In this paper I explore the way that mental illness stigma impacts epistemic credibility in people who have mental illness. While any kind of stigma has the potential to discredit a person’s epistemic agency, in the case of mental illness the basis for discrediting is in some cases and to some extent justifiable, for impairments in rationality, control, and reality perception can indeed be obstacles to participating appropriately in epistemic activities such as normal conversation and public discourse. People with mental (...) illness are still potentially subject to epistemic injustices, however, especially when we rely on stereotypes and fail to make complicated and nuanced judgments which are more accurate. In this paper, I explain some of the ways that people with mental illness may be subject to epistemic injustices, and I propose some suggestions for how epistemic injustice can be avoided. (shrink)

People who have mental health diagnoses are often subject to sanist microaggressions in which pejorative terms to describe mental illness are used to represent that which is discreditable. Such microaggressions reflect and perpetrate stigma against severe mental illness, often held unconsciously as implicit bias. In this article, I examine the sanist attitudes that underlie sanist microaggressions, analyzing some of the cognitive biases that support mental illness stigma. Then I consider what responsibility we have with respect to microaggressions. I argue that (...) all people share in a collective responsibility to engage in acts of epistemic resistance that challenge sanist attitudes so that it is easier for bystanders who witness microaggressions, and targets of microaggressions in particular, to identify microaggressions and to point out biased behavior. The act of pointing out bias is best understood as an act of epistemic resistance that is more effective and meaningful in the context of other acts of epistemic resistance. Ultimately, whether to point out bias is an individual decision that one must make after weighing the risks involved; engaging in a range of acts of epistemic resistance, on the other hand, is a moral responsibility everyone shares. (shrink)

This paper uses a non-ideal theory approach advocated for by Alison Jaggar to show that practices involved with the medicalization of serious mental disorders can subject people who have these disorders to a cycle of vulnerability that keeps them trapped within systems of injustice. When medicalization locates mental disorders solely as problems of individual biology, without regard to social factors, and when it treats mental disorders as personal defects, it perpetuates injustice in several ways: by enabling biased diagnoses through stereotyping, (...) by exploiting and coercing people who are seen as insufficiently competent, and by perpetuating idealized conceptions of choice and control that do not take into account people’s real limitations and the social context of health. Through practices of diagnosis, treatment, and recovery, medicalization can perpetuate injustices toward people who have serious mental disorders. (shrink)

The scientific model of mental disorder, which is the foundation of American psychiatry, is easily imperialistic when it is applied globally. This unwarranted extension of power is especially problematic for women, since psychiatry is easily used to deny women discursive and agential power and to ignore social and political contexts for women’s suffering. By analyzing the epistemic function of narratives, I argue that the hegemonic power of the scientific narrative is unjustified and often harmful, and that a more accurate and (...) more justly applied understanding of disorder requires accounting for alternative cultural narratives as well. (shrink)

People who have mental illness are in particular need of what a home can provide, but they are especially vulnerable to not being in a place with a home-like environment, whether due to homelessness, incarceration, or hospitalization. At any given time, approximately 170,000 people are inpatients in psychiatric units or hospitals (NASMHPD 2017). Psychiatric hospitals are not homes, and they are not designed for long-term stay. The main purpose of the modern psychiatric hospital is to stabilize people in mental health (...) crises, such as those who are psychotic or suicidal; hospitals are best thought of as temporary, transitional dwellings. Even though a person may only reside there for a week or a month, however, it is a crucial period of stabilization and healing. As this paper argues, practices of home-making increase epistemic and moral agency, which enables crisis stabilization, healing, and recovery. This paper examines several functions of home and shows some of the ways that patients in psychiatric hospitals try to replicate these functions in the physical space they have given their many constraints. Because practices of home-making support the goals of hospitalization, the hospital experience should be designed to encourage these practices as much as possible. (shrink)

The predominant narratives of addiction—Disease and Choice narratives—frame addiction as a personal problem to be addressed by controlling an individual’s behavior. By analyzing the epistemic function of narratives of addiction, this paper shows that these narratives construct a story about the nature of addiction by assuming simplistic views about human agency, leading to drug policies that narrowly focus on individual behavior. Assumptions embedded within narratives must be made transparent so that the partial, perspectival, and situated nature of the knowledge that (...) narratives convey is made evident and can be evaluated. As a result of their over-simplistic assumptions about human agency, Disease and Choice narratives neglect a significant factor in addiction: the social context which informs and sets limits on the reasons and values that enter into decision-making. This paper argues for the adoption of Social Constraint narratives, which would require policy agendas to focus on the social contexts that make drug use so appealing. As a result, agencies dealing with drug policy would need to collaborate with other agencies focusing on relevant social issues in order to create structural change, thus affecting the social environment and not merely the individual. (shrink)

The predominant narratives of addiction—Disease and Choice narratives—frame addiction as a personal problem to be addressed by controlling an individual’s behavior. By analyzing the epistemic function of narratives of addiction, this paper shows that these narratives construct a story about the nature of addiction by assuming simplistic views about human agency, leading to drug policies that narrowly focus on individual behavior. Assumptions embedded within narratives must be made transparent so that the partial, perspectival, and situated nature of the knowledge that (...) narratives convey is made evident and can be evaluated. As a result of their over-simplistic assumptions about human agency, Disease and Choice narratives neglect a significant factor in addiction: the social context which informs and sets limits on the reasons and values that enter into decision-making. This paper argues for the adoption of Social Constraint narratives, which would require policy agendas to focus on the social contexts that make drug use so appealing. As a result, agencies dealing with drug policy would need to collaborate with other agencies focusing on relevant social issues in order to create structural change, thus affecting the social environment and not merely the individual. (shrink)

This book considers what responsibilities affluent individuals have toward global poverty, given that global poverty is a problem with structural, political causes, and one that generally requires collective action. By looking at the intersection of moral, political, and legal philosophy, this book gives a pluralistic and differentiated account of individual duties based on a person's moral agency, her roles within collective groups , and her institutional identities as citizen and consumer.

Mental disorders are assessed globally using the World Health Organization's International Classification of Diseases Classification of Mentaland Behavioural Disorders (ICD), which is largely modeled after (though it also influences) the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) used in the United States. Situated within the scientific narrative of American psychiatry, disorders are typically viewed by practitioners who use the DSM and ICD as essential categories of human experience, with internal, purely descriptive, value-free conditions. Criteria identified in the DSM and (...) ICD describe the behaviors and psychological experiences that manifest from these internal conditions. In .. (shrink)

Many rights theorists argue that global poverty violates certain human rights, so that responsibility to address poverty involves carrying out the duties that correspond with relevant rights-claims. Liberatirians argue that the rights and duties associated with global poverty, especially what are sometimes thought of as “positive” rights, or rights of assistance, are inappropriately agent-neutral, giving them less justificatory force than agent-relative rights and duties. To counter libertarian concerns, Thomas Pogge tries to reframe the responsibilities corresponding to human rights as institutional (...) rather than as belonging to agents. While admirable, his approach inadequately expalains the relationships between institutional responsibility and individual and collective action. A better way to respond to libertarian concerns—that is also compatible with Pogge’s emphasis on institutional responsibility—is to show that the duties regarding global poverty are indeed agent-relative, but by virtue of individual and collective action within institutions. (shrink)