Why talk of illness entrenches discrimination
| Published date | 06 May 2014 |
| DOI | https://doi.org/10.1108/MHSI-03-2014-0009 |
| Pages | 68-76 |
| Date | 06 May 2014 |
| Author | Liz Sayce |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Why talk of illness entrenches
discrimination
Liz Sayce
Liz Sayce is a Chief Executive,
based at Disability Rights UK,
London, UK.
Abstract
Purpose – Biological understandings of mental illness are promoted by both anti-stigma campaigners and
increasingly by activists protesting against social security cuts. The purpose of this paper is to analyse the
pitfalls of the “illness”conceptualisation for reducing discrimination, comments on divisions between those
arguing for a right to work and those who seek a right not to work, and proposes bridge building and more
effective messages, drawing on the UN Convention on the Rights of Persons with Disabilities.
Design/methodology/approach – Review of relevant evidence on the effectiveness or lack of it of the
“mental illness is an illness like any other”message in anti-stigma work, and discussion of grey literature from
campaigners and bloggers.
Findings – There is a growing body of evidence that the “illness like any other”message entrenches rather
than reduces stigma and discrimination: this message should not be used in anti-discrimination work. At the
same time some social security bloggers and campaigners have argued they are “sick”in order to resist
efforts to compel them to seek work or face sanctions; whilstolder disability rights campaigners have argued
for the right to work. The paper argues for new bridge building and use of evidence based messages in
campaigning.
Research limitations/implications – This paper is based on review of evidence on the impact of using the
“illness”message to reduce stigma and discrimination; and on discussion of campaigns and blogs. It is not
based on a systematic review of campaigns.
Practical implications – There is a need for campaigns that support rights holistically – the right to a
decent standard of living and the right to work. This requires bridge building between activists, which could
conceptualisation is harmful to the effort to reduce stigma and discrimination. Mental health staff can act as
allies to those they serve in securing all these rights.
Originality/value – This is the only recent paper to analyse the evidence that the “illness like any other”
message is harmful in anti-stigma work, together with its implications for the recent phenomenon of mental
health campaigners moving from opposition to the medical model, to a new argument that they are
“too sick”to work. This paper suggests ways forward for everyone with an interest in combatting stigma
and discrimination.
Keywords Stigma, Social security, Discrimination, Campaign, Illness
Paper type Conceptual paper
For several decades the mental health service user movement has had a strong tradition
of objecting to narrow biological explanations of mental health challenges; and to a
disproportionate emphasis on pharmaceutical treatments. For example, in the USA in 2003
a group of eight people with lived experience went on hunger strike to pressurise the American
Psychiatric Association (APA) to publish evidence for their claim that mental illnesses are
biological brain diseases. The group – MindFreedom – sought to challenge the scientific basis of
a psychiatric enterprise that used supposed facts about chemical imbalances and serotonin
levels to justify coercive medical treatment. Thus began a dialogue that culminated in 2005
in APA President, Steven S Sharfstein stating that “as a profession we have allowed the
bio-psycho-social model to become the bio-bio-bio model [y]. If we are seen as mere pill
PAGE 68
j
MENTAL HEALTH AND SOCIAL INCLUSION
j
VOL. 18 NO. 2 2014, pp. 68-76, CEmerald Group Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-03-2014-0009
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