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The former director of a US-based psychiatric survivors organization focused on rights and freedoms, David Oaks , has advocated the taking back of words like "mad", " lunatic ", "crazy" or "bonkers". While acknowledging that some choose not to use such words in any sense, he questions whether medical terms like "mentally ill", " psychotic " or "clinically depressed" really are more helpful or indicative of seriousness than possible alternatives.
Oaks says that for decades he has been exploring the depths of sanism and has not yet found an end, and suggests it may be the most pernicious 'ism' because people tend to define themselves by their rationality and their core feelings. After his accident breaking his neck and subsequent retirement, Oaks refers to himself as "PsychoQuad" on his personal blog.
British writer Clare Allen argues that even reclaimed slang terms such as "mad" are just not accurate. In addition, she sees the commonplace mis-use of concepts relating to mental health problems — including for example jokes about people hearing voices as if that automatically undermines their credibility — as equivalent to racist or sexist phrases that would be considered obviously discriminatory. She characterises such usage as indicating an underlying psychophobia and contempt. Interpretations of behaviors, and applications of treatments, may be done in an judgmental way because of an underlying mentalism, according to critics of psychiatry. If a recipient of mental health services disagrees with treatment or diagnosis, or does not change, they may be labeled as non-compliant, uncooperative, or treatment-resistant.
This is despite the fact that the issue may be healthcare provider's inadequate understanding of the person or their problems, adverse medication effects, a poor match between the treatment and the person, stigma associated with the treatment, difficulty with access, cultural unacceptability, or many other issues. Mentalism may lead people to assume that someone is not aware of what they are doing and that there is no point trying to communicate with them, despite the fact that they may well have a level of awareness and desire to connect even if they are acting in a seemingly irrational or self-harming way.
In addition, mental health professionals and others may tend to equate subduing a person with treatment; a quiet client who causes no community disturbance may be deemed improved no matter how miserable or incapacitated that person may feel as a result. Clinicians may blame clients for not being sufficiently motivated to work on treatment goals or recovery, and as acting out when things are not agreed with or are found upsetting. But critics say that in the majority of cases this is actually due to the client having been treated in a disrespectful, judgmental, or dismissive manner. Nevertheless, such behavior may be justified by characterizing the client as demanding, angry or needing limits.
To overcome this, it has been suggested that power-sharing should be cultivated and that when respectful communication breaks down, the first thing that needs to be asked is whether mentalist prejudices have been expressed. Mentalism has been linked to negligence in monitoring for adverse effects of medications or other interventions , or to viewing such effects as more acceptable than they would be for others. This has been compared to instances of maltreatment based on racism. Mentalism has also been linked to neglect in failing to check for, or fully respect, people's past experiences of abuse or other trauma. Treatments that do not support choice and self-determination may cause people to re-experience the helplessness, pain, despair, and rage that accompanied the trauma, and yet attempts to cope with this may be labeled as acting out , manipulation , or attention-seeking.
In addition, mentalism can lead to "poor" or "guarded" predictions of the future for a person, which could be an overly pessimistic view skewed by a narrow clinical experience. It could also be made impervious to contrary evidence because those who succeed can be discounted as having been misdiagnosed or as not having a genuine form of a disorder — the no true Scotsman fallacy. While some mental health problems can involve very substantial disability and can be very difficult to overcome in society, predictions based on prejudice and stereotypes can be self-fulfilling because individuals pick up on a message that they have no real hope,  and realistic hope is said to be a key foundation of recovery.
At the same time, a trait or condition might be considered more a form of individual difference that society needs to include and adapt to, in which case a mentalist attitude might be associated with assumptions and prejudices about what constitutes normal society and who is deserving of adaptations, support, or consideration. Offensive and injurious practices may be integrated into clinical procedures, to the point where professionals no longer recognize them as such, in what has been described as a form of institutional discrimination.
This may be apparent in physical separation, including separate facilities or accommodation, or in lower standards for some than others. Mental health professionals may find themselves drawn into systems based on bureaucratic and financial imperatives and social control , resulting in alienation from their original values, disappointment in "the system", and adoption of the cynical, mentalist beliefs that may pervade an organization.
However, just as employees can be dismissed for disparaging sexual or ethnic remarks, it is argued that staff who are entrenched in negative stereotypes , attitudes, and beliefs about those labeled with mental disorders need to be removed from service organizations. However, the point is also made in such views that institutional and group environments can be challenging from all sides, and that clear boundaries and rights are required for everyone.
