What is the BizOMadness Blog?

This blog is devoted to raising critical awareness of psychiatry generally. It is likewise devoted to the antipsychiatry research projects, publications, and related activities of Dr. Bonnie Burstow. Especially foregrounded are The Psychiatry Project, The Madness Project, and "Psychiatry and the Business of Madness". Related to one another, The Psychiatry Project and The Madness Project involve hundreds of interviews, a dozen focus groups, analysis of several hundred documents and their activation, and dedicated periods of institutional observation. The culmination of both as well as of decades of related interviews and activities is "Psychiatry and the Business of Madness" (timely updates on its publication will be provided)--a cutting edge book in which psychiatry is investigated from multiple angles and which begins to tackle the inevitable question: So if we get rid of psychiatry, where do we go from there?

For the Events page to find events related to this research or this book, see
http://bizomadnessevents.blogspot.ca/

To check out reviews of Psychiatry and the Business of Madness and related publications, see http://bizomadnessreviews.blogspot.ca/

Tuesday, January 2, 2018

Yet More Creeping Fascism: Social Work Professionals, Beware

On April 12, 2017 the regulatory body for social workers and social service workers in Ontario--The Ontario College for Social Workers and Social Service Workers in Ontario--posted a news update on their website, announcing an imminent change to their regulations. The change in part provides "the College with the authority to request information and documents related to the Continuing Competence Program at any time". [bolding in original] It further notes, "Members are already required to make a declaration in the CCP [Continuing Competence Program] at their annual renewal of registration…This addition to the Registration Regulation allows the College to request information and documents related to a member’s CCP at any time. (italics in original) (see https://www.ocswssw.org/2017/08/02/changes-to-the-registration-regulation-what-you-need-to-know/) It goes on to state, that it is "improving language in the current regulation so that all applicants are required to indicate whether or not they suffer from any physical or mental condition or disorder that would affect their ability to practice social work or social services work in a safe manner." [bolding in original]. Drawing on what is at this point a frightening easy-to-recognize code word--unfit to practice--finally, the College states, "The new wording furthers the College’s public protection mandate by ensuring that members are fit to practice in a safe manner."

Looking at what is written uncritically, on the surface the direction being taken here may seem like a good idea. After all, who would want "incompetent" social workers out there practicing?  People say, lacking in communication skills, practitioners who commonly exhibit poor judgment, people hopelessly Eurocentric, or worse yet, sexually predatory social workers. A far closer look, and more critical eyes, however, are needed to discern what is really happening here. For the most part the college is not looking for predatory social workers. They are not on the lookout for racist social workers. Despite the addition of the words "physical illness", nor are they particularly weeding out people too physically ill to manage their job (though obviously, the physically ill and physically disabled are likewise in jeopardy). They are on the hunt for social workers who in the eyes of the establishment have a "mental illness". In the process, they are in essence requiring any professional who has ever been given a psychiatric diagnosis (as most everyone who has ever seen a psychiatrist has been) to declare that diagnosis. Correspondingly, they are reserving the right to require data and information about this, in their words, at any time.  

Is this general direction new? Alas, it is not—just an intensification of a direction already in place. What is being called here "unfit to practice" is becoming an ever-increasing feature in regulatory governing not only for social workers but for most of what is known as the "regulated professions". Perfectly capable professionals routinely lose their professional standing and livelihood by just such regulations. By way of example, in their ground-breaking research into current regulation in nursing, Chapman, Poole, Azevedo, and Ballen  (2016) document just how such information, regulations, and processes are being used against perfectly capable nurses, with the professionals in possession of such information using it to harass these colleagues, to place their colleagues under hyper scrutiny, with the inevitable result being that all actions of the thereby jeopardized nurses end up being interpreted as signs of mental illness and many highly capable nurses eventually lose their right to practice.

Let there be no mistake about it. This is a loss to society. At the same time, this does unnecessary and irrevocable damage to the professionals so treated. 

The critical point to keep in mind here is that, whatever credence you do or do not afford the concept, "mental illness" has nothing to do with safety, despite the regulatory bodies so naming it. There is no proof whatsoever that professionals with psychiatric diagnoses are any less safe than any other professional. By the same token, despite the facile conflation of "mentally ill" with "incompetence", it has nothing to do competence. Someone with a psychiatric diagnosis may or may not be incompetent, just as any other professional may or may not be. What we are witnessing in short is prejudice and oppression pure and simple. We are witnessing ableism.  We are witnessing "sanism".  We are likewise seeing incredible short-sightedness--for the truth of the matter is that people in touch with their own personal difficulties have a tendency to be better helping professionals—not worse ones.

