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I& #39;m going to venture some thoughts on psychiatry, activism/advocacy & change that hopefully *de-center* medications. (Thread.) https://twitter.com/shayla__love/status/1298646511333638146">https://twitter.com/shayla__l...
(1) whether we& #39;re talking about increased rates of disability since de-institutionalization or influences on & #39;recovery,& #39; arguably the central forces are not medications at all but policy--specifically re social welfare, healthcare, jobs and the economy, housing
(2) Notably, not only did the repeal of the Community Mental Health Act devastate services but also 90s era & #39;workfare& #39; (welfare) reforms; & many facets of the US disability benefits system & the ways in which disability, poverty and race have become entangled.
Helena Hansen and colleagues work, including & #39;Pathologizing Poverty& #39; ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920192/)">https://www.ncbi.nlm.nih.gov/pmc/artic... providers very helpful insights into the ways in which reconfigurations of disability-driven welfare policy have impacted poor communities
(3) Wrt psychosis, humility is a requisite: there is so much we don& #39;t know/haven& #39;t figured out. & what we& #39;re really talking about is a sprawling, heterogeneous set of conditions/experiences. My question, w humility, how do we respect/honor the full range of these experiences?
Places to start: resisting any tendency to & #39;generalize& #39; given the many probable causal pathways involved, underlying mechanisms, & sociocultural influences on conceptualization, service access & personal response.
Thoughtfully acknowledging the social consequences of claims that over-step extant science & risk invalidating difficult personal choices--eg risks of & #39;pill shaming& #39;, of elevating/moralizing certain treatment choices over others (cd be therapy, peer support, spirituality, meds)
(4) Wrt to folks w ongoing, significant disability: Acknowledging that they are almost never part of the conversation, that the heterogeneous nature of & #39;madness& #39;/disability easily leads to new hierarchies even w/in activist circles. Also deep forms of racial marginalization.
On this cf Jayasree Kalathil & my Unsettling Disciplines ( https://muse.jhu.edu/article/648225/summary)">https://muse.jhu.edu/article/6... and my Inconvenient Complications ( https://www.researchgate.net/publication/267096813_Inconvenient_Complications_On_the_Heterogeneities_of_Madness_and_their_Relationship_to_Disability)">https://www.researchgate.net/publicati...
And @DianaRose160 and Jayasree& #39;s Power, Privilege & Knowledge ( https://www.frontiersin.org/articles/10.3389/fsoc.2019.00057/full)">https://www.frontiersin.org/articles/...
(5) When it comes to making change happen, of course I& #39;m a researcher, so one thing I& #39;d argue we need is systemic efforts to build up research capacity w/in the service user community, and meaningfully co-produced research; good research is slow, systematic, critical & thoughtful
To do this we have to sort through an incredibly complex set of power relations/hierarchies, we have to ask a lot of hard questions, we have to be able to make sacrifices. And the difficulties really can& #39;t be overstated.
