Why talk of illness entrenches discrimination

Abstract

Purpose – Biological understandings of mental illness are promoted by both anti-stigma campaigners and increasingly by activists protesting against social security cuts. The purpose of this paper is to analyse the pitfalls of the “illness” conceptualisation for reducing discrimination, comments on divisions between those arguing for a right to work and those who seek a right not to work, and proposes bridge building and more effective messages, drawing on the UN Convention on the Rights of Persons with Disabilities. Design/methodology/approach – Review of relevant evidence on the effectiveness or lack of it of the “mental illness is an illness like any other” message in anti-stigma work, and discussion of grey literature from campaigners and bloggers. Findings – There is a growing body of evidence that the “illness like any other” message entrenches rather than reduces stigma and discrimination: this message should not be used in anti-discrimination work. At the same time some social security bloggers and campaigners have argued they are “sick” in order to resist efforts to compel them to seek work or face sanctions; whilst older disability rights campaigners have argued for the right to work. The paper argues for new bridge building and use of evidence based messages in campaigning. Research limitations/implications – This paper is based on review of evidence on the impact of using the “illness” message to reduce stigma and discrimination; and on discussion of campaigns and blogs. It is not based on a systematic review of campaigns. Practical implications – There is a need for campaigns that support rights holistically – the right to a decent standard of living and the right to work. This requires bridge building between activists, which could usefully be rooted in the UN Convention on the Rights of Persons with Disabilities. The “illness” conceptualisation is harmful to the effort to reduce stigma and discrimination. Mental health staff can act as allies to those they serve in securing all these rights. Originality/value – This is the only recent paper to analyse the evidence that the “illness like any other” message is harmful in anti-stigma work, together with its implications for the recent phenomenon of mental health campaigners moving from opposition to the medical model, to a new argument that they are “too sick” to work. This paper suggests ways forward for everyone with an interest in combatting stigma and discrimination.