The mental health professions have themselves been criticised. While social work also known as clinical social work has appeared to have more potential than others to understand and assist those using services, and has talked a lot academically about anti-oppressive practice intended to support people facing various -isms, it has allegedly failed to address mentalism to any significant degree. The field has been accused, by social work professionals with experience of using services themselves, of failing to help people identify and address what is oppressing them; of unduly deferring to psychiatric or biomedical conventions particularly in regard to those deemed most unwell; and of failing to address its own discriminatory practices, including its conflicts of interest in its official role aiding the social control of patients through involuntary commitment.
He suggested that when prejudice is applied by the very professionals who aspire to eradicate it, it raises the question of whether it will ever be eradicated. The psychiatric survivors movement has been described as a feminist issue, because the problems it addresses are "important for all women because mentalism acts as a threat to all women" and "mentalism threatens women's families and children. She reported that the most frequent complaint of psychiatric patients is that nobody listens, or only selectively in the course of trying to make a diagnosis. On a society-wide level, mentalism has been linked to people being kept in poverty as second class citizens; to employment discrimination keeping people living on handouts; to interpersonal discrimination hindering relationships; to stereotypes promoted through the media spreading fears of unpredictability and dangerousness; and to people fearing to disclose or talk about their experiences.
With regard to legal protections against discrimination, mentalism may only be covered under general frameworks such as the disability discrimination acts that are in force in some countries, and which require a person to say that they have a disability and to prove that they meet the criteria. In terms of the legal system itself, the law is traditionally based on technical definitions of sanity and insanity , and so the term "sanism" may be used in response. The concept is well known in the US legal community, being referred to in nearly law review articles between and , though is less well known in the medical community.
Michael Perlin, Professor of Law at New York Law School, has defined sanism as "an irrational prejudice of the same quality and character as other irrational prejudices that cause and are reflected in prevailing social attitudes of racism, sexism, homophobia, and ethnic bigotry that permeates all aspects of mental disability law and affects all participants in the mental disability law system: litigants , fact finders , counsel , and expert and lay witnesses. Perlin notes that sanism affects the theory and practice of law in largely invisible and socially acceptable ways, based mainly on " stereotype , myth , superstition , and deindividualization.
This results in judicial decisions based on stereotypes in all areas of civil and criminal law, expressed in biased language and showing contempt for mental health professionals. Moreover, courts are often impatient and attribute mental problems to "weak character or poor resolve". Sanist attitudes are prevalent in the teaching of law students, both overtly and covertly, according to Perlin. He notes that this impacts on the skills at the heart of lawyering such as "interviewing, investigating, counseling and negotiating", and on every critical moment of clinical experience: "the initial interview, case preparation, case conferences, planning litigation or negotiation strategy, trial preparation, trial and appeal.
There is also widespread discrimination by jurors, who Perlin characterizes as demonstrating "irrational brutality, prejudice, hostility, and hatred" towards defendants where there is an insanity defence. Specific sanist myths include relying on popular images of craziness; an 'obsession' with claims that mental problems can be easily faked and experts duped; assuming an absolute link between mental illness and dangerousness; an 'incessant' confusion and mixing up of different legal tests of mental status; and assuming that defendants acquitted on insanity defenses are likely to be released quickly.
Although there are claims that neuroimaging has some potential to help in this area, Perlin concludes that it is very difficult to weigh the truth or relevance of such results due to the many uncertainties and limitations, and as it may be either disregarded or over-hyped by scientists, lawyers or in the popular imagination. He believes "the key to an answer here is a consideration of sanism", because to a great extent it can "overwhelm all other evidence and all other issues in this conversation". He suggests that "only therapeutic jurisprudence has the potential power to 'strip the sanist facade'.
Perlin has suggested that the international Convention on the Rights of Persons with Disabilities is a revolutionary human rights document which has the potential to be the best tool to challenge sanist discrimination. He has also addressed the topic of sanism as it affects which sexual freedoms or protections are afforded to psychiatric patients, especially in forensic facilities. Health information technology essay population explosion in pakistan css essay , why become an army officer essay. Issa case study steve rogers. Extended essay psychology structure crime and punishment justice essay essay on raja festival in odia language.
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