Infrahuman madness: Mental health nursing and the discursive production of alterity

Abstract

By examining an exemplar sample of mental health nursing educational policies and related legislation, in this article, we trace the discursive production of madness as an “othered” identity category. We engage in a critical discourse analysis of mental health nursing education in Canada, drawing on provincial and federal policies and legislation as the main sources of data. Theoretically framed by critical posthumanism and mad studies, this article outlines how the mad subjectivity becomes decontextualized out of its identity‐based understanding and recontextualized as an inferior category of “the human,” circulating within discourses of pedagogy, economics, law, and psychiatry. The article maps the intertextual nexus of the discourse of mental health nursing education, making visible the complex, the arbitrary, and the sometimes‐contradictory nature of the discipline's grappling with identity‐based mental health concepts. We close with several implications for nursing policy, education, and practice.

Critical ethnography and its others: Entanglement of matter/meaning/madness

“…Madness was not articulated as a standalone and nominalized state of existence, but rather as an assemblage emerging from various marginality‐producing practices. Elsewhere, we have demonstrated the discursive construction of this sort of infrahuman identity, generated at the intersections of nursing education and humanist‐based mental health discourse (Adam et al, 2022). What this current study adds, beyond the understanding of how problematic identities are superimposed, is how the research process itself can be a site for the reproduction of marginality and alterity, particularly for those who do not/refuse to fit into Cartesian‐Kantian humanist geometries.…”

“…Recently, critical posthumanism has become a burgeoning area in nursing scholarship, with a number of critical works emerging from such topics as environmental/indigenous studies (Adam et al, 2021), antiracism and decolonial studies (Dillard‐Wright et al, 2020), mad studies (Adam et al, 2022), neoliberal critiques (Dillard‐Wright & Shields‐Haas, 2021), and nursing burnout (Smith et al, 2022), for example.…”

“…Based on the current ontological orientations of critical ethnography, we posit that it furnishes opportunities for epistemic violence by drawing boundaries around those who can be researched and those who cannot. As such, it risks the exclusion of whole segments of people and communities whose knowledge/ ability to produce knowledge is assigned a nonstatus or the status of the "infrahuman" (Adam et al, 2022), which results in systematic silencing and/or indifference by the hegemonic other.…”

Sanism

“…Today, sanism is often the focus of people working in the scholarly fields of mad studies, disability studies, disability justice, abolition studies, and increasingly in the health and care fields. [9][10][11][12] So, what does this have to do with you? Maybe you've been told that you don't know what you're talking about or that you're "crazy" or "unwell."…”

“…It is so normalized that it has become part of some so-called best practices. Today, sanism is often the focus of people working in the scholarly fields of mad studies, disability studies, disability justice, abolition studies, and increasingly in the health and care fields 9-12…”