Bill 67: Criticism of the Medicalization of Social Issues
The College of Physicians and the Order of Pharmacists see the promise of easier access to mental health care. The same goes for guidance counselors, clinical nurses, psychologists, sexologists, and speech therapists.
Last week, Quebec’s Minister responsible for government administration and president of the Treasury Board, Sonia Lebel, introduced Bill 67. If passed, it would expand the powers of these professionals in the health and social services network. Many of them could now diagnose certain mental disorders without consulting a doctor beforehand.
The idea may seem perfect on paper to address waiting lists. However, my discomfort is full and complete. While a psychiatric diagnosis can facilitate access to medication, it is often used to discredit and gaslight those who receive it. Paradoxically, this also happens in spaces where we strive to “help the community.”
A double-edged weapon
A recent study, led by social work professor Katharine Larose-Hébert at TELUQ, documented a common phenomenon: the excessive pathologization of women who have survived violence. Those who are disproportionately labeled as having borderline personality disorder under a blatant sexism.
The anger of women is seen as a flaw to be eliminated at all costs, rather than the most advanced form of self-love, a way of saying “I am someone and you have no right to treat me like this.”
Céline Lamy also alerts to the epidemic of diagnoses of attention deficit hyperactivity disorder (ADHD). In her recent essay, “The Tragedy of Perfect Children,” the experienced child psychiatrist hits the mark from the start, with a heartfelt dedication to children, the whistleblowers “who, through their discomfort, symptoms, agitation, and perpetual movements, unconsciously denounce a system supposed to help them grow.”
Moreover, last month, La Presse reported the observations of key players in the field who noticed a not surprising correlation between the housing crisis and the reasons why many seek psychiatric help.
Politizing distress
Far be it from me to deny the existence of mental illnesses. Diagnostic wandering, not knowing the name of the affliction, can lead to real distress.
However, it is crucial to question this casual discourse, which allows ordinary individuals to become psychiatric experts after skimming through the DSM-IV pages and reading some bogus psychopop articles found on the internet.
Labeling a person to avoid the “trouble” of listening to them is tempting in our fast-paced world. The interplay of this denial of humanity with the increasingly suffocating demands of capitalism is clear.
We must also address this double standard stigmatization. The way anxiety and depression are not considered on the same level as schizophrenia, the latter being deemed more “serious.”
Or the rain of misdiagnoses. Autistics mistaken for bipolar individuals. Gifted individuals overlooked by school and home. Being gifted is at best a “luck” and at worst an elitist trait in the kingdom of “born with a silver spoon.”
Yet, it is hard to imagine the burden borne by those who understand without being understood in return. Quickly prescribing pills to all those who break societal norms as the sole solution to their problems is more economical in time and energy.
Add to that a layer of racism or a lack of money hindering the ability to be properly evaluated, and the picture becomes more complicated. Piecing together the puzzle to see clearly is a perilous task, even for the most eminent specialists, due to a lack of training.
Adapting to a sick environment
Some behaviors perceived as pathological demonstrate a person’s sanity. The intensity of a person’s emotions can also be proportional to the harm they have suffered.
Unfortunately, when unable to adapt to a toxic environment, one becomes the problem. How many organizations lose all their best players one after the other, without ever reflecting on their leadership and internal culture? When everyone abandons ship, perhaps it is the ship itself that needs repairing before it sinks.
In conclusion, as a social worker, I see many blind spots in Bill 67, in what it says, but especially in what it does not say.
Failing to address human distress holistically, any attempt to heal the mental ills of Quebecers will be as effective as a drop in the ocean.
The road to hell is paved with good intentions. Concerns should be raised about the thunderous applause burying any critical perspective following this announcement by Minister LeBel.