Care As Disability Justice: Reimagining Dignity in Mental Health

Syllabus: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

Lived Experiences and Nature of Suffering

  • Personal narratives reveal deep emotional pain that numerical data rarely communicate.
  • Individuals display varied responses to distress shaped by context, history and belief systems.
  • Ignoring these narratives minimizes discourse on barriers, attitudes and inadequate care systems.
  • Harmful experiences, including childhood neglect and abusive psychiatric practices, highlight systemic failures.

Problems with Dominant Approaches

  • Psychosocial disability is often framed through a deficit lens, focusing on forced community integration.
  • Such approaches promote narrow notions of “normalcy” and productivity, leaving social structures unquestioned.
  • Global mental health-care gaps remain extremely high, ranging between 70%–90%.
  • Despite new medicines and therapies, core issues surrounding dignity and justice remain unresolved.

Reimagining Mental Health Care

  • Authors argue for mental health care centred on dignity, equity and disability justice.
  • Care must accompany individuals through relational, material and structural suffering.
  • It involves supporting meaning-making, responding to adverse events and meeting needs for safety and relationships.
  • Real solutions require asking what societal conditions create such suffering and how personalisation can scale.

Intersections of Distress and Social Context

  • Material and relational deprivation often remains unaddressed, worsening mental ill-health.
  • NCRB data show one-third suicides linked to family issues and one-tenth to relational ruptures.
  • Distress is influenced by biological, psychological, social, cultural, political and historical factors.
  • These elements intersect with caste, class, gender and queer identities, shaping both suffering and access to care.

Rethinking Care Practices

  • People in crisis require space to explore existential uncertainties and emotional pain.
  • Biological and social determinant models often suppress these deeper dimensions of well-being.
  • Tangible support like housing or income cannot substitute connection and meaning.
  • Care must include relational work, addressing vulnerabilities, purpose and coherence within social-ecological contexts.

Towards Relational Justice

  • Transforming care requires solidarity, dialogic practice and recognition of non-linear outcomes.
  • Justice involves asking whether systems centre dignity and address root injustices causing harm.
  • Effective care depends on trust-building to prevent despair, withdrawal and homelessness.

Reforming Education and Research

  • Mental health education must teach practitioners to handle uncertainty, complexity and small progress.
  • Research should prioritise granular, real-world processes over purely large-scale findings.
  • People with lived experience must be recognised as practitioners with community wisdom and compensated accordingly.

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