

Timing: Allow about 30 minutes

Read the short extract below by Veronica Dewan. Make notes on how she explains the origins of her mental distress.

Veronica Dewan

I became engaged in an official system of care at birth, a system that denigrated my Indian heritage, a system that made meaningless my true identity. It was my first encounter with social services in 1957 at six weeks of age – an illegitimate, ‘mixed race’, hard-to-place baby. […]

Several inpatient admissions to an acute psychiatric ward compounded childhood and adult experiences of racism, misunderstanding and intimidation. I persisted with suicidal plans and attempts, and was severely depressed, with psychotic episodes of manifestations of my adoptive mother’s attempts to kill me as a child. The underlying requirement of the psychiatric system appeared to involve fully internalising the racism, to make me completely ill forever. […]

As I challenge more and more my own perceptions, question their origins and try to understand my place in the world, I believe that the official care system tried to silence me into living a life that was not my own. While institutional racism continues, by its insidious nature, to cause so much unarticulated pain, I have to be vigilant in holding onto my right to exist, as a Black woman of dual heritage. The people who have no interest or motive in controlling me, but only a willingness to engage through mutual love, acceptance and respect, are those who remain in my life.

(Source: Dewan, 2001, pp. 44–9)
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Veronica’s explanation of her mental distress includes:

  • admission into care as an illegitimate, mixed race, ‘hard-to-place baby’

  • childhood experiences of racism (combined with the denigration of her heritage)

  • admissions to hospital

  • suicide bids

  • breakdown of the relationship with her adoptive mother.

The author acknowledges the importance of her personal experiences and histories. Abuse, rejection and separation played a part in creating her experiences of mental distress. She also highlights how her experiences of mental health systems had a negative impact on their lives, compounding her original difficulties. She has a voice now, as a survivor and writer, but the systems of the time sought to silence her. Her accounts also point to structural factors within society – racism, discrimination and oppression.

Is mental distress a cry for help? Is it a form of resistance? Or is it a response to ‘unarticulated pain’? The answers are not so straightforward. But British artist Kingsley Nebechi skilfully highlights the impacts of distress in the artwork below. Explaining that uncertain or stressful times can make it difficult for us to stay focused on our daily tasks. In fact, what was once a simple daily routine can feel like a strenuous mental ladder.

This is an illustration of a head in profile view, with an illustration of a person in the centre.
Figure 4