One size fits all?

It’s only very recently that we, as mental health service users
andsurvivors, have begun to think of ourselves in terms of our
rights, rather than just of what’s “wrong” with us. Yet we have
long faced high levels of discrimination and stigma. This may be as
a background to our lives, with language like “nutters”, “mad” and
“crazy” endemic in popular culture, from kids’ TV onwards. More
directly, it means strange looks when people find out about us and
massive barriers restricting access to and opportunities in
employment. Mental health service users are the group of disabled
people with the highest level of exclusion from the labour market.
The pressure for legislation extending compulsion and further
restricting mental health service users’ rights is only likely to
make this worse.

To challenge and give focus to this discrimination, the Disability
Rights Commission set up a mental health action group, made up of a
majority of mental health service users, which in turn set up an
action group of people with learning difficulties. Mental health
service users have often been marginalised in the world of
disability. There can be no doubt there are hierarchies here, as
there are in other aspects of life. But there is now also no doubt
that mental health service users are recognising their links with
other disabled people and beginning to benefit from the increasing
strength that comes from unity. The extended provisions of
disability discrimination legislation and the support that the
Disability Rights Commission is giving to the rights and interests
of mental health service users are making a difference.

This is doubtless why many mental health service users and other
disabled people have very mixed feelings about the replacement of
existing equality bodies with a single, unified Commission for
Equality and Human Rights.

Disability has always come bottom of the pile. There are widespread
fears among health and social care service users that this will
continue to be the case and without an organisation dedicated to
dealing with disability discrimination, it will again be at risk of
falling off the agenda.

But there’s a problem with this argument too. Few of us fit neatly
into any single box. We are rarely only one thing or another. Our
identity may include many different strands of experience in
complex relationships with each other, relating to age, gender,
race, sexuality, ethnicity, class, culture and disability.

Independent disability consultant Jenny Morris has, for example,
been critical of simplistic attempts to reduce the identity of a
disabled woman to a matter of “double disadvantage” or to assess
which oppression is “worse”. Ayesha Vernon, in a research study she
undertook as a black disabled woman¹, writes: “Disabled
black and ethnic minority women experience a multiplicity of
barriers resulting from the combination of disablism, racism and
sexism.” As one of the participants in her study, Anita, says: “It
happens singularly, plurally and multiply, and it’s the totality
that counts at the end of the day. You are thought of as completely
inferior because you are all three things.”

That’s what gives a unified rights body such liberatory potential.
But there’s a tension here, which can never be discounted, between
what might work best in theory to safeguard our rights and needs,
and how structures and organisations actually work in practice –
their own internal logic. Many members of the disabled people’s
movement never set much store in equality bodies as a means of
safeguarding rights. Instead, they argued for the proper resourcing
of disabled people’s own organisations.

In a complex context of institutionalised discrimination, just
setting up one body to address all rights and needs is unlikely to
ensure they are all addressed with equality and equity. Such a body
has first to transcend dominant values. Mental health service users
learned long ago what a difficult journey this can be for existing
institutions. The rejection of disability discrimination and
“mentalism”, both in its own working as well as in society
generally, must be written into the heart of the new equalities
body. It must also be reflected in proper, dedicated resourcing,
the recruitment of sufficient (disabled) staff, and specific
priorities to take forward work to safeguard the human and civil
rights of disabled people. Only then will it truly be “fit for
purpose”.

¹ Ayesha Vernon, “A stranger in many camps:
The experience of disabled black and ethnic minority women”, in
Encounters With Strangers: Feminism and Disability, Jenny
Morris (editor), Women’s Press, 1996

Peter Beresford is professor of social policy, Brunel University,
and is actively involved in the psychiatric system survivor
movement.