I would add that it is not only the helping professions that are taking systematic measures to weed out people whom they see as mentally ill.  Just as the helping professions are calling such practitioners "unfit to practice" and creating regulations which make it easy to get rid of them, institutions of higher learning (universities and colleges) are calling students deemed mentally ill "unfit to study" and progressively placing them on "mandatory leave". Hundreds of universities around the world have just such polices and most of those that do not are aggressively  considering them (see, for example, University of Toronto’s recent "mandatory leave" proposal at http://www.governingcouncil.lamp4.utoronto.ca/wp-content/uploads/2017/09/a1005-6i-2017-2018ab.pdf; for an in-depth critique  of University of Toronto’s  proposal, also see https://www.madinamerica.com/2017/11/creeping-fascism-university-unfit-to-study-policies/) And it is all of this together which I am dubbing "creeping fascism."

To quote in regard to these phenomena from a previous publication of mine (see https://www.madinamerica.com/2017/11/creeping-fascism-university-unfit-to-study-policies/):

There is a historical echo here that is unmistakable. While I am well aware that the people applying these policies are not intending this echo and indeed would be shocked at the suggestion of it, I cannot but notice that "unfit to study" and "unfit to practice" are on a continuum with "unfit to live"—or to use the more common designation, "life unworthy of life"—a concept that ushered in the systematic murder of Jews, "mental patients" and others during the Nazi era, with the eradication of "mental patients", significantly, coming first, paving the way for the others. (For one of the earliest and most influential articulations of this fascist concept, see Binding and Hoche,1920; for an analysis, see Lifton, 1986.)

Now to be clear, I am in no way equating these measures or in any way comparing them—for the differences are enormous. Nor am I imputing what might be called "intent".  However, I am suggesting that they exist on a continuum. I am likewise suggesting that with this extension of psychiatric rule into areas like academia and into professions like social work and nursing (both, not coincidentally, "regulated professions"), what we are witnessing is creeping fascism—hence the title of this piece. 

Alas, it is all too easy for the fascistic nature of such measures to go undetected for it is not the blatant fascism that we hear about on the streets in Charlottesville.  It is not hatred. It is rather, to coin a phrase, "respectable fascism".  Indeed, it bears all the marks of being kindly as well as responsibly intended. All the more reason we need to be on the alert.

That noted, to return to the proposed changes with which with this blog article began:

Since the news of the regulatory change in question was posted on the website of the College of Social Workers and Social Service Workers, an ad hoc group has coalesced to oppose what is happening. When one of the members of this ad hoc group contacted the College to talk, his objection was purportedly trivialized and put down to mere miscommunication (as if the very knowledgeable social work professor in question was not fully capable of deciphering what he was reading). By the same token when another professor associated with this group talked to a representative of the college and asked about the mandatory reporting, she was advised purportedly (in a tone that suggested that the information being given should be reassuring) that there was no problem here, that the College was just keeping this information on file in case it became of use later. Interesting! And just how long are they intending to keep it? It would seem indefinitely. 

Question: Does anyone feel reassured by the clarification provided by the College? Does anyone believe that this information which College is allowing itself to keep indefinitely will not substantially bias and bias indefinitely how the practitioners’ actions and words are interpreted? And with whom might this highly sensitive information be shared? Given that people of colour are disproportionately diagnosed as mentally ill, is not the reporting that the College is requiring going to lead to even less social workers of colour practicing, ergo, more social workers dealing in colonizing ways with groups and cultures that they do not understand? Is not the very act of compelling the self-reporting of personally sensitive and prejudicial information a flagrant invasion of privacy? If this is how officials at the College treat their colleagues, how do they treat their clients? How is that folks with criminal records can have their record expunged in the fullness of time, while these practitioners who have committed no crime whatever have to live with a record that sits in the computer and can be trotted out and used against them at any time? How can a society which places a value on freedom tolerate such ongoing and intrusive scrutiny?

