About
We were inspired to create this workshop for current and aspiring mental health care workers based on what we learned from a study we conducted where we reviewed 161 psychiatric in-patient charts from a psychiatric hospital located in Ontario, Canada.
While reviewing the charts, we were struck by how charting practices can both perpetuate and challenge the systemic power dynamics that dis/empower service users. For example, we observed how cisnormativity underpins documentation practices, resulting in persistent problems in the way trans and non-binary people are treated in psychiatric settings. Some documentation was analyzed as activating common tropes about Black women. Other charts were examined to reveal dominant ideologies about those who have experienced or perpetrated sexual violence.
These study findings have implications for the ways in which mental health care workers document information in service users’ charts. Specifically, the theoretical and practical knowledge emerging from the research offers a portal through which current and aspiring mental health care workers can explore how seemingly ‘objective’ and ‘neutral’ documentation practices contribute to systemic oppression (e.g., institutional racism, sexism, cisnormativity, and sanism), particularly for multiply marginalized service users.
The workshop and the study on which it is based (Cultural Representations of Gender in Psychiatric Narratives) use a Mad Studies framework. Mad Studies is grounded in the lived knowledge of those who have experienced the mental health system or whose behaviour, appearance, identity or ways of being are seen as disordered. Mad Studies challenges the dominant understanding of distress and madness as a deficit in need of correction and cure and illuminates intersectional forms of structural oppression faced by service users.
There are many current and aspiring mental health care workers who have had limited opportunities for engaging with social justice praxis when it comes to clinical documentation skills, especially when it comes to using a Mad Studies framework. For this reason, we decided to put theory in action by operationalizing the findings from our chart review study via a workshop on systemic oppression and chart documentation.
Land Acknowledgement
In the context of the workshop, we acknowledge the relationship between colonization, land, and psychiatry. More specifically, we recognize the ways in which land that was stolen from Indigenous Peoples across Turtle Island have been used to discipline and physically contain difference, distress, and madness.
This has happened and continues to happen in what we know as asylums and mental hospitals, and similarly, houses of industry and refuge and poor houses. In these places and spaces, psychiatric theories and practices that were developed in the context of the politics of colonialism serve as a technology of colonialism to impose Western notions of normality rooted in normative expressions of gender, race, sexuality, ability, and class, among other markers of ‘difference’. That is, normality rooted in the rationality of settler colonialism as it is structured by white supremacy, cisheteropatriarchy, and neuronormativity, among other ideologies of dominance. We know that these normative ideologies are often expressed through organizational texts and related practices, such as documentation. And, that other ‘psy’ professions, such as social work, psychology, and nursing, are implicated in practices that sustain colonizing practices and thinking in the mental health care service system, and beyond. It is our intention that this workshop centres the psychiatric chart to reveal and deconstruct the colonial psychiatric institution and related practices.
We acknowledge the various Indigenous lands and territories on which the contributors to this workshop live, work, and play. We invite you to pause and reflect on the territory on which you reside and your commitment to reconciliation and decolonization.
Toronto Metropolitan University
Toronto is in the 'Dish With One Spoon Territory’. The Dish With One Spoon is a treaty between the Anishinaabe, Mississaugas and Haudenosaunee that bound them to share the territory and protect the land. Subsequent Indigenous Nations and peoples, Europeans and all newcomers have been invited into this treaty in the spirit of peace, friendship and respect.
Renison University College
With gratitude, we acknowledge that Renison University College is located on the traditional territory of the Anishinaabeg, Hodinohsyó:ni, and Attawandaran (Neutral) Peoples, which is situated on the Haldimand Tract, the land granted to the Six Nations that includes ten kilometres on each side of the Grand River from mouth to source. Our active work toward reconciliation takes place in all corners of our campus through research, learning, teaching, community building and outreach. We are guided by the work of our Reconciliation and Re-storying Steering Committee and Anti-Racism and Decolonization Spokescouncil, as well as the University of Waterloo’s Office of Indigenous Relations.
The Empowerment Council
CAMH is situated on lands that have been occupied by First Nations for millennia; lands rich in civilizations with knowledge of medicine, architecture, technology, and extensive trade routes throughout the Americas. In 1860, the site of CAMH appeared in the Colonial Records Office of the British Crown as the council grounds of the Mississaugas of the New Credit, as they were known at the time. Today, Toronto is covered by the Toronto Purchase, Treaty No. 13 of 1805 with the Mississaugas of the Credit. Toronto is now home to a vast diversity of First Nations, Inuit and Métis who enrich this city. CAMH is committed to reconciliation. We will honour the land through programs and places that reflect and respect its heritage. We will embrace the healing traditions of the Ancestors, and weave them into our caring practices. We will create new relationships and partnerships with First Nations, Inuit and Métis and share the land and protect it for future generations.
As an organization within CAMH, the Empowerment Council supports the ongoing importance of recognizing, respecting and acknowledging the First Peoples land, on whose traditional territory we work–both with our client membership and in our work with Board members and staff. The Empowerment Council is also committed to working in solidarity towards reconciliation in partnership with First Nations, Inuit and the Métis.