Epistemic injustice in psychiatry

Crichton, Paul; Carel, Havi; Kidd, Ian James

doi:10.1192/pb.bp.115.050682

Cited by 169 publications

(146 citation statements)

References 15 publications

(14 reference statements)

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“…It is exacerbated by the framing of ME/CFS as a psychiatric problem. This is more than just an 'additive' process where people with ME/CFS face multiple forms of epistemic disadvantage -illness (Carel and Kidd 2014); medically unexplained symptoms (Blease et al (2016a); and 'mental illness' (Crichton et al 2017). It may be that psychiatric-specific injustice operates as the 'trump card' in the pack.…”

Section: Me/cfs and Epistemic Injusticementioning

confidence: 99%

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Contesting the psychiatric framing of ME/CFS

Spandler

Allen²

2017

Soc Theory Health

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ME/CFS is a medically contested illness and its understanding, framing and treatment has been the subject of heated debate. This paper specifically examines why framing the condition as a psychiatric issue-what we refer to as 'psychiatrisation'-has been so heavily contested by patients and activists. We argue that this contestation isn't simply about stigmatising mental health conditions, as some have suggested, but relates to how people diagnosed with mental illness are treated in society, psychiatry and the law. We highlight the potentially harmful consequences of psychiatrisation which can lead to people's experiential knowledge being discredited. This stems, in part, from a psychiatric-specific form of epistemic injustice which can result in unhelpful, unwanted and forced treatments. This understanding helps explain why the psychiatrisation of ME/CFS has become the focus of such bitter debate and why psychiatry itself has become such a significant 'field of contention', for both ME/CFS patients and mental health service users/survivors. Notwithstanding important differences, both reject the way psychiatry denies patient explanations and understandings, and therefore share a collective struggle for justice and legitimation. Reasons why this shared struggle has not resulted in alliances between ME and mental health activists are noted.

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Section: Me/cfs and Epistemic Injusticementioning

confidence: 99%

“…concept of 'epistemic injustice' to illness experience(Kidd and Carel 2016;Wardrope 2015), including ME/CFS(Blease et al 2016) and also 'mental illness'(Liegghio 2013;Crichton 2016). Epistemic injustice refers to the systematic discrediting of oppressed people's knowledge claims about their own experience.…”

mentioning

confidence: 99%

Contesting the psychiatric framing of ME/CFS

Spandler

Allen²

2017

Soc Theory Health

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“…To this effect, the significant gap observed between patients' reports of various types of bodily symptoms and illnesses, on the one hand, and etiopathogenetic theories and clinical diagnoses, on the other, is particularly concerning (Sestito et al 2017), given the influence of neurological reductionism and concurrent promissory rhetorics of recovery in approaches to mental illness, to the detriment of patient experiences and priorities (Reardon 2014). This disparity between patient reports and medical theories also maps onto larger ethical and epistemic concerns about the place given to the voices and experiences of those immediately affected by illness in medical discourse and the perceived legitimacy of their claims to suffering (Crichton, Carel, and Kidd 2017;Carel 2017, 2018). More generally, this gap undermines the richness of our understanding of mental illness and the quality of our ways of attending to it (for example, through institutionalized care).…”

Section: A Feminist Phenomenology Of Illnessmentioning

confidence: 99%

Being at Home: A Feminist Phenomenology of Disorientation in Illness

Lajoie¹

2019

Hypatia

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This article explores the relation among illness, home, and belonging. Through a feminist phenomenological framework, I describe the disorientations of being diagnosed with borderline personality disorder (BPD) and living with mental illness. This research anticipates the consequences of illness and serious (bodily) disorientations for a conception of belonging as seamless body–world compatibility. Instead, this article examines how the (in)stability of bodily dwellings in experiences of disorientation can suggest ways of being in the world that are more attentive to interdependency, unpredictability, and change in human experience. I argue that these types of dwellings function as a more capacious and apposite metaphor to account for variations in belonging. This discussion outlines the ethical importance of building worlds that make room for different ways of being at home in and through our interactions with others. Although my discussion does not supply norms for ethical action, I contend that a feminist phenomenology of illness generates saliences and illuminates sensibilities that can transform our ways of being with others.

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“…We have been involved in various mental health movements, predominantly as allies of psychiatric survivors/service users, and have reflected upon the value of such conjoint activism (e.g. Cresswell and Spandler 2013;McKeown et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Exploring the case for truth and reconciliation in mental health services

Spandler

McKeown

2017

MHRJ

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Purpose The purpose of this paper is to explore the case for a truth and reconciliation (T&R) process in the context of mental health services. Design/methodology/approach The approach is a conceptual review of T&R approaches; a consideration of why they are important; and how they might be applied in the context of mental health services and psychiatry. First, the paper sets out a case for T&R in psychiatry, giving some recent examples of how this might work in practice. Then it outlines potential objections which complicate any simplistic adoption of T&R in this context. Findings In the absence of an officially sanctioned T&R process a grassroots reparative initiative in mental health services may be an innovative bottom-up approach to transitional justice. This would bring together service users, survivors and refusers of services, with staff who work/ed in them, to begin the work of healing the hurtful effects of experiences in the system. Originality/value This is the first paper in a peer-reviewed journal to explore the case for T&R in mental health services. The authors describe an innovative T&R process as an important transitional step towards accomplishing reparation and justice by acknowledging the breadth and depth of service user and survivor grievances. This may be a precondition for effective alliances between workers and service users/survivors. As a result, new forms of dialogic communication and horizontal democracy might emerge that could sustain future alliances and prefigure the social relations necessary for more humane mental health services.

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Epistemic injustice in psychiatry

Cited by 169 publications

References 15 publications

Contesting the psychiatric framing of ME/CFS

Contesting the psychiatric framing of ME/CFS

Being at Home: A Feminist Phenomenology of Disorientation in Illness

Exploring the case for truth and reconciliation in mental health services

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