If at this point, you too are becoming alarmed, I would invite you to protest what is happening here. Do consider giving the College and pivotal members of the legislature a shout and letting them know that when the College resorts to measures like this, they are not safeguarding the welfare of public--rather, they are eliminating some of our best workers, placing all workers under surveillance, and in the process making the lot of us complicit in oppression. Correspondingly, if you are someone who advocates for human rights, do think of getting involved for human rights are blatantly at stake.

Finally, if you are social worker, or indeed, a member of any of the other "regulated health professions", whether or not your profession or provincial professional association has yet formally adopted policies of this ilk, a word to the wise: beware, be prepared, organize.


REFERENCES

Binding, K. and Hoche, A. (1920). Die Friegabe der Vernichtung Lebensunwerten. Lebens. Leipzig: F. Meiner.

Chapman, C. Poole, J., Azevedo, J., and Ballen, R. (2016). A kind of collective freezing out.  In B. Burstow (Ed). Psychiatry Interrogated (pp. 21-40). New York: Palgrave.


Lifton, R. (1986). The Nazi Doctors. New York: Harper and Row.

Tuesday, December 5, 2017

Naomi as “Every-Woman”: The Other Mrs. Smith

The Other Mrs. Smith by Bonnie Burstow
Inanna Publications, 2017
447 pages.

In late October, my novel The Other Mrs. Smith—a novel centred on electroshock—was published. The fact that the release of such a novel was newsworthy became evident shortly after its launch. I was approached by CTV National News Channel for an interview (http://www.ctvnews.ca/video?clipId=1270212) But days later, I was approached by Amy Pitt for an interview. What follows is the edited version of the second interview; I invite the reader to peruse and ponder it:

AP: This novel traces the life experiences of one highly successful woman who falls prey to electroshock. What inspired you to write it? 

BB: In the early 1980s, I was part of group that held hearings into electroshock. And those hearings were an incredible eye-opener. I had known people who has been subjected to electroshock, but the few I knew were men. And so while I had certainly seen terrible damage—nothing like what I witnessed from the legions of women at this hearing. The extent of the memory and other losses was horrifying. And that was the start of my becoming highly involved in the fight to ban electroshock. What followed were decades of research, articles, and activism. Now at one point in the mid 80s, it looked like we had the electroshock industry on the ropes. Then we lost the interest of the press and the public and never got it back. Anyway, after decades of research and activism, I remembered the power of art and embarked on this novel. Could a novel, if powerful enough, lead to a public outcry against shock?, I wondered. So what was my inspiration? Very real people and the very real damage done to them.

AP: Primarily, you wrote it from the perspective of Naomi, the protagonist, who suffers from enormous memory loss. How did you go about writing a novel from the perspective of someone who can’t remember much of anything?

BB: That was the struggle; and that, the gambit. As I was keenly aware, all instructions on how to write novels warn you against writing from the first person where the person has been severely damaged or traumatized. And I could totally see why. Nonetheless, I knew from the get-go that this was the only way to do it if the reader was to end up really understanding. So I took the plunge.  Decided to write it from inside the head of a brain-damaged narrator. And indeed, writing from the first person virtually forced me into her perspective.

AP: Did you have to employ any special strategies to tell the story?

BB: Well there was no problem getting into her head—none, for I had been making common cause with shock survivors for decades. The issue was: How was she to tell a story when she cannot remember? Also, how do I ensure that reader does not get drowned  in her problems? What did I do? I started employing two devices early on in the project.  One was to switch back and forth between pre-shock days—when her memory was good—and her post-shock life. The second was to invent point-of-view characters and allow the novel to occasionally drift into the third person narrative from their points of view—for that way we could learn the odd thing that we that we needed to know but that Naomi was in no position to tell us. Those were the two main devices. But even doing that did not come close to addressing the biggest problem facing me. The point is, narrating a novel primarily from within the head of someone who could not remember her story was crazy-making for I kept running into dead ends. Anyway, a couple of years into the project, I decided: I can’t take this any more. I want my life back. And I can get my life back. All I have to do is stop writing this novel. Then it hit me like a thunderbolt: Yes, I can’t get my life back. But shock survivors cannot get their lives back. Which means that I have to continue and to do it well.  Herein lie the moral imperative. And once I took that in, I solved problem after problem. And in the process, the novel grew richer and  richer.

AP: I get that. Let me ask you something somewhat different. They say that all writing is autographical. Where’s Bonnie in this?

