Vol. 2 No. 2 (2020): Power, Discourse and Resistance: Critical Perspectives on Mental Health and Mental Health Nursing
Dave Holmes, PhD, RN, FAAN, Professor, School of Nursing, University of Ottawa
Amélie Perron, PhD, RN, Associate Professor, School of Nursing, University of Ottawa
Intended Focus of this Special Issue
This Special Issue aims to foster and bring together critical perspectives on matters that directly or indirectly relate to contemporary notions of mental health and mental illness, and the way these notions suffuse everyday life. It seeks to promote scholarship that brings forth the complex intersections of sex, gender, race, class, age and ability and their effects on persons’ capacity to conform to various expectations. Such expectations may include for example the need for self-management, self-work and individual transformation; entrepreneurship; or ensuring one’s (socioeconomic) relevance in contemporary societies through proper patterns of performance, choice, consumption and competition. Such expectations are neither neutral nor inconsequential. For many individuals, groups and communities, they predetermine discourses of normality, acceptance and inclusion on the one hand, and of abnormality, rejection and exclusion on the other. They also fix corresponding identities in ways that both open up and close off opportunities for representation, recognition, justice and equity.
Making sense of the above is key to understanding two distinct but interrelated phenomena: the growing pathologization of human thoughts, emotions and behaviours, and the parallel downplaying of systems of discrimination and oppression that undermine human agency, personhood and connectedness, leaving only individual explanations of mental distress centered around ‘deficits’. The language of mental health and illness suffuses everyday life in such a way that every emotion brought on by the struggles or pleasures of life can become a symptom to be clinically managed and treated. In short, every individual can be subject to an expert evaluation of whether their thinking and functioning falls within social expectations and norms. Such thinking can be difficult to identify and problematize. It determines the way we perceive ourselves, our capacities and decisions, how we resolve problems, and how we categorize our responses to everyday occurrences. It also changes the way we perceive others around us, in particular those who think and act outside the realm of ‘normal’. Yet ‘normal’ is a moving target, spurred by multiple forces ranging from free-market policies and pressures to human rights discourses. Defining ‘normal’ is therefore a powerful act—but so is challenging the social, economic, scientific and legal foundations of such definitions.
There is a need to question those discourses, practices, institutions and laws that shape the realities of persons who experience emotional difficulties and/or who are constructed as mentally ill. We believe there is also a need to challenge and rethink the way certain agents, such as nurses, are called upon to intervene on those individuals deemed to pose a problem because of their mental state. Nurses practice at the intersection of individual and collective experience, state objectives, clinical guidelines and scientific evidence. They play a key role in the way current configurations of care and support can perpetuate or disrupt patterns of suffering, exclusion and violence. In other words, they are unequivocally bound to people’s experiences of mental health and illness. Nursing scholarship in this area is thus critical in order to shape a healthcare agenda that is respectful of people’s agency and personhood. We therefore hope this Special Issue can contribute meaningfully to the discussion, toward the full realization of social justice, equity and human dignity in mental health work.
Note: COVER IMAGE: "ISOLATION AS PUNISHMENT." A Pastel by K. Haines.