1 The contagion of stigma: the ethics and politics of research with the ‘far right’ Reading the American literature on the extreme Right, it is impossible not to acknowledge the tone of universal disapproval. The conviction prevails that there is something ‘weird’ or ‘alien’ about the extremist. (Fielding, 1981: 15) Fielding attributes this disapproving tone to lack of sympathy towards members of far right groups rooted in the ‘clash between a positivist and a Verstehen methodology’ (1981: 16). Three decades on, interpretivist approaches are well established
maternal line. When European women had sex with Africans, however, both they and their offspring were irreversibly spoiled. 12 What this meant in psychological terms – and specifically, what it meant for children to be both the objects of their mothers’ love and the carriers of their stigma – we can only imagine. What it meant in social terms is clearer. Prestige depended above all on women behaving as they should. 13 Men also had
6 Prevention and stigma: the sanitary control of Muslim pilgrims from the Balkans, 1830–1914 Christian Promitzer Introduction The fight against plague and cholera allegedly or actually communicated by Muslim pilgrims from India and Southeast Asia while on the Hajj (pilgrimage to Mecca) has been the object of sustained research in the field of medical history. A recent contribution, Stefan Winkle’s book Cultural History of Epidemics, explains how intensified maritime traffic over the course of the nineteenth century made the region of the Hejaz on the Western
3 CHALLENGING THE STIGMA OF MENTAL ILLNESS THROUGH NEW THERAPEUTIC APPROACHES Perceptions of the asylum changed dramatically between 1837, when the alienist W. A. F. Browne painted a compelling picture of the therapeutic powers of the ideal asylum, ‘a spacious building resembling the palace of a peer, airy, and elevated, and elegant’,1 and 1961, when Enoch Powell, then Minister of Health, unveiled plans to close Britain’s psychiatric hospitals.2 Like many other mental health reformers, Powell conjured a history of psychiatry which legitimated his objectives
). Misconception 7: Men/Boy Survivors Are More Profoundly Impacted by Sexual Victimisation than Women and Girls An additional myth that has gained traction is that men/boys survivors are more profoundly impacted by sexual victimisation, face more service uptake barriers and ‘will need to navigate … maybe even greater levels of stigma’ than women and girls ( SVRI, 2012 : 3). While there is some evidence suggesting that men/boy survivors are less likely than women
properly trained staff and fully integrated into health and social care systems across the life-course. Community-based rehabilitative approaches must be developed and/or expanded, and the number of qualified service personnel increased. Stigma must be combated. MHPSS must be coordinated, integrated, accountable and culturally appropriate, engaging with the community, including vulnerable groups. Sufficient political will is recognised as essential. National mental health policies
: [ On the survivor’s fear of stigma ] Like victims of rape, they will be with fear. At times, it will be very difficult for them to move because they think that people will be talking about them. And it is true; people will be talking about them. And you get to know that they were raped, maybe if the pregnancy comes out. It is when they will tell you that ‘I was raped by so and so, or some unknown person’. (Woman Refugee Leader
denialism by gaining the trust and cooperation of the affected population. Over the course of its long history, plague has been consistently defined by high mortality, rapid spread and association with poverty. Dangerously, affected populations may prioritise avoiding the stigma of plague over responding to it. If plague conflicts with core cultural values, as with Chinese burial rituals in San Francisco or famadihana in Madagascar, a population with
Challenging the assumption that the stigma attached to mental illness stems from public ignorance and irresponsible media coverage, this book examines mental healthcare workers’ efforts to educate the public in Britain between 1870 and 1970. It covers a period which saw the polarisation of madness and sanity give way to a belief that mental health and illness formed a continuum, and in which segregative care within the asylum began to be displaced by the policy of community care. The book argues that the representations of mental illness conveyed by psychiatrists, nurses and social workers were by-products of professional aspirations, economic motivations and perceptions of the public, sensitive to shifting social and political currents. Sharing the stigma of their patients, many healthcare workers sought to enhance the prestige of psychiatry by emphasising its ability to cure acute and minor mental disorder. However, this strategy exacerbated the stigma attached to severe and enduring mental health problems. Indeed, healthcare workers occasionally fuelled the stereotype of the violent, chronically-ill male patient in an attempt to protect their own interests. Drawing on service users’ observations, the book contends that current campaigns, which conflate diverse experiences under the label mental illness, risk trivialising the difficulties facing people who live with severe and enduring mental disturbance, and fail to address the political, economic and social factors which fuel discrimination.
In 1985 Roy Porter called for patients to be retrieved from the margins of
history because, without them, our understanding of illness and healthcare would
remain distorted. But despite concerted efforts, the innovation that Porter
envisaged has not come to pass.
Patient voices in Britain repositions the patient at the centre of healthcare histories. By prioritising the patient’s perspective in the century before the foundation of the National Health Service, this edited collection enriches our understanding of healthcare in the context of Britain’s emerging welfare state. Encompassing topics like ethical archival practice, life within institutions, user-driven medicine and the impact of shame and stigma on health outcomes, its chapters encourage historians to reimagine patienthood. It provides a model for using new sources and reading familiar sources in new ways. And, exploring traditional clinical spaces and beyond, it interrogates what it meant to be a patient and how this has changed over time.
Crucially, the collection also aims to help historians locate and develop policy relevance within their work, reflecting on how these historical tensions continue to shape attitudes towards health, illness and the clinical encounter. Each chapter presents a framework for using history to speak to pressing policy issues.