BB: Besides the concern over shock? Like the protagonist, I spent most of my life in two cities—Toronto and Winnipeg. Now Naomi loves Winnipeg, not Toronto, and I’m the opposite. So I asked myself, if you loved Winnipeg, what would you love about it? Also I found myself drawing on the type of arguments that my best friend and I have when I scripted quarrels between Naomi and her sister. One way or another, your life always flows into the fiction that you write, and in the absence of that, you just cannot write anything deep.

AP: I’ve heard you refer to this as very much a Canadian novel. How so?

BB: Two Canadian cities come alive in the novel, Toronto and Winnipeg—especially Winnipeg. We are led to shiver at the cold Winnipeg winter. We are introduced to the legendary flooding of the Red River. Aspects of Canadian history—the Winnipeg General Strike, for instance—are frequently referenced. We experience Kensington Market in its heyday. We get a taste of Newfoundland. So, yes, this is quintessentially Canadian. Let me just add, it is at the same time a Turtle Island novel, if I may call it that. An Indigenous theme runs throughout. We witness the oppression of Indigenous people. We make the acquaintance of a remarkable Indigenous man named “Jack”. And we see Indigenous wisdom. When Naomi does not know what to do, she calls to mind Jack—and suddenly, she knows.

AP: Which reminds me, this novel has a huge rich cast of well developed characters. Who’s your favourite and why?

BB: Hands down, Naomi. That said, if I were to choose another, it would be Ger. Ger is a trans man. He is also the kindest and most sensitive soul in the novel—the sort of guy we would all dearly love to have as a friend. And we see him thoughtfully make the connection between his struggles and those of other oppressed people. And then there is his uncanny eye. He realizes early on that there is a secret lurking between the lines in some writing of Naomi’s known as Black Binder Number Three. But let me ask, Amy:  Who’s your favourite?

AP: One of the many characters that I love is Naomi’s father. His kindness, his spirituality, his open-mindedness, his connection with nature. My favourite scene is when he takes the girls outside to feed the birds. It reminds me of my own father. You know, we can all identify with your characters, for they link up one way or another with our own lives. Okay, a more literary question: How’s this novel different from the other famous novel about electroshock—One Flew Over the Cuckoo’s Nest?

BB: Let me say from the outset, that Kesey’s is a truly terrific novel for Kesey is an exceptional writer. At the same time, his novel does not provide either an intricate or an accurate depiction of electroshock. On one level, we are left with the impression that electroshock mainly befalls men, when two to three times as many women as men are shocked. Moreover, women are way more damaged by it. Nor is there any exploration of the damage done. Now it is a fascinating novel, but I would have to add, it is also a sexist novel. The primary adversary in One Flew Over the Cuckoo’s Nest is Big Nurse—a woman, in other words, not the patriarchal figures who actually have the power. By contrast, in The Other Mrs. Smith I lay bare the reality of electroshock. In other words, my novel is once experiential, true-to-life, and what goes along with this, a feminist novel. I was trying to show what happens to women in this patriarchal society and what happens to women with electroshock—the sheer violence against women involved.

To move beyond the question of Kesey, you know, every woman survivor that I have ever known—and I’ve literally known hundreds—have overlapping stories to tell. Which leads me to this point: While the character Naomi is very individual, there is a way in which some version of what befalls her not only has befallen many women, but beyond that, could happen to any woman. You know, the morality plays mounted in the Middle Ages typically contained a character called “Everyman”. And, as unique as Naomi is, what we gradually come to realize, if I may coin a term, is that Naomi is “Every-Woman”. What happened to her happened ultimately for no reason other than that she is a woman. So we see the plight of Every-Woman in Naomi. We also see the wondrous strength of Every-Woman. A testament in itself to the beauty of the human spirit.

AP: Yes, we do indeed see her heroically and brilliantly rebuild a life. Bonnie, congratulations on writing an exceptional novel. You have written a highly lyrical novel. You have provided a sobering account with such grace and tenderness that it speaks to the paradox of what it means to be human. There is something here for everyone.

BB: Humour, pathos, ingenuity, comraderie, activism, mystery, insight.

AP: All and all, a stunning work of art. And I imagine many people will be itching to dip into it over the holidays. So one more question: Where can one pick it up?
BB: From libraries. From the publisher’s website (https://www.inanna.ca/catalog/other-mrs-smith/), from Amazon. Also, from local bookstores. For example, in Toronto, Book City on the Danforth has the equivalent of signed copies.

