Crazies in the Community: An Ethnographic Study of Ex-psychiatric Clients in Canadian Society--Stigma, Management Strategies, and Identity Transformation

Abstract

<p>This dissertation deals with the social world(s) of former psychiatric patients in Canadian society. Adopting a symbolic interactionist perspective, specifically a labelling approach, this study, in an effort to fill a neglect in the literature, seeks to discover what the everyday world(s) of Canadian ex-mental patients are really like. Specifically, this research focusses on stigma as it applies to long-term chronic and short-term non-chronic ex-psychiatric patients, the manner by which such persons discover that they possess a stigmatizable attribute, the strategems ex-patients develop in order to mitigate the stigma potential of mental illness, and the implications of adopting such strategles for identity transformation.</p> <p>Using an exploratory, qualitative approach, data were collected through participant observation and informal and semi-formal interviewing on a stratified, disproportionate, random sample of two hundred and eighty-five former psychiatric patients living in Canadian communities.</p> <p>The data indicate that ex-patients categorize "mental illness" as a stigmatizable attribute through: (a) societal reaction, official labelling and processing, (b) through negative interactions with "normals," and through self-labelling. The findings indicate that ex-patients deal with the stigma potential of mental illness in a variety of ways having profound implications for identity transformation.</p> <p>The long-term chronics, who not only conceive of their deviant identities as "permanent fixtures," but receive no support from others in transforming their identities, and anticipate stigmatizing responses from normals, employ the following strategies of stigma management: institutional retreatism, societal retreatism, dissociation, passing, capitulation, and subcultural participation--strategies having negative implications for identity transformation. The short-term ex-patients, who conceive of their deviant identities as "temporary fixtures," receive support from others in transforming their identities, adopt the following strategies of stigma management: selective concealment, therapeutic telling, preventive telling, normalization and political activism--strategems having positive implications for identity transformation.</p> <p>In this research, it is demonstrated that actors are not passive entities, but are active in dealing with the stigma accompanying their deviant labels and identities by eliciting preferred societal reactions through their own behaviour, through the images that they project, and in attempting to transform their deviant conceptions of self. The implications of this study for labelling theory, the sociology of mental illness and for the topic of deinstitutionalization are considered.</p>