Paper short abstract:

This paper examines the role of psychiatric diagnoses in the moral project of making a good life.

Paper long abstract:

Based on fieldwork in Sydney, this paper examines the lived experiences on the boundaries of psychiatric diagnoses. Through an engagement with parents of "difficult" children - those who are neither considered normal, nor officially diagnosed - I have explored the role of diagnoses in the moral projects of making a good life.

In Australia, as in many other Western countries, we have seen an increased attention to mental health issues in recent years. This focus has almost exclusively been the domain of psychology and psychiatry. This paper argues that anthropology has important contributions to make in order to understand the broader cultural and socio-political context of mental illness and mental health. Taking the stance that we are both embodied and embrained in particular social and historical contexts, I examine how a neoliberal vocabulary, comingled with a psychiatric idiom of distress, is stitched into the fabric of everyday family life, reorienting the family towards a particular ideal of the good life. By sketching the challenges these families face, this paper grapples with the question of how the mechanisms of help are entangled with the same neoliberal regimes of truth which may be producing the suffering.

Paper short abstract:

This paper will explore the tensions between the biological reality and the social construction of autism. This paper will also explore the some of the tensions within and between the neurodiversity community, the public mainstream and academic perspectives.

Paper long abstract:

This paper will explore the tensions between the biological reality and the social construction of autism. With more knowledge being circulated about autism spectrum conditions comes with more complicated and nuanced understandings of what autism is and what it isn't. There has been an increase from the neurodiversity movement resisting against deficit understandings of the condition while at the same time there is an increased demand that the general public make more accommodations and recognise autism as a disability. These aspects do not work in conflict with one another but they have created more difficult and often contradictory conversations regarding neurodiversity.

Ian Hacking's (1999) "looping effect" has been an effective concept in making sense of these biological and social construction tensions. The "looping effect" has been specifically useful in understanding how the definitions of autism continually affect the autism population and how the autism population in turn also affects the definitions of autism. Because of the changing nature of definitions and classifications, diagnosing autism spectrum conditions is still not a simple and straightforward process. This paper ultimately concludes that because of the increased knowledge and understanding of the autism spectrum, there is space to be having those difficult conversations regarding what makes up an autistic identity in ways that are productive and that do not further harm to the autistic population.

Paper short abstract:

Stigma is one of the 'grand challenges' for the global mental health movement. Interventions in India coming out of psychiatry and public health focus on community education with limited success. What innovative approaches can anthropology contribute to these efforts?

Paper long abstract:

Addressing mental illness stigma is described as one of the 'grand challenges' for the global mental health movement. Amplifying the suffering of the mentally ill and hampering their treatment and recovery, stigma also bleeds into the lives of those around them. Interventions coming out of psychiatry and public health have focused on community education and have had limited success in alleviating the suffering people with mental illness in India. Anthropological and sociological approaches emphasise a theorisation of stigma that it is located in the social to grapple with the moral processes that underpin stigma, and how institutional and structural power can stigmatise and marginalise individuals.

In this paper we use the framework of moral experience to inquire what is at stake in mental illness for individuals, their families, and communities. Focusing on mental illness stigma in India and approaches taken thus far to address it, we ask how an understanding of what matters most in the local worlds of both the stimatised and stigmatisers can be of value in efforts to support the recovery of people with mental illness. How can anthropology's ability to illuminate and hold the complex and messy in view make concrete contributions to public health interventions focused on one-dimensional, simple solutions? What innovative approaches to addressing mental illness stigma can anthropology contribute to the global mental health movement?

Paper short abstract:

Psychiatry holds in high regard measuring the unmeasurable. To eradicate the stigma that such measurements perpetuate, this paper aims to break through the glass ceiling to enable the silenced to be heard, better understood and empowered, manifested through text. This is the Silenced Manifesto.

Paper long abstract:

This paper takes the form of an anthropological study of mental health. Specifically, my autoethnography of living with schizoaffective disorder.

I have been labelled as a lesser citizen, lesser human and a social misfit. This labelling is part of the culture and values which encompass it. There is a continuing medical culture of measurement, which seems to justify values and an ethos which disempowers those living with a major psychotic illness.

I explore the experience of being tested and measured. I explore how biomedicine has the capacity to stigmatise and de-humanise people living with mental health conditions, but also how difficult it is to resist the definitions and labels imposed upon me; how mental health is textualised.

In a sense, biomedicine tries to measure the unmeasurable, and use crafted measurements to define and confine subjects, as in the mentally ill, often inappropriately and over-zealously.

By looking at the ways I have been labelled, and by understanding that labelling as a function of the scientific culture that crafts it and the social culture that validates it, I examine this hypothesis: that psychiatric science rests on a self-vindicating ethos of clinical measurement and consequent labelling which perpetuates mental illness.

This paper sets out to break through the glass ceiling and straight jacket of labelling, to enable the silenced to be heard, better understood and empowered, manifested mainly through text and otherwise. This is here called the Silenced Manifesto.