AP: Good to hear. Congratulations again.

Sunday, November 19, 2017

Creeping Fascism: The Universities’ “Unfit to Study” Policies


I am being put on medical leave by my college due to a number of long standing mental health issues…. I am . . . devastated….I have nowhere to go.” (private correspondence, October 30, 2017)

I was declared “unfit to study” by my college over a year ago. It took the ground out from under me; and I doubt that I will ever get back my life. Dr. Burstow, how can they just do things like this to people? (private correspondence, November 6, 2016)

These are excerpts from two of the many letters that I have received over the last couple of years from students who have left their respective universities involuntarily. Called “mandatory leave” the students subjected to these measures are categorized as “unfit the study”, and such policies are sweeping the globe, with the UK demonstrably taking the lead. Examples of UK universities that have adopted “unfit to study” policies are Oxford, Bradford, Bristol, Brunel, Cardiff, Leeds, London, Reading, and Queen’s University Belfast (see http://www.idras.ac.uk/designing-a-better-system-for-dealing-with-complaints/is-there-a-dispute/fit-to-study-dealing-with-problem-students/). Many universities in North America have similarly adopted them, and the most prestigious university in Canada—University of Toronto—appears to be poised to pass just a policy.

So what exactly are these policies? How are we to understand them? And as people concerned about human rights, decency, and social justice, what should we be doing about them?

On a simple level, they are provisions whereby the university administration can compel a university student to take a “leave of absence”. While the university’s code of conduct is frequently cited, breaking the code of conduct is neither a necessary nor sufficient condition to be placed on mandatory leave. What is pivotal is the university being uncomfortable with the student—oh yes, and that magical term “mental illness”.

Being of danger to self or other is generally how this is understood, though thrown into the mix as well are what would appear to be primarily academic considerations. The policy currently being actively considered by University of Toronto, for example, reads (http://www.governingcouncil.lamp4.utoronto.ca/wp-content/uploads/2017/09/a1005-6i-2017-2018ab.pdf):

The threshold for intervention encompasses two potential scenarios:

Scenario 1: A Student’s behaviour imposes a risk of harm to self or others . . .
Scenario 2: While not posing a risk of harm to self or other as described in Scenario 1, the Student is unable to engage in the activities required to pursue an education at the University not withstanding accommodations.

Scenario 2 is curious, for it appears to preclude at least one possible obvious explanation which is that either the services are insufficient or the university is fostering a toxic or less than accepting environment that is taking its toll on students (e.g., rigid rules, snap tests, the systematic ignoring of the impact that life circumstances inevitably have, a lack of openness to people who think or act differently or not as those around them expect).  One has to wonder why this does not occur to administrators? One also has to ask, how failures generated in part by the university itself have been miraculously transformed into a “health” or to be more precise “mental health” issue besetting the student? More generally, what we seem to be seeing here is a grab-all category which allows universities to get rid of students viewed as troublesome or otherwise not up to the mark. As these expulsions are defined as temporary, they appear benign to the administrators. The problem is that they circumvent choice; they ignore circumstances, they invisibilize the university’s own role in what is happening; they take negotiation out of the hands of both students and faculty; they deeply stigmatize the students subjected to them, and they utterly disrupt the student’s life.

To see how the two scenarios described in U. of T.’s proposed policy work together—it is situations like the one depicted in scenario 1 which allow the policy in its entirety to be seen as about “mental illness” and which is the essence of what most universities appear to have in mind. Note the strategic use of words here like “harm to self or others”— words that echo the phrases found in involuntary committal protocols (see Burstow, 2015). In turn, scenario 2 widens the net, thereby enabling more people to be caught up by the policy. To put this another way, Scenario 1 defines how we are to understand the policy while Scenario Two greatly expands its application.

To briefly cover a few other aspects of these policies, typically, an intricate procedure is spelt out which needs to be followed, with the procedure generally involving assessments by “mental health professionals”. An appeal process is likewise spelt out. And invariably, the mandated leave is described as not punitive but as a kindness to the student. Suicide is sometimes explicitly mentioned and indeed, the students most commonly subjected to the provisions are ones deemed “suicidal” and/or anxious. That said, window dressing aside, what are we actually encountering here?

