By Kaz DeWolfe

For the past year or so, I have been creating info-graphics to use in our education and outreach work across the state. This graphic, titled What is Sanism? illustrates some statistics on psychiatric oppression, coercion, and discrimination.

So what is sanism?

Sanism is a systemic and systematic oppression of people who the world deems “insane,” “mad,” or “mentally ill.” It effects people with mental differences, emotional distress, or who have been diagnosed with psychiatric disorders.

Some people effected by sanism may consider themselves psychiatric survivors, or mental health consumers, service users, or ex-patients. Some may identify strongly with their psychiatric diagnosis, feeling that it effects every part of their life and has become an essential part of their identity. Others may simply identify as Mad or Neurodivergent.

Regardless of how we conceptualize our experiences and identity, once our emotions and behavior exist outside of a narrowly defined “normal” we are often subjected to sanist discrimination, and psychiatric coercion.

What does sanism look like?

This graphic lists some of the form that this systemic discrimination takes. Nearly all areas of our lives can be impacted by sanism.

Discrimination in housing and employment

There are often barriers to accessing housing and employment, with some landlords or employers holding prejudice or bias towards people who do not “pass as sane” or towards people who disclose their mental health history. Discrimination based on disability status is illegal, but it happens often.

Some people with mental differences may also need some help and support in maintaining housing. Some of us struggle to pay rent on time or keep the place clean enough according to the landlord’s standards. Unfortunately, many of us lose our housing when we are unable to access the support we need.

Similarly, in the work place, many people are unable to get accommodations necessary to perform the duties of their job. High-stress and fast-paced work environments may be extremely disabling to people experiencing anxiety or sensory processing differences. Unable to meet the productivity demands of our capitalist employers, many of us end up out of work.

Conflating “mental illness” with violence

Sanism often appears in the media and in conversations around violence. Whenever there is a mass shooting or other extremely violent event, we hear talking heads on the news conflating the violence with mental illness. Statistically, people diagnosed with psychiatric disorders are not more likely to be violent than the general public. The majority of people arrested for violent crimes do not have psychiatric labels.

Targets of violence, including police brutality

We know statistically, that we are actually far more likely to be the victims of violence then we are to be the perpetrators. The graphic lists a statistic found on mentalhealth.gov that people diagnosed with psychiatric disorders are 12 times more likely to be the victims of assault than the general public. We believe that discriminatory beliefs that we are violent and dangerous is a factor contributing to these assaults of psychiatrically disabled individuals.

Police are also disproportionately violent towards psychiatrically disabled individuals. A study by the Ruderman Family Foundation found that half of the victims of police shootings surveyed were disabled people, with the overwhelming majority being psychiatrically disabled. We know that police are disproportionately violent towards black and indigenous people. People who experience the intersection of racism and ableism or sanism are at a greatly increased risk of police brutality.

Forced or coerced psychiatric interventions

Fear of the “dangerousness” of psychiatrically disabled people is also the basis behind forced and coerced psychiatric interventions. Out patient commitment orders (Orders of Nonhospitalization in Vermont) Started with the passing of Kendra’s Law in NY in 1999. The law was named for Kendra Webdale who was attacked on a subway platform by a man diagnosed with schizophrenia, who pushed her into the path of an oncoming train. This of course was a tragic incident. The vast majority of people diagnosed with schizophrenia do not attack anybody, and are statistically more likely to be attacked themselves.

Out patient commitment, psychiatric holds, and involuntary treatment orders all strip a person of their bodily autonomy and cognitive liberty. When we oppose psychiatric coercion and force, some mental health consumers and service users fear we are trying to take away services they need. Some people may voluntarily seek confinement to a psychiatric unit for safety in a crisis. Others may recognize that in an extreme state they might refuse treatment that they need, and might write an advance directive stipulating a desire to be forced to take certain medications if determined to lack capacity. Opposing coercion does not mean opposing voluntary requests for intensive care.

What we are opposing is instead the forced confinement and forced drugging and forced adherence to treatment, against the will of the individual. Many who have lived through such ordeals describe them as traumatizing and dehumanizing. Involuntary emergency procedures such as restraint and forced drugging can often lead to physical injury for both the patient and staff. We are opposing not treatment, but acts of violence against disabled members of our community.

So what do we do about it?

We can work to challenge sanism, starting with recognizing our own biases and our own assumptions about madness and disability. Coming to this movement, I realized how much I needed to unlearn, as sanism is everywhere and has played a part in shaping all of us. We can be the change by acknowledging our own value and need for dignity and respect, and by showing that respect to others in our community. We can also organize and advocate for systemic change in our work places, in healthcare settings, in our communities, and in legislation.

More ideas on how to make the world safer for Mad, neurodivergent, and psychiatrically disabled people can be found in a recent article I helped author on radicalabolitionist.org.

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