Paper short abstract:

Drawing on various ethnographic and sociological works dealing with self-injury, dementia and sex addiction, the present paper proposes a critique and a reshaping of the concept of medicalization.

Paper long abstract:

The concept of medicalization has been useful in the toolbox of sociologists and anthropologists of mental health, especially as it effectively de-naturalizes the categories people experience as describing their problems, in tying these categories to their historical conditions of production.

However, now that many works have critically addressed the historically situated construction of manifold medical categories, the concept of medicalization requires to be questioned and refined. First, the initial formulation of this concept does not encompass the practical activities through which something is medicalized. Second, it does not allow understanding how labels change what people "are." Third, processes of medicalization, as depicted in the literature, set aside several crucial dimensions of social life, such as the social conditions under which a given category "works" or not, the actual configuration of stakeholders involved in the diffusion of a category, and what people do with the "existential residue," that is, what remains not-labelled by the medicalization process. To tackle these issues, drawing on various ethnographic and sociological works dealing with self-injury, dementia and sex addiction, the present paper aims at proposing a reshaping of the concept of medicalization.

Paper short abstract:

This paper examines how the constructions of and responses to deviance by the moderators in online support spaces can potentially frame to the forum-goer the discourses - both health and non-health related - they employ in these spaces.

Paper long abstract:

A typical image of the forum-goer that emerges from the literature of online support spaces is one that is free in their expression, articulating their own ideas and empowered in their approach to their health, due to the 'democratic imperative of the internet' (Light 2001 p.1179). However, forum-goers are coerced in the discourse they employ, becoming prompted, rewarded and criticised for their performance online. This paper addresses the production of rhetoric in online support spaces. Using a case study of pro-recovery eating disorder forums, I analyse how the activities of moderation as well as the selection process and expectations of moderators shape the forum-goers' discourses. Ultimately, this analysis unveils an aspect of the backstage discourse production of the narratives that appear on these forums, raising questions around the effect this production has on the forum-goer construction of their narrative on themselves, part of their subjectivity.

Paper short abstract:

Drawing on a case study of young New Zealanders’ uses of health apps and other digital technologies, this paper examines changing understandings and enactments of responsibility for mental wellbeing.

Paper long abstract:

Questions of how to best harness digital technologies for promoting

mental health have become a hotbed of governmental, health policy and

social debate. Campaigns for optimizing digital healthcare generally

focus on promoting patient responsibilization or self-responsibility,

emphasizing encouraging the development of more informed patients who

draw on digital resources as part of self-care strategies, deepening and

expanding their health-related knowledge as well as enabling easy forms

of self-tracking. Arguably, however, while “self-care” often involves

the promotion of patient self-responsibility, it simultaneously

foregrounds other modes of ethical engagement, such as care for, or

from, (known and unknown) others and concerns over states’ and

corporations’ responsibilities for ensuring mental wellbeing. Indeed,

the broader literature on responsibility suggests that rather than an

overriding emphasis on personal responsibility, advanced liberal

societies create a much more fertile and contested ground upon which

multiple, “competing responsibilities” can flourish. Digital

technologies, moreover, add additional layers to how responsibility is

enacted, reshaping experiences of time and space by enabling new forms

of continuous, or seemingly continuous, person-person and

person-technology relations, and consequently refracting users’ sense of

where agency lies (i.e. in themselves, in their relations with (human)

others, or in technologies themselves). Drawing on a case study of a

newly emerging ethics of care that is being developed through young New

Zealanders’ uses of health apps and other digital technologies for

promoting mental health, this paper examines how interpersonal dynamics,

human-technology relations, and questions of agency are recasting

understandings and enactments of responsibility for mental wellbeing.

Paper short abstract:

This presentation focuses on the recovery trajectory of those whom have previously been diagnosed with depression.

Paper long abstract:

The psychological and sociological literature regarding depression have largely neglected the study of individuals whom have recovered from it. These individuals, or "recovered depressives", remain voiceless within a climate which prematurely forecasts mental illness as something inevitably protracted and, in many cases, incurable. In order to ascertain the perspective of this group, audio-recorded, semi-structured interviews were conducted with twenty university students who had not only sought treatment by a psychologist for either "depression" or "depressive symptoms", but who also currently self-identify as having "recovered". The interviews were transcribed verbatim, and an abductive, grounded-theory methodology was applied to analyse them. Based on this analysis, the author contends that the interviews reveal a particular sequence that the majority of participants underwent before arriving at the time-point at which they self-identified as "recovered" - a sequence that is termed "The Recovery Arc". Through applying a theoretical lens that synthesises Bourdieu, Archer, and Ravaisson, the author aims to show that "recovery" is largely the product of socialisation, where "being recovered" is a habit(us) that emerges through repetition: of either the modality of reflexivity one has been socialised into at prior moments, or the modality of reflexivity one has been externally provoked into adopting.