On one level, we are encountering a profound human rights violation. It is one thing to remove students from their course of study on the grounds of them breaking the university’s rules of conduct—not that expulsion should ever be the default mode. It is quite another to throw them out on the grounds of being mentally ill. We are likewise encountering expediency. The university has an obligation to accommodate and provide service to students experiencing difficulty. The situation which the policy in essence sets up is minimal accommodation happening with the university thereby saving money—for if you kick out students whom you regard as high maintenance, you save a great deal of money on services. By the same token, a pathologization is happening, which similarly saves the university money. Note in this regard that instead of the university, for example, being faced with having to actually do something about the fact that it is creating an environment that leads to students becoming anxious and depressed, the university is identifying the students themselves—and only the students—as the problem and configuring “their problem” as grounds for mandatory leave—hence, the university need not take stock of how it is operating. At the same time, the policy is both actively drawing on and perpetuating stereotypes. The point here is, as has been repeatedly demonstrated, the so-called “mentally ill” are no more violent than anyone else (see Burstow, 2015). Correspondingly, we are seeing ableism and a human rights violation, moreover, a violation of other civil rights, including the right to an education. We are likewise seeing the universities intrude on personal matters which in the final analysis are none of their business.  Once again, as I have repeatedly stated elsewhere (e.g., see https://www.madinamerica.com/2016/04/75895/), while we might dearly wish for people to stay alive. people have a right to kill themselves.  Moreover, they have a right to think and act differently. We are additionally seeing a conduit into the psychiatric system being established both initially (note, in this regard,  “mental health services” are framed as something to try first, that is before a student is put on “mandatory leave”) and in the long run.  On top of which we are seeing a woeful lack of insight and abject cruelty, whether intended or not.

In this regard, the majority of students that are subjected to such policies never return to school or at very least, not to the school that has cast them out.  As numerous emails which I have received suggest, they are humiliated and traumatized by what has happened. Moreover, they typically find themselves at a loss, for they have been robbed of the routines on which they rely, of their way of coping, often of their housing, in short, of the life they have built.

Question: Why would anyone expect that banishing a “depressed” or “suicidal” person from our midst would do anything other than make them more depressed? More isolated? More “suicidal”?

If these policies are a disaster on the personal level—and for the most part they are—they are every bit as disastrous on the systemic level—and we need to keep our eye on this.  What is happening here is institutionalized sanism. Moreover, what is happening is nothing less than an extension of psychiatric rule into the operation of the university. “Mental health services”, which as most readers know, are themselves dangerous and can seriously harm—are being foisted on students.  Psychiatry—not students and faculty—will be deciding who gets to be university learners. And psychiatry to a large part will be dictating who gets to return after the students have been turfed out (it goes without saying that only those who have “availed themselves” of “mental health services” have much of a chance). 

There are very clear winners and losers here. So who wins? Psychiatry of course and by extension the entire mental health industry win for they are thereby colonizing yet another area and thereby securing yet another stream of steady “customers”. And who loses? Pathologized people, the vulnerable, indeed, all students at any risk of being subjected to these measures—and who isn’t? While most academics seem strangely unaware of this, I would add, academia also loses—and at that, profoundly. The point is, what is in effect being accomplished by these measures is the ceding of an important part of the governing of the university to the “mental health industry”. More generally still, society overall loses, for in enacting and applying such policies, we are marginalizing and harming large segments of our populace.

Is this really what we want for our universities? Is this really what we want for society?

The story which I am telling here, of course, clashes in significant ways with the official university narrative, that being a story of progress and of generosity. Which brings us to a series of myths and facts:

Myth: Mandatory leave policies benefit the students subjected to them.
Fact: Evidence shows that the students are not benefited. Rather the students in question are profoundly harmed.  

Myth: There are built-in safety mechanisms like the right to appeal that makes these policies reasonable, for students can always contest the mandatory expulsion.
Fact: The majority of the students are so overwhelmed that they never appeal. Correspondingly, as with issues of involuntary admission to a psychiatric institution, those who appeal almost never win, for the deck is stacked against them (see Burstow, 2015).  Moreover, why should anyone be faced in the first place with such stigma, with such a profound assault on their dignity and liberty? 

Myth: Other students feel unsafe with “these students” around.
Fact: Insofar as this is the case, that is a reason to engage in consciousness-raising, to take measures to counter sanism—not a reason to reinforce sanism by casting people out.

