Resisting Adultism in Mental Wellbeing Unit

Takeaways

• Through an understanding of intersectionality, examine the ways discourses about “childhood” intersect with mental health discourses from the perspectives of psychiatrized youth.
• By looking at how youth understand mental health, and mental health issues, recognize how psychiatrized youth resist pathologization of their experiences of distress in childhood.
• By examining how children and youth express their expertise on mental wellbeing, appreciate the role of youth in mental health decisions that go beyond being heard and include their knowledges and expertise in a meaningful way.

Components

The Thought Bubbles were part of workshops and focus groups with young people with experience accessing and using mental health services. A total of seventeen youth with lived experiences of accessing and using child and youth mental health services provided feedback. Due to the COVID-19 pandemic and social distancing measures, the feedback was obtained remotely using Zoom.

In empty “thought bubbles”, youth were asked to consider the following:

• Thought Bubble 1: Write down five words that describe what “mental health” for children and youth means to you from your perspectives.
• Thought Bubble 2: Write down five words that describe what “mental health issues” for children and youth means to you from your perspectives.

Evaluating the Components

Looking Closer
Time: 60 minutes; flexible
Format: In-Class; online

Working either solo or in partners:

1. Begin by reading Thought Bubble 1.
   • While reading the thought bubbles, what similarities and differences do you notice between the responses (words)?  Jot them down or create a mind map.
2. Read Thought Bubble 2.
   • Again, while reading the thought bubbles, what similarities and differences do you notice between the responses (words)?
3. Identify for each question the top 5 concepts represented about “mental health” and about “mental health issues”.

Returning to the full class, or in a larger group of four individuals, share discuss the five concepts identified. Are there common threads across different lists?

Discussion Questions
Time: 60 minutes; flexible
Format: In-Class; online

After engaging with the module and examining the thought bubbles discuss the following questions:

1. What stands out for you about how young people involved with the mental health system conceptualize “mental health” and “mental health issues”?
2. What knowledges are reflected in the thought bubbles? How does this add nuance to understanding mental wellbeing?
3. How do you see the responses addressing the adult creation of healthy children, and how is this misaligned with the lived experiences of children and youth?
4. How do the responses align or resist dominant discourses about “childhood”, “becoming an adult”, and “mental illness”?
5. How do the thought bubbles reflect the power dynamics of whose knowledges are validated and whose are subjugated? What does this mean for the mental wellbeing of children and youth?

Learning Lens

“As a whole, the concept of children’s mental health is just not looked upon very much. Sometimes people think that the only thing they need to do is like food, clothes on their backs, and then they’re set.”

Childhood is a social construct. Ideas of what childhood looks like and how it is understood as a meaningful category vary culturally, historically and geographically. When it comes to child mental health in the Global North, professionals in developmental and behavioural psychology first began to formulate theories by observing white, middle- and upper-class boys in the 20th century. This resulted in the lack of intersectional understanding of mental wellbeing in children. Alongside this, pediatrics emerged as a distinct field of medicine, resulting in a set of assumptions about childhood associated with gender, class, race, and ability. As historian Mona Gleason pointed out in her book Small Matters (2013), pediatrics and its proponents implemented a standard vision of health that centred whiteness, middle-class family status, and ability. These elements would become the markers of normal and happy childhoods. As such, mental health issues are seen as an interruption to a healthy, normal, and happy childhood.

The mental health system treats childhood as universal. The approaches to children’s mental health fail to consider how prejudices about childhood are created and exacerbated through mental health theories and practices. In other words, how adultism intersects with sanism. Adultism is the belief that adults are superior to young people. It supports the belief that adults should have control over children, which is often the foundation for relationships between children and adults. Adults become the primary knowledge and power wielders. Moreover, adultism upholds the belief that children do not have the competence to know, and that adults know what the best interests of a child are. This adult gaze of competence and best interest intersects with how children experience psychiatry. This has led to the exclusion of children in theories, practices, and policies that are meant to support them.

Sanism also works to deny psychiatrized children as knowers. Children continue to be understood as incompetent knowers concerning their mental wellbeing. While sanism is often understood as an irrational stereotyped prejudice against people deemed mentally ill, children often emphasize how sanism reproduces adult benevolence and the incapacity of children. Sanism fails to acknowledge and address that marginalized individuals have the right to control and hold ownership over the knowledge produced about them.

In bringing together adultism and sanism, scholars Brenda LeFrançois and Vicki Coppock (2014) wrote: “the incompetence that may be attached to a child based on a negative mental health label and the incompetence that may be attached to a child based on age (as well as based on social relations of gender, race and class) mutually constitute each other, allowing sanism to intersect with adultism and other possible aspects of a child’s disadvantaged and socially constructed identity to reinforce and reproduce notions of incompetence and inferiority.” Thus, what emerged from this intersection of adultism and sanism is the idea that adults know best when it comes to the mental wellbeing of children, and consequently, responses to mental wellbeing are riddled with prejudice.

The school-age participants of the workshops and focus groups challenged the intersection of adultism and sanism by highlighting how adults created policies that do not work because they do not consider children’s intersectional experiences and knowledge. The participants also pointed out that children and youth may react to the same situation differently. Mental health varies. Thus, themes discussed included how individuals felt misunderstood and dismissed. This arose because mental wellbeing is largely understood from an adult lens. Participants felt dismissed because of their status as children.

In addressing the issues of dismissal and sharing their own knowledges, the youth pushed back on the medical approach to mental wellbeing, the presence of toxic positivity in child wellbeing, and the idea that children are innocent and in need of benevolent protection from adults. The participants addressed the importance of welfare, education, and real meaningful interventions as foundational for mental wellbeing. They also pushed back on adult understandings of wellbeing and stigma sharing that: 1) wellbeing is not the lack of illness, but the state of health; 2) mental health is not linear; and 3) the lack of mental health resources is not about stigma, but it is because it is under discussed and overlooked.