The psychiatrization

The psychiatrization of our children, or, an autoethnographic narrative of perpetuating First Nations genocide through ‘benevolent’ institutions

Specializing in children’s rights and childhood studies, Dr. Brenda LeFrançois has conducted research on the rights of psychiatrized children and young people within inpatient mental health services. As an academic and social activist, she has been working on disrupting sanism, and applying queer theory to psychiatric diagnosis and practice, to contribute to the emergent field of mad studies.

the autoethnographic ‘I’ is queered and is reflexively positioned, with the potential to allow me to become someone new through the writing of the story. Like queer theory, autoethnography understands identities to be fluid not fixed, to be in flux not static, to be open to interpretation rather than to contain closed definitions, to be uncertain and unstable. […] with the ultimate goal of producing social change. And so, ‘I’ write this story, to challenge myself and to challenge you,

I have lived periods of so-called ‘tomboyishness’, and I have been intensely feminine; I am both a lapsed Catholic and a lost Jew; I cherish my working classy-ness, but the discourses associated with my education, employment status, and salary level have mapped my body as elite

I have known hunger and gluttony; I have eaten out of the garbage, and I have been served seven-course meals lit up by perfectly polished silver candelabras, with port, cigars, and chocolate to follow, at Cambridge University.

Regardless, nothing fits; nothing is fixed. Except that I am white. I am a white colonizer. It is clear I am white, until we undo and do away with whiteness. It is clear I am white, until we do away with racism. …but I must nonetheless acknowledge my complicity in the power, pain, and privilege that the white community has produced—the power, pain, and privilege that I have produced and reproduced.

It is 1992, 9 a.m., Monday morning. I sit at the table, upstairs where the meetings are held. This building where we divvy out cases and make decisions regarding the protection ‘needs’ of children in our community (again, whose community?).

I am waiting for the others to come to the table. I wonder if I will speak or remain silent. When I speak, we argue. I am seen as young, silly, belligerent, argumentative, wrong. I am mostly silent because they hate when I talk, when I have an opinion; they hate me. They don’t know who I am. I don’t belong on this social work team; I (don’t) want to belong. I wonder how I will pay the bills if my contract is not renewed. I wonder how I can keep doing this job, if my contract is renewed.

The others arrive. Three intakes came in over the weekend. “Who is next on the list to take on a new case?” “Brenda. Anabel. Nathalie.” Great. The intakes are discussed. I am handed an easy one; a mother is requesting support for what has been categorized as a ‘parent–child conflict’ by the after-hours intake worker. “Wait a minute. Is ‘mom’ the same person that I had in care when she was a child? … It sounds like her … I know her. Brenda, I’ll come with you on this one.”

She will teach me how it is all supposed to be done and I will be grateful, returning to the office to submit my notes, tidy up the file, and either put into place the intervention she has determined best or close the file. I am bitter because she sees me as silly and young; I am bitter because she criticizes me to others on the team, but never openly.

Understanding the history of the systemic abuse and violent oppression of Indigenous people at the hands of an inherently racist/colonialist child protection system […] is important in order to contextualize this referral. The referral was made by a mother who was scooped as a child, amongst so many others, in what is now commonly referred to as the “Sixties Scoop”.

From the mid-1950s until the early 1970s, Indigenous children were taken from their communities in an alarmingly high rate and placed in (mostly) white foster homes; buses were sent to reserves and were filled with the children from these communities. Not surprisingly, this was experienced as traumatizing for children, parents, extended family, and community members alike. For the first time, Indigenous children were over-represented in the child welfare system in Canada and continue to be overrepresented today (Walmsley, 2009). There is little evidence that individual (white) social workers resisted or challenged the policy to massively remove Indigenous children during the Sixties Scoop,

Neckoway (2011) contends that the parenting practices of First Nations people, and in particular of the Anishnaabek people, has been profoundly impacted by the mass removal of children from their homes and communities. This removal into white foster homes and residential schools ensured that these children would not learn cultural approaches to parenting, which would have been modeled for them if they had remained in their communities.

This loss of traditional knowledge and culturally appropriate role models reinforces the white agenda of assimilation within the logic of genocide. As such, it is not surprising that during a difficult time in parenting, this mother turned to the agency that was directly responsible for her own upbringing; even if the experiences were violent and traumatizing for her, white child welfare knowledge remained speakable, knowable, and accessible to her.

