So, I want to pose a question: is a mental health disorder a disability? I suspect the answer to this question hinges on how disability is contextualized.
There are several ways of going about thinking about disability. I want to focus on the purely academic conversation out there in higher education today. This framework casts disability and its study as a social construct. A mental illness, or a mental health disorder, wouldn’t be an impairment but a divergence or neurodivergence from the “norm” by a purely academic lens.
Many academics suggest these norms center around “ableism” or a belief within society, which privileges the existence of power differentials that suppress marginalized community members and their circumstances. Given this framework, there is no such thing as a mental illness, is there? Only the disorder, which these academics believe is rooted in the normative medical narrative dominating what the social influencers make out to be good mental health. This is where my problem with disability studies and the predominant academic history surrounding mental illness is located.
Underneath this prevailing academic version of mental illness is a silent minority in the University. These are the very sick, the chronic mentally ill, who know that their suffering extends beyond what social apparatuses define and fail to validate. These are the experiences of so many who understand their disorder for what it is, and still hate their symptoms because they are very real, very disabling. These folks are left without the support of the higher-ups in the discourse due to conflicting ideas of illness, disorder, and disability.
Given. The disabilities narrative is incredibly empowering in the same way a veneer of confidence serves someone who is genuinely self-critical and self-loathing. Sure, I get it. The disability studies notion of impairment as a social construct allows people to externalize their self-doubt, even feelings of difference and possible shame from having a potential life long stigmatizing illness in a culture that privileges ability and means.
This is genuinely marvelous for some folks who:
1) will benefit from engaging in externalization (a word of caution as externalization can often be a way of avoidance or avoiding an issue directly that is causing more harm than good,
2) live inside the walls of the academy. Outside the University the disabilities narrative is often nonexistent (people outside of academia don’t buy into the social construct theory due to the fact people have to live out their lives and with these impairments within their reality divorced of journal articles and spirited lectures in higher education.
So, this means people wheelchair-bound must deal with sidewalks without ramps and accessibility issues? Also not the case.
The simple truth is that resource-poor folks will encounter even more issues related to access and getting their hands on adaptive software or hardware to allow their disability not to control their life or how they go about living. These are just physical disabilities or impairments. In the world of mental health, people in the public mental health system must deal with the realities of getting treatment within a plan of care that doesn’t see them as individuals. This stigma exists. Just because disability studies refute the stigma and make it visible to small cliques in their university departments continue to reject the harsh realities for people with mental illness outside of higher ed.
These are realities like stigma, discrimination, forced treatment, and all sorts of negative issues related to having a mental illness. These are issues impacted by social constructions. I’ll give the disabilities studies camp this much. However, social constructivism and its impact on our lives’ reality only explain how the public contextualizes mental illness. Other aspects of mental illness aren’t described by social constructivism. These aren’t small or unimportant issues either. These are real issues for many people who have a mental illness.
For example, according to disability studies, mental illness or serious mental health disorders are manifested by social apparatus conventions at work in the broader normative culture. If this is true, then must I live in a world that defies all traditions, and the world at large outside of the University, to feel okay and healthy? Must I live outside the realities of my life to feel like I am without a disorder? is it really a society that makes my condition an illness? Well, let me tell you, folks.
I live in Yonkers, New York, in the United States. You can look it up on a map. It’s there. It’s a real place. As accurate as geography and state lines get in a world where nationalism still functions and divides up the world.
The social security administration understands, thank god, that my mental illness is an impairment. The social security administration (SSA) and disability benefits department doesn’t care about social constructivism. Why? Because SSA is not bound up in the metaphysical world. All of us here in the real world need money to pay bills and medical care to pay for our mental illnesses.
Odd. If mental illness is just a social construct, why isn’t Social Security Administration out there doing social campaigns? Instead, they are dolling out the necessary money for the treatment of serious illnesses.
Thank god, because, without my (intramuscular injection), my illness would destroy everything I have ever built again. I would return to a state of persistent delusions and other symptoms that are so intense and difficult to tolerate. I would need immediate intervention (not from a disability studies university professor disputing my social constructions but a clinical therapist and expert in severe mental illness) Because when my voices return. When my mania returns, no professor or academic will help (I learned this first hand from my break while enrolled as a student). I will need specialized interventions, and I would likely be so disordered, ill, sick, whatever, that I wouldn’t survive outside of the hospital. With this said, thank god academics don’t run the state benefit or hospital system.
Furthermore, I am also grateful people like my therapist and other clinicians know social constructivism is only part of the picture. It is not an explanation for every aspect of divergence in culture, mental health, or otherwise. I am suggesting the disabilities studies contextualizing of mental illness, disorder, or problems is not only limited, but it’s also monolithic and very much dismissive of the realities out there in the world outside the gates of the University.