When Mad Misfits Talk Back: Towards a Telos of Care in Emory's Mental Health System Open Access
Sawyer, Nathaniel (Spring 2018)
Abstract
As colleges consistently document rising rates of mental illness and counseling centers struggle to keep up with rising demand for services as well as increasing acuity of symptoms, university mental health systems have adopted various techniques and best practices to respond to students who are struggling with mental illness. Yet there is a profound lack of in-depth qualitative research understanding the nuances of student experiences within these mental health systems and the various ways that stigma, injustice, and misfitting take place within these sites of supposed support. Briefly tracing some of the dominant forces that shape our cultural understandings of mental illness, I argue that Emory University's mental health system is characterized by the influence of historical and contemporary forces that have long submerged the mentally ill subject to the psy-complex's discourse of pathology, depoliticization, and biomedical clinical authority. Drawing heavily from disciplines of mad studies, critical disability studies, medical anthropology, and social justice theory, this thesis project engages with student testimonies--some anonymous, some not--about their various experiences within and against Emory's clinical infrastructure and the various moral hazards that have arisen, broadly understood as various sites of what disability studies scholar Rosemarie Garland-Thomson calls misftting. This project does not seek to reject the entirety of Emory's mental health system as broken and flawed; instead, it seeks to understand its ideological underpinnings and problematize what I call a telos of management--a system interested in fixing, preventing, identifying and referring, and ultimately expelling students who are struggling with mental illness who misfit the mental health system and our broader Emory community. Concluding remarks are offered as a general blueprint for future research and policy orientation for universities with an emphasis on the importance of developing epistemically just research methodologies and practices to disrupt a long-standing history of discrimination against the mentally ill. To that end, strategies and research from disability and mad studies offer crucial ways to "talk back" to the dominant clinical infrastructure and to works towards a telos of care that is interested in how we can resolve misfitting rather than responding through solely clinical means.
Table of Contents
FORWARD......................................................................................................................... 1
Dear Emory...................................................................................................................... 1
CHAPTER 1: Constructing a "counter-diagnostic" epistemic disobedience......................... 2
On navigating this text as a conduit of power.................................................................. 2
Epistemic disobedience through interdisciplinarity........................................................... 7
Misfits............................................................................................................................ 12
CHAPTER 2: Misfitting in the mental health system: when madness "talks back"............ 18
The shape shifting counseling center............................................................................... 18
Emory's mental health system.................................................................................... 23
Confronting Emory's clinical infrastructure.................................................................... 31
Treatment without healing......................................................................................... 34
The CAPS waitlist and a "meritocracy of suffering"................................................... 42
Encountering the "culturally competent" counselor....................................................... 48
CHAPTER 3: Concluding remarks..................................................................................... 57
Towards epistemic justice in theory and praxis............................................................... 57
Beyond the biomedical idiom of distress--embracing misfits......................................... 65
References.......................................................................................................................... 80
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