We arrive on the reserve and find ‘mom’s’ house. This is not a pre-booked appointment because ‘mom’ does not have a telephone. There are no steps to walk up to the front door, making the door unusable; instead, we walk around the back of the house, nervously negotiating gentle contact with the unchained dog when ‘mom’ opens the back door. Jennifer explains who we are and reminds her that she was her social worker fifteen years ago when she was in care. ‘Mom’ says she remembers. There is no pouring forth of emotion, like what you may see between friends or family members who have not seen each other for many years. There is no emotion, yet.

‘Mom’ tells us about her daughter, Terra. Terra is fourteen and has been hanging out with a group of friends on the reserve. ‘Mom’ is concerned that she is smoking pot, drinking, and having sex. She is out with them three to four times a week. She is wondering if we have any advice we can give her. ‘Mom’ wants to know what she can do to stop her daughter from acting like this.

Jennifer validates ‘mom’s’ concerns and notes the risks associated with substance (ab)use and (unprotected) teen sex. Jennifer suggests that there is a very good drug and alcohol detox center in a nearby province, with a program for Native children, which we could get her admitted into. However, because she is fourteen she would have to consent to be admitted. ‘Mom’ says there is no way that Terra will agree to be admitted

“Well, in that case, your other option is to put her in the car on a Saturday, don’t tell her where you are going, and drive down stateside. There is an adolescent psychiatric hospital across the border where you can admit her.” Jennifer explains further that in the USA all that is needed is parental consent and that, in addition, the Canadian government will pay for Terra’s treatment because she is Aboriginal.

There are three different types of rights embedded in the United Nations Convention on the Rights of the Child (CRC). These include the right to protection, the right to the provision of services, and the right to participate. The USA is the only country in the world, bar Somalia, which has not ratified the CRC. As such, the treatment of Canadian children in institutions in the USA is questionable and opens the door to the experience of increased rights abuses, particularly for Indigenous children who live within the Canadian border but are incarcerated in psychiatric hospitals in the USA.

With the ongoing expansion of diagnostic categories within revised versions of the Diagnostic and Statistical Manual of Mental Disorders, the increased influence of pharmaceutical companies as state-sanctioned drug pushers, and the proliferation of (white) biomedical psychiatry around the world, we are all being psychiatrized at alarming rates, both children and adults alike (Menzies, LeFrançois, and Reaume, 2013). The widespread intergenerational trauma experienced by Indigenous peoples due to the legacy of colonialism, often leads to the psychiatrization of their distress

The pathologizing of Indigenous peoples, perceiving them as social problems, is rampant in the general public as well as within ‘benevolent’ institutions (Jeffery, 2009). Moreover, children who are unable or refuse to conform to comfortable adult-defined normative behaviour are increasingly psychiatrized in order to reinstate adult control (LeFrançois, 2013a).

In this story, the assessment of Terra as in need of psychiatric inpatient treatment speaks to the ways in which the assessment judged her behaviour by the middle-class norms of appropriate behaviour for girls.

An intersectionality analysis (Crenshaw, 1991) […] allows us to see the ways in which normative notions of race, gender, class, sexuality, and age, reproduce each other creating a space ripe for psychiatrization. The gendered nature of the assessment is evident, because whilst ‘boys will be boys’, girls can get pregnant.

And yet, hanging out, drinking, having sex, and smoking pot at that age may be consistent with the culture of many children…

An inherent assumption within the assessment was the notion that the sex was unprotected and that the consumption of drugs and alcohol was excessive, which plays in to the stereotypes of the wild, partying, sexually promiscuous ‘Indian’ girl. Yet, being institutionalized for drinking, smoking pot, and having sex becomes a punishment for behaving like many other adolescents.

Even if the behaviour was ‘excessive’—which was never even inquired about—and the child was experiencing distress, firsthand accounts of incarceration within child psychiatric hospitals in the USA, like elsewhere, tell stories of enduring abuse, fear, alienation, violence, and increased distress (Michener, 1998) rather than of being offered support for trauma and emotional/spiritual renewal.

