Unit II Self-Determination and Activism
The roots of mental health activism in Canada lie in the 1970s, a time often associated with social change and unrest. During this period, social movements such as human rights, women’s rights and gay rights are credited with changing the status of many marginalized people in mainstream society. Following from the energy and success of these movements, and responding to demands for self-determination and equity, the mental health rights movement became an empowering and influential force across the country. The shift from institution to community was key to this change: many mental health patients discarded the label of “patient.” Instead, they adopted new ways to describe themselves – psychiatric survivor or consumer – and reclaimed derogatory terms like “mad” and “crazy.”
This unit provides context to this movement by beginning with a snapshot of conditions in mental health institutions and the shift to life in the community. We move to an examination of patients’ rights, steps toward self-determination, and alternatives to health care and support designed by psychiatric survivors/consumers. Learners are encouraged to read and reflect on both institutionalization and community living from a perspective of the lived experience, and to think about the factors that go into the historical and current demand for rights.
By the end of this lesson students will be able to:
- Understand issues related to mental health and patient experience in Canada (1950 to present) – Institutionalization, deinstitutionalization, community care, movement for change, patient rights/right to vote, current issues
- Demonstrate an understanding of the concepts of self-determination and activism through participation in activities and answering of questions.
Background Information for Teachers
During the latter half of the twentieth century, there was a transformative shift in mental health care as patients were released from residential mental health facilities, signalling the end of the era of institution-based care. Deinstitutionalization, a trans-national phenomenon in the post-World War II period, relocated large numbers of individuals deemed “mentally ill” in communities across North America. The move to abandon asylum-based care derived from a number of factors including a contemporary dissatisfaction with chronically overcrowded and under-funded state institutions. The introduction of new pharmaceutical treatments in the 1950s offered compelling evidence that patients could manage their symptoms and recover more effectively in normal community surroundings.
This unit uses historical materials drawn from the time prior to and following the closure of large residential mental health facilities to explore activist responses to human rights and mental health. Before the 1970s, institutionalized patients had few rights. Leaving the institution, patients entered local communities where reactions from the general public ranged from ambivalence to hostility. Today, the model usually involves shorter periods of hospitalization rather than long stays in largely custodial institutions, and an emphasis on recovery. Explain to the students that they are going to look at what has happened between then and now and see how things have changed over the past 60 years.
Many ex-institutional-patients adopted the names “mental health consumer” or “psychiatric survivor,” some forming politically active communities and support networks. Patient concerns became strongly informed by a growing appreciation for human rights and patient advocacy. In this unit, we consider some of these institutional and community experiences and focus on mental health activism and human rights.