Toward a Social Understanding of Mental Health: An Alternative Perspective for Educators, Psychologists, and Counselors

• In Event: Public Scholarship, Development, and Research With Transformative Agendas: A Vygotskian Approach to Passionate Egalitarianism

Abstract

Mental illness is typically discussed through the lens of the medical model of diagnosis. NAIMI, a mental health advocate organization, employs this perspective’s reliance on deficit phrasings such as “disorder” and “diminished” and compares mental health to a defective pancreas that can be treated, an analogy that is problematic in that a defective human vital organ that is left untreated leads to death, and treating a disabled pancreas focuses directly on the pancreas itself. Mental health, however, is not analogous to physical illness in this fashion. Depression itself is not deadly in the manner of a pancreatic dysfunction, and doctors cannot (yet) transplant neurological components from one body to another.

The analogy between mental health and physical illness contributes to the idea that people who are different are the only ones with a responsibility to change themselves. Although attention to stigma is included in the perspective articulated by research and doctors, it is termed as a means of understanding the treatment of individuals’ disorders, rather than changes in the environment such that mental health variation is not stigmatized pathologically, with or without medical intervention. Within this perspective, the individual is disturbed, disordered, or troubled, a view that fits well within the Western view of mental health difference, and in need of repair.

This paper will contest the deficit views of people who are discursively constructed as being mentally ill. The author will review related work on how difference becomes pathologized, and draw on Vygotsky’s (1993) work in defectology to provide a social understanding of mental health that informs a social view of mental health variation that is less oriented to individual illness and more centered on adaptations made by the broader society to accommodate and support a wider range of mental health profiles.

In relation to the themes of this session, the author will look at the oppressive social structures that surround people discursively constructed as mentally ill by diagnosticians and other people in their environment. Bozalek’s (2014) account of privileged irresponsibility elaborates how the needs of the privileged are more likely to be considered important and to be met than are those of the marginalized, thus enabling people with little political power or status to be overlooked and neglected. Tronto’s (2013) construct of epistemological ignorance in which those with privilege feel no need to understand or feel obligated to serve the needs of the oppressed. As a consequence, the lives of those on the margins or in subjugated social positions are vulnerable to the phenomenon of dualism, in which the life circumstances of social outsiders are constructed and represented as inferior to those of people from the dominant culture.

Vygotsky’s defectological formulation emphasizes the manner in which human difference is a social issue rather than a problem of the individual. This paper attends to changes in environments, rather than in individuals, in order to make life more fulfilling for people of mental health difference.

Author

• Peter Smagorinsky, University of Georgia