I am compelled by Chapman (Chapman, 2010) to point to the ways in which the culture of care within ‘benevolent’ social work institutions for children (be that within ‘mental health care’, foster ‘care’, or other types of residential ‘care’) are saturated with the discourses of ‘care’ whilst enacting the most coercive, inhumane, and violent forms of treatment, all contrary to social work ethics.

Not only do the systems together serve to pathologize typical adolescent behaviour, by calling it deviant (in assessments that are clearly classed, raced, and gendered), but when children are experiencing trauma as the result of abuse, that trauma is decontextualized and viewed as symptomatic of mental illness and a result of an individual’s biochemical imbalance, rather than as a result of a violent society. As such, child protection agencies and child psychiatry may act together as two powerful (white) institutions that feed off each other’s

In narrating this story from my past, I am reminded of other stories, other lived experiences from a further past, that intertwine with this one. I am reminded of witnessing others being psychiatrized around me. I am reminded of the way in which psychiatric discourse has intricately framed my existence, through witnessing the psychiatrization of people close to me, from a very young age; I am reminded of the way in which psychiatric discourse intricately framed my existence, even before I was born.

we are 150 kilometers away. I must speak, there is so little time; I must speak now. I look at Jennifer; I look at ‘mom’. I must speak, there is so little time. My partner is unemployed; how can I let myself lose this job here and now? How can I stay silent, when it has never been so important to speak? There is so little time; I must speak. Yet, I feel the moment flicker, “and in short, I was afraid” (Eliot, 1917).

But then ‘mom’ doesn’t ‘need’ me to speak, does she? She changes everything, herself. She says, first slowly: “But Terra isn’t crazy, Terra isn’t a drug addict or an alcoholic; she is just hanging out with her friends on the reserve and getting into trouble.” “I don’t want her to get into trouble anymore but …” ‘Mom’ continues to inform Jennifer and me that she would never do anything to disrespect her daughter; she would not lie to her. She would never kidnap her daughter and admit her into a mental hospital against her will. She is getting angry now, talking faster. She is questioning what kind of help we have on offer. She is questioning our ethics, our humanity, our personal and professional integrity. She orders us to leave her home; she wants us out now, out of her life now.

In understanding Jennifer’s words as racist, as personal prejudice, I ignore the insidious existence of deeply embedded structural racism, I ignore the insidious existence of institutional whiteness in child welfare and child psychiatry, I ignore the insidious existence of white supremacy constructed through institutional discourses of “Indian as deficit” and “Native alcoholism,” (Tam, 2013) and I ignore the insidious existence of relational whiteness in our interactions (Jeffery, 2009), in order to position myself comfortably as the ‘good’ white social worker. Yet, whiteness is an organizing principle in social work…

White identity is self-defined as being ‘good’, being ‘innocent’, and being ‘virtuous’. It is through these discourses surrounding white identity and ‘benevolent’ institutions that the ‘good’ social worker is formed: one who recÓnstitutes the social relation of dominance and subordination with racialized and colonized others.

As Jennifer asks this mother to override her daughter’s wishes in order to regulate her behavior – to lie to her, to disrespect her – this mother is being asked to reproduce the relationship of domination and subordination with her daughter that exists between her and the white social workers.

‘Mom’, standing now, is pointing, her arm and index finger fully stretched toward the door; she is directing us to the back door…  Jennifer doesn’t budge. She does not move in her chair. Her face becomes red, red with anger more than embarrassment. “Let me tell you something …,” begins her aggressive response to ‘mom’s’ resistance. “… I am not just a social worker, I am also a mom.” She is offended and shouting. […] She is livid, defending herself. “I’ll tell you something: I don’t care one bit about her rights, about being respectful. I care about keeping her safe.” She stands up, bringing her physicality into the verbal tirade, and pointing into ‘mom’s’ face: “You have a responsibility as a mom. Nothing else matters. You are responsible for protecting her.” She turns from her and walks out of the house. I hear the door of Jennifer’s car slam shut, I get in the passenger side and listen as Jennifer continues her tirade for the next five to ten minutes of driving. I do not speak. I do not look at her as she speaks. After she finishes her rant, we drive the rest of the way to the office in silence; I do not speak. We drive the rest of the way to the office in silence, as I think about how I did not speak.