This study is focused on analyzing how sexual violence is discussed in the biomedical mental health system. Critical discourse analysis is used in this study to locate and analyze discourses in the biomedical mental health system uncovered in three interviews with mental health service providers. The definition of the mental health system that I used for this article was broad and included all positions that had a biomedical understanding of mental health.
However, I argue that the bio-medical understanding of mental health does just that to survivors of sexual violence. In this paper I refer to people who have experienced sexual violence at times as "survivors". In this paper I chose to investigate how sexual violence is discussed in the bio-medical mental health system, specifically because I have experience working and volunteering in the mental health system and in a sexual assault center.
Discourses about sexual violence in the mental health system are very important to me to disrupt because I have experienced working in that system first hand.
LITERATURE REVIEW & THEORETICAL FRAMEWORK
Three of the articles in the literature review that focused on mental health outcomes were quantitative surveys (Bryant-Davis, Ulman, Tsong, Tillman & Smith, 2010; Eisenberg, Lust, Hannan & Porta, 2016; Gomez & Freyd, 2017). Similar to the idea of discovery, many articles on the topic of sexual assault and mental health focus specifically on how survivors interact with different systems (Ahrens, Stansell, et. al. 1998). The mental health system to identify gaps in service.
Due to the small sample size, conclusions cannot be drawn about the experience of working as a mental health practitioner and meeting a sexual assault survivor. Instead, I try to draw attention to the biomedical mental health system and the way it functions to maintain power structures. Criticizing the ways in which sexual violence is discussed within mental health care is one way to challenge psychocentrism.
Using scholarship from these standpoints, I hope to offer a critique of the biomedical mental health system and the ways in which it operates to oppress survivors of sexual violence.
METHODOLOGY
I come to the research primarily as a service provider with experience in the field of mental health and sexual violence. My knowledge of the mental health system has been validated in problematic ways that deny the validity of Indigenous and mad epistemologies. This also applies to the people I interviewed, as they are all professionals who have been empowered by the mental health system.
This fits my study because I interviewed professionals in the bio-medical mental health system. I focused specifically on the bio-medical model because it is the dominant way mental health is viewed in Canada and holds a lot of power at the individual and societal level. The biomedical mental health system also maintains social control by shaping the types of services that are accessible to people.
For my study, I relied on primary sources of inquiry in the form of individual interviews with service providers in the biomedical mental health system. While Critical Discourse Analysis is often done using secondary sources, I decided to use primary sources because I could not find any documents to analyze that specifically focus on sexual violence from the perspective of the bio-medical mental health system. It makes sense that psy-discourses would be present in documents issued by bio-medical mental health institutions.
Therefore, I believe that individual interviews have created a more accurate picture of the discourse on sexual violence within biomedical mental health care. I used my personal networks for my recruitment because I have had professional contact with mental health and sexual violence in the past. My previous experiences working in mental health have led me to believe that the biomedical model is extremely harmful and contributes to the epidemic.
The individuals I recruited come from diverse backgrounds within the biomedical mental health field. The criterion for participation was that they had to be a provider working in biomedical mental health who had experienced sexual violence in their workplace.
FINDINGS
This was reflected in the simplistic categorization of the person they worked with or their experiences. Because this study focuses on mental health systems and processes that do not appear to address sexual violence, I was very interested in talking to participants about the training they received in their workplace. From this excerpt I get the impression that this is a discourse about the mental health system.
Terra mentions that part of the obstacles to doing affective work in long-term care is. Moreover, in her workplace, Terra saw the devaluation of support work in long-term care due to the social norm that does not see work done by black women as "professional". I was really lucky there in the sense that a lot of the staff, even though they were nurses and doctors, all came from a particular background.
I think part of it is that it was women and a lot of them were women who were Black. Part of this may be, as Pauline mentioned, partly because of the way social workers are trained to focus on "research-based". What happens a lot of the time is that people want to go into like, some kind of treatment for sexual violence or trauma, and they either like to start or have their assessment and.
The separation of services into trauma services and mental health services in this case slows or completely stops people's access to trauma services because of the expected behavior of people in that program. For example, it is not only about suitability for a program, but also about the accessibility of the program and whether what they need actually exists. In Sarah's interview, she said that responses to trauma are unpredictable and often misunderstood if they don't fit into a specific idea that people have.
I was really lucky there in the sense that many of the staff, even though they were nurses and doctors, all came from a specific background. She thought that one way to "get it" was to work from a specific framework based on "common sense". She also described how many of the people who work in long-term care are black women who bring lived experience of oppression that allows them to do good work. In all interviews, participants were generous when talking about co-workers who have done things that are harmful to people who have experienced sexual violence.
In my interview with Sarah, she also gave other clinicians the benefit of the doubt when I asked whether or not people were believed when they disclosed experiences of sexual violence.
DISCUSSION & IMPLICATIONS
Two of the participants mentioned BPD as a particular diagnosis that stood out to them when thinking about their work in the mental health system with survivors of sexual violence. Participants noted a lack of training from the mental health system not only about sexual violence, but also training related to mental health services. In reality, the bio-medical mental health system is one that supports and reinforces systems of oppression, including sexism.
To make it safe for survivors, I believe that the entire mental health system needs to undergo a reform that makes it center the needs of people and social justice instead of social. So I suggest that any training should come from advocacy groups and people who are personally affected by the psychocentric mental health system and sexual violence. It is important to think about how trauma affects mental health because mental health and marginalization are interrelated.
Capitalism is clearly intertwined with the mental health system and influences the type of care people have access to. Although the information given by participants may be indicative of larger systems, it is important to point out that these are personal experiences and do not "prove" trends in the biomedical mental health system due to the qualitative nature of the research. I see how my study reflected mental health institutions' centralization of whiteness and this is one of the main limitations of this paper.
However, I think the experiences of people of color are important to hear and suggest that their perspectives on the mental health system and sexual violence may be an area for future study to get a stronger view of the issues. In conclusion and based on the findings of this MRP, I would argue that the mental health system is causing harm to people. The aim of the research is to explore the ways in which sexual violence is discussed within the bio-medical mental health system in Canada.
It is important to understand the ways in which sexual violence is discussed in these settings because survivors of sexual violence are most likely to encounter the mental health system before other professional services, including sexual assault centers, medical systems, or legal systems. Furthermore, previous research has suggested that biomedical mental health services are often harmful to survivors of sexual violence. People who do not consider their previous/current workplaces to work from a biomedical understanding of mental health are not eligible for this study.
Can you tell me about a time, or multiple times, where someone who accessed your facility's mental health services revealed that they were a survivor of sexual violence?
