Autonomy and violence

02Jul10

Two recent news stories regarding mental health.

First of all, one which focusses on the idea that people with mental health problems have autonomy, that is that they can make decisions for themselves and act on those decisions, should be accepted as a commonplace. Of course it should! Its incredible that this still isn’t the case. One thing I really do enjoy about this article is the end wherein the philosopher being interviewed states that autonomy is never a matter of isolation, decision making is always a “collective endeavour”. You can read the full story on the Guardian website here.

“That [mental capacity] test is a public safety test; if you’re a danger to yourself or to others, then the state has a responsibility to minimise the threat to public health. In the old days, that probably meant locking you up; now, it could mean that you are forced to take your medication. Safeguards have been introduced. But the key thing is that there is nothing in that Act that talks about your freedom to make decisions for yourself. It’s all about ‘are you a danger?'”

On this note, I am about to start reading a book called Pure Madness: how fear drives the mental health system, which can be glimpsed here. For myself, coming from an anarchist/post-marxist perspective, I am an advocate of autonomy and I’m kind of amazed that its taken this long for the question to be raised internally to the system of psychiatry. Whether or not an answer can come from the inside might be another question. It seems natural and obvious to me that where decisions are being made that directly affect people’s lives those people should be directly and genuinely involved in the decision making process.

Here is another news item on mental health, also from a few days ago, that I have just come across. This time the story focusses on legislating against a more expansive concept of violence that the usual physicalist reduction.

The French parliament has approved a groundbreaking law that makes psychological violence an offence as part of a broader range of measures aimed at improving protection of victims of domestic abuse.

Anyone found guilty of breaking the law faces up to three years in jail and a €75,000 ($91,530) fine. The bill defines mental violence as “repeated acts which could be constituted by words or other machinations, to degrade one’s quality of life and cause a change to one’s mental or physical state”.

Full story here.

There are already complaints about the law being too vague and thus being a nightmare to institute in concrete cases, as well as people claiming that religious groups will attempt to hide behind it. None of that is important, what matters is the degree to which psychological violence is now being recognised and that should be praised, even if it has come very late in the day. At the same time we have to be mindful that this legislation, while rightly protecting individuals, will never be applied to the objects that it should; the social structures that perpetuate psychological violence against every one of us.

As an aside, to refer back to my discussion of neurodiversity, would those adherents who claim that any change in brain structuring equates to neurodiversity- and therefore a form of difference to be uncritically affirmed and celebrated- want to do away with this law?

These stories give some very modest signals that we can be hopeful but in order that we don’t run away into the clouds we must remember that incidences of mental health problems are not about to disappear and are, more than likely, still on the increase and the mental health system is still far from adequate.

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