Myth: Were it not for mandatory leave measures, the “mentally ill” who break rules would be banned permanently.
Fact: Let’s not kid ourselves. That, for the most part, is what with these measures accomplish. Moreover, there is no law in any land compelling university administrations to remove students for any period of time who break rules. This is a university invention.  And the university quite simply needs to find more creative and more humane ways to deal with conflict. What adds insult to injury, the issue of whether or not someone is ‘mentally ill” is a “red herring”, is at very best irrelevant for rule-breaking and violence have no intrinsic connection with so-called “mental illness”.

Myth: Mandatory leave is a measure of last resort. It goes along with added support so that more students can stay in school.
Fact: While all administrations who adopt such policies make claims of this ilk, there is no evidence whatever that such practices function as measures of last resort. The point is that universities who have introduced such measures have historically not increased their services. In fact, most have cut back on their services. Which leads one to ask: Could not the desire to spend less on services actually one of primary motivations for introducing such measures? On top of which, the services offered are not just “offered”. There are forced on student and are a way of controlling students. Additionally, as already specified, so much of what is “offered” is incredibly harmful (see Breggin, 1991 and Burstow, 2015).

Nor is this all that is wrong with “unfit to study” policies.

On yet another level—and we fail to recognize this level to our peril—this expansion of psychiatric rule into academia is itself part of a larger and truly worrisome trend. Significantly, just as psychiatric ruling is being used to remove students from school, it is likewise being used to purge the “helping professions” of members that in any way trouble their colleagues. In this regard, being/being deemed “mentally ill” is progressively being seen as a sign of “professional incompetence” with mental illness discourse being leveraged to drive what are often perfectly capable social workers and nurses (especially those of colour) out of their professions (for a detailed analysis of this growing practice, see Chapman, Poole, Azevedo, and Ballen, 2016).

How does this happen? Each of the regulated professions have colleges or other similar bodies associated with them with which members must be in good standing if they are to continue practicing. The policies mandated by these colleges specify that for person to be a member in good standing they must be “competent to practice ” and the policies explicitly allow for the removal of members found to be “incompetent”. Now with mental status progressively dictating how competence is understood, a member’s colleagues, a member’s supervisor, and others in their workplace are progressively on the look-out for signs of “mental illness”.

A nurse’s confidentiality having been broached in that her supervisor mentioned to others that she was once diagnosed as bipolar, the nurse begins to be treated differently, whereupon she becomes noticeably uncomfortable with her colleagues. A social worker seems distraught one day when talking to some of her less than helpful other team members.  A precarious worker at some point is spotted in tears—and who does not know that precarity makes one’s life harder? All this can and indeed has served as ammunition to level against them, to deem them mentally ill and so incompetent and to deprive them of the right to practice. What makes matters worse, as shown by Chapmen, Poole, Azevedo, and Ballen, 2016, people of colour are in special jeopardy of having these policies applied to them.

Further insight into this worrisome trend can be gleaned by looking at the language employed. To whit, just as vulnerable students seen as mentally ill and accordingly thrown out of the university are called “unfit to study”, social workers and nurses thrown out of their profession on “mental health” grounds are called “unfit to practice.” 

There is a historical echo here that is unmistakable. While I am well aware that people applying these policies are not intending this echo and would indeed be shocked at the suggestion of it, as a Jew and as an authority on the Holocaust, on anti-Semitism, and on fascism, I cannot but notice that  “unfit to study” and “unfit to practice” are on a continuum with “unfit to live”—or, to use the more common designation “life unworthy of life” (see https://en.wikipedia.org/wiki/Life_unworthy_of_life)--a concept that ushered in the systemic murder of Jews, mental patients, and others during the Nazi era, with the eradication of the “mental patients” significantly, coming first, paving the way for the others.  (For one of the earliest and most influential articulations of this fascist concept, see Binding and Hoche,1920; for an analysis of what came of it, see Lifton, 1986).

Now to be clear, I am in no way equating these measures or indeed in any way comparing them—for the differences are enormous. Nor am I imputing what might be called “intent”.  However, I am suggesting that they exist on a continuum. I am likewise suggesting that with this extension of psychiatric rule into areas like academia and into professions like social work and nursing (both, not coincidentally, “regulated professions”), what we are witnessing is creeping fascism—hence the title of this piece.  

