In the last decade there has been an explosion of government inquiry into psychiatric disability accompanied by a call for “consumer/client” input into Canada’s mental health initiatives. A few notable examples include the Senate report Out of the Shadows at Last (2006), the Ontario government’s report Navigating the Journey to Wellness (2010), and Canada’s first national mental health strategy Changing Directions, Changing Lives: The Mental Health Strategy for Canada (2012). Despite increased attention to psychiatric disability and calls for “consumer/client” participation, substantial gender analysis is absent from these reports and from broader discussions of psychiatric disability and welfare-state reform. This lack of attention to gender dynamics operating in and through the largely uncoordinated and broadly defined mental health care system may mean that barriers to mad women’s participation are overlooked.
There is a significant body of scholarship exploring women’s opportunities for and barriers to participation in politics and policy making. Women’s locations within prevailing gender relations have a direct impact on opportunities for participation in political decision making (Lister 2003; Iversen and Rosenbluth 2008; Coffé and Bolzendahl 2010). In calling for the participation of psychiatric “client/consumers” in politics and policy making, the structural and attitudinal barriers impacting mad women’s access into policy making must be considered.
Critical disability scholarship provides a starting point for investigating barriers to mad women’s participation in setting the mental health agenda, and in political practices generally. This is the concept of transinstitutionalization. Transinstitutionalization refers to the diffuse operation of services for mad people through governmental and extra-governmental structures such as hospitals, prisons, social housing and income support that developed following deinstitutionalization (Simmons 1990; Stavis 2000; Slovenko 2003; Thakker et al 2007) and crystallized in the era of neoliberal welfare-reform.
In-depth analysis of the gender dynamics of transinstitutionalization has not been conducted, but my preliminary research suggests it is replete with barriers to participation for mad women. For example, as not all supportive housing accepts children, mad women’s housing choices may be limited or they may forgo essential supports in order to parent. The lack of access to the full housing spectrum and/or supportive housing may negatively impact the time and/or support that make political participation possible. Furthermore, as Robert Wilton (2004) demonstrates in his study on Hamilton boarding homes, mad women in boarding homes are less engaged than men in paid labour to subsidize income support. These women, therefore, have less money for transportation, clothing, food, and childcare. This lack of funds may impact opportunities to travel to and engage in political discussion.
These brief examples demonstrate how transinstitutionalization impacts mad women in unique ways that can affect opportunities for participation in policy making. Given calls for participation by the mad community in policy making processes, further research is needed on barriers impacting not only mad women, but all mad people in the context of transinstitutionalization.
 The use of “mad” is a re-appropriation advanced by the mad movement which seeks to promote mad pride, to combat saneism and eradicate psychiatric torture, abuse and incarceration.
Resources and Further Reading
Canada, Parliament. Senate. The Standing Senate Committee on Social Affairs, Science and Technology. (2006).Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. 38th Parl. 1st Session. Retrieved from: http://www.parl.gc.ca/Content/SEN/Committee/391/soci/rep/pdf/rep02may06part1-e.pdf
Coffé, H, and Bolzendahl, C. (2010). Same Game, Different Rules? Gender Differences in Political Participation. Sex Roles. 62(5-6): 318–333
Iversen, T, and Rosenbluth,F. (2008). Work and Power: The Connection Between Female Labor Force Participation and Female Political Representation. Annual Review of Political Science. 11, 479-495.
Legislative Assembly of Ontario. Select Committee on Mental Health and Addictions. (2010). Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians. 39th Parl. 2nd Session. Retrieved from: http://www.ontla.on.ca/library/repository/mon/24008/303884.pdf
Lister, R. (2003). Citizenship: Feminist Perspectives (2nd ed.). New York, N.Y.: New York University Press.
Mental Health Commission of Canada. (2012). Changing Directions, Changing Lives: The Mental Health Strategy for Canada. Retrieved from: http://strategy.mentalhealthcommission.ca/pdf/strategy-images-en.pdf
Simmons, H. (1990). Unbalanced. Toronto, ON: Thompson Education Publishing Inc.
Slovenko, R. (2003). The transinstitutionalization of the mentally ill. Ohio North University Law Review. 29(3), 641-60.
Stavis, P. (2000). Why Prisons are Brim-Full of the Mentally Ill: Is Their Incarceration a Solution or a Sign of Failure. George Mason University Civil Rights Law Journal. 11, 157-202.
Thakker Y., Gandhi Z., Sheth H., Vankar G.K., and Shroff S. (2007). Psychiatry Morbidity Among Inmates of the ‘Beggar Home’. International Journal of Psychosocial Rehabilitation. 11 (2), 31-36
Wilton, R. (2004). Putting Policy into Practice: Poverty and People with Serious Mental Illnesses. Social Science & Medicine. 58, 25-39.