The struggles of marginalized communities always involve a reaffirmation of oneself, one’s identity and one’s pride. Quebecers needed joual plays to reclaim who they were. But language policies were essential to redress the injustices suffered by the French-speaking majority at the time.
Open up, be outraged?
The fight for the mental health of Quebecers can be understood through an identical prism; it is made up of two distinct battles. The first battle that must be won is that of sick people who want to be reborn with dignity and stop hiding. This is what the famous safe spaces partly allow (safe space). Although we see them as the symptom of a cajoled and hypersensitive generation, the principles that govern them – respect for differences, non-judgment – allow the most vulnerable to open up without fear of being judged.
But there is an opportunity cost, a term economists use to describe what we give up when we make a choice. Indeed, safe spaces are not the most fertile spaces for expressing frustration at having gone through a system riddled with deficiencies.
When we open up about our inner struggle, as I have done on a few occasions, we often receive compliments such as the courage to reveal ourselves. Unfortunately, in what could now be described as a culture of coming out, we observe a ballet of unveiling and congratulations which could extinguish the equally legitimate indignation felt by the person concerned. Indeed, who could express their anger against a society that shows full sympathy towards them?
The movement for better mental health care is quite unique in this regard. How would Malcolm Or the Femen, who once, with their chests in the air, raged against archaic patriarchal values. Many service users would happily trade public sympathy for adequate care. To quote a French activist, it is not welfare that we want, but emancipation.
The second battle
The battle to regain dignity on a personal level is essential, but will always remain incomplete without the battle to fundamentally change the system. It is true that this second battle, that of collective demands, is not completely non-existent. But very often, it targets caregivers who are seen as those who have failed to provide humane care to patients.
A psychiatrist who prescribes in a rushed manner, a worker who provides sporadic follow-ups, teams who resort to restraint in a hospital environment. We target individuals while forgetting the system within which they operate. It’s tragic that much of the outrage capital is aimed at them rather than those who ultimately have the real levers of change, the decision-makers.
Learn from the past
In 1961, even before the nationalization of electricity and the creation of the Ministry of Education, the Lesage government established the Bédard commission, which had the mandate to thoroughly review mental health care, until then largely confined to asylums. The decision to hold this commission, taken urgently, followed the publication, barely a month earlier, of the testimony of Jean-Charles Pagé, a patient who denounced the inhuman conditions he had experienced during his internment.
What we often forget when recounting these events is that thirty-nine psychiatrists had published an open letter demanding change in the months preceding Pagé’s release. Basically, doctors joined forces with patients to demand change by addressing those in power. Like the time that saw the birth of the Bédard commission, today, the fight should be done jointly with all stakeholders in society, including caregivers who, although discreet, also want better care. for their patients.
The Coalition of Psychologists of the Quebec Public Network is an example. Certainly, its members are fighting to obtain better salaries, but, at the same time, want to increase the accessibility of care for the entire population.
Ideally, the two mental health battles would be fought jointly without one encroaching on the other. Far be it from me to invalidate those for whom a safe space allows them to open up. But at the rate things are going, I’m considering an emerging reality that scares me: that of a society in which everyone feels accepted without more lives being saved.