Alas, it is all too easy for the fascistic nature of such measures to go undetected for it is not the blatant fascism that we hear about on the streets in Charlottesville.  It is not hatred. It is rather, to coin a phrase, “respectable fascism”.  Indeed, it bears all the marks of being kindly as well as responsibly intended. All the more reason we need to be on the alert.

What other groups will society start trying to control this way? What new modes of surveillance, control, and exclusion will be put into place?  These are larger questions that are beyond the auspice of what can be handled in this article, but as society progressively goes down this path, they are important to keep in mind.

That said, to hone in once again specifically on what is happening to students, so what can we do?

One thing we can do is rally students to mobilize their colleagues and the general public to sign petitions to stop these practices, to mount teach-in for students and others on the issue (both of which actions I currently involved in at University of Toronto). When taking part in any such activity, it is important to challenge sanism, to prepare myth/fact sheets, to systematically make visible the contradictions, and to help people see beyond the rhetoric of the university, or to put this another way, beyond the rhetoric of psychiatry—would that they were not currently overlapping so! Other actions that can be taken include legal challenges (for we are witnessing human rights violations here), the mounting of university-wide demonstrations, the insistence on real (and of course voluntary) services.  

On a broader and more philosophic level, we need to educate around sanism. More broadly speaking still, if we are help society arrive at a place where such policies would be unthinkable, we need to integrate what I have called “mad literacy” into school curriculums from the early grades onward (for details on what this might like, see Burstow, 2015, Chapter Nine). We need people growing up knowing that that there are many different ways of thinking and acting—rather than one right way. And we need them to be able to follow and value what is currently dismissed as “crazy”.

On an equally philosophical level, we need to help others recognize fascist thought when they see it or creeping fascism will inevitably continue. On a more basic level, students and faculty need to proceed from vision. More generally, we all of us need to defend freedom, know what it means to be in community, and everyone who cares about human rights and social justice need to announce unambiguously: We stand for inclusivity and accommodation. We stand for real community. We stand for learning from one another. And we affirm together: No one is “unfit to study”.

Make no mistake about—there is a huge fight ahead of us. Allies that can be meaningfully turned to in the fight ahead include psychiatric survivors and their allies, the autistic community, student unions, students from every sector of the university, progressive educators, progressive university staff, disability rights groups, lawyers, activists, advocates, ombudsmen, politicians, religious leaders, organizations of on-side parents. 

The task before us, as I see it, is to assemble as many allies as possible, to build a broad-based coalition, and not to cease in our labour until a) such policies are stuck down; b) university environments are safe for students, c) adequate accommodation is happening; and d) the oppression known as sanism becomes understood and instances of it are transparently treated as unacceptable—even when these arise from university governance  itself. To be clear, while of course the actions of some students may legitimately be seen as a problem by university administrators, this reality is no way justifies sanist and otherwise oppressive policies and processes.

In ending, to touch base once again on exclusionary policies more broadly, beginning with what is currently happening to besieged professionals, by the same token, while individual social workers or nurses may well be incompetent and best not be employed for any number of reasons (e.g., they are woefully hegemonic, lacking in skill, or just plain insensitive), as Chapman, Poole, Azevedo, and Ballen (2016) so astutely put it, “the human experience pathologized as ‘mental illness’” is decidedly not among these. Correspondingly, in accordance with the same principle, while there are people who should not be parenting, perhaps because they are abusive, perhaps because they are negligent, being saddled with a psychiatric diagnosis is likewise not among these.

The point here is that where marginalization, exclusion, and control on the basis of putative “mental illness” is happening and/or is starting to happen in any arena, or to any designated group—and who’s to say that university administrators won’t be next?—we need to oppose the institutionalized oppression and to stand in solidarity with those under siege. Just as we must do so with respect to students. Just as we must oppose “involuntary treatment” and incarceration more generally.

How else are we going to build a better world?

References

Binding, K. and Hoche, A. (1920).  Die Friegabe der Vernichtung Lebensunwerten. Lebens. Leipzig: F. Meiner.

Breggin, P. (1991). Toxic psychiatry. New York: St. Martins Press.

Burstow, B. (2016). Psychiatry and the Business of Madness. New York: Palgrave.

Chapman, C. Poole, J., Azevedo, J., and Ballen, R. (2016). A kind of collective freezing out.  In B. Burstow (Ed). Psychiatry Interrogated (pp. 21-40). New York: Palgrave.


Lifton, R. (1986). The Nazi Doctors. New York: Harper and Row.