"Discredited" and "Discreditable": The Search for Political Identity by People with Psychiatric Diagnoses

Article excerpt

You're never the same--mental health diagnosis is an opinion and attitude. You cannot cure or have remission from others' attitudes of rejection. (1)

Friends and family--they don't understand my illness/disability--they think I am getting away with something--that there is nothing wrong with me. (2)

INTRODUCTION

Identity matters. In particular, identity matters to people who are stigmatized and stereotyped because they belong to a socially disfavored group. Although individual members of these groups may have very different ideas about how to respond to prejudice and mistreatment, the matter of identity itself--membership in the group--is generally not at issue. Justice Clarence Thomas and the Reverend Jesse Jackson may have sharply conflicting ideas about the meaning of being an African American in our society, but the identity of each man as an African American is hardly open to question.

When it comes to disabilities, however, these distinctions begin to blur, in part because disability is as much about environmental context and social functioning as it is about any physical or mental characteristic. Asthma may or may not be a disability, depending on the presence of pollen and pollutants in the air. Mild mental retardation may be less disabling in a rural farming community than in a busy urban environment. In addition, impairments exist along a spectrum, both physical and functional, rather than representing a dichotomy between a class of clearly identified disabled people differentiated unmistakably from nondisabled people. Therefore, a person's self-identification as "disabled" is often not as automatic as self-identification with respect to race and sex. In fact, self-identification as a person with a disability is often a long, complex, and difficult process. In this respect it may resemble self-identification as gay or lesbian.

Disability, unlike race and sex, but like sexual preference, is usually not identifiable at birth, (3) and often becomes salient in an individual's life after she has formed a personal identity. Indeed, one of the most hurtful aspects of disability discrimination is that newly disabled persons find it very difficult to accept that people who knew them before they became disabled can treat them so differently once they are disabled, and people with hidden disabilities are shocked when they are abandoned by old friends and even family after they reveal their disabilities.

The fact that disabilities exist along a spectrum contributes to another disparity between the identity of disabled people and the identity of people in other groups that experience discrimination. Because disabilities exist along a spectrum, it is unclear when someone actually becomes "disabled." Disability is a status that is initially identified, named, or conferred, not by the individual, but by "experts," usually medical experts, although the ramifications of disability are significantly social and political.

Furthermore, unlike race or gender, experts hold themselves out as being able to mitigate or treat disability. (4) Although people with disabilities have challenged the claims and dominance of experts for many years, experts retain a position of primacy in defining both the categories and the meaning of physical and mental disability, and are considered the only authority on the mitigation, treatment or cure of the disability. (5)

The centrality of experts to the experience of disability has enormous social, legal, and political consequences. A large number of cases under the Americans with Disabilities Act involve claims by the plaintiff that she is disabled. (6) Defendants dispute these claims by hiring experts to refute the plaintiff's claims to identity as a person with a disability. In many cases, the Supreme Court has rejected the plaintiff's claim to belong to the protected group--persons with disabilities. (7) This process--permitting experts and the judiciary to determine whether an individual fits into a protected class--would be unthinkable in the case of race, gender, age, religion, or sexual orientation. …