Conference Agenda

The COVID-19 pandemic laid bare social inequities, drove up economic costs, and has had multiple mental health impacts. The result has been the deepening of global crises related to homelessness, poverty and inequities grounded in classism, racism, sexism and sanism. In some jurisdictions, we have seen upticks in violence, especially in public places. This has fueled stigma against people in emotional distress as the trope of the violent, mentally ill person has found new life in public discourse. These developments have been used to justify increased public controls in the lives of vulnerable people through police intervention and calls to increase legislative powers to involuntary detain and treat people.

Against this backdrop we are doing international (Canada, Kenya, Australia) intersectionality informed qualitative research that foregrounds the lived experiences of people who have been held involuntarily and have experienced coercion and discrimination in the context of mental health care. In this presentation we discuss the preliminary results of our field research in Canada and present the results of our international literature review/environmental scan on promising practices. We argue that societal resources need to be put towards enhancing community-based interventions that optimize care and human rights and aims to reduce/eliminate coercive practices.

Background: Transgender and gender diverse (trans) people experience significant oppression, with resulting mental health disparities and greater need for acute mental healthcare, i.e. mental health hospitalizations and emergency department visits. Few qualitative studies have focused on trans people’s experiences of acute and post-discharge mental health care, which was the aim of this study.

Methods: Trans people living in Toronto, Ontario, who have experienced acute mental healthcare (n = 15) were recruited. In-depth individual interviews were conducted, transcribed, and analyzed using constructivist grounded theory.

Results: Participants described the inpatient psychiatric environment as regularly invalidating and misgendering, requiring vigilance, energy, and self-advocacy to address; which were limited resources during a mental health crisis. These experiences impeded recovery and led to future avoidance of care. Participants described how their care needs were not adequately addressed in or out of hospital. They identified multiple layers of needed changes to improve care in the system, including autonomy and anti-oppression in the mental healthcare system, addressing of social determinants of mental health, prioritizing of connection to community, and support in navigating a complex system.

Conclusions: Trans people face multiple unique barriers to accessing the mental healthcare they need. Addressing this requires shifting of the existing mental healthcare system.

Mental health problems are discussed increasingly on different Internet channels and social media. Due to the culture becoming more visualized and memetic, mental health is represented also in Internet memes. Memes are one way of showing individual and shared experiences on the treatment, diagnoses, and living with mental health problems. They also reflect millennial and Gen-Z humour by utilizing semiotic resources from various pop-culture products.

This presentation focuses on mental health memes that use images and references from SpongeBob Squarepants and examines the intertextualities, semiotic processes, and humour of mental health memes. Moreover, I discuss how these intertextualities form representations of mental (ill-)health, and how these representations link to different cultural and societal phenomena surrounding mental health.

The data consists of mental health themed SpongeBob memes collected from Imgur.com and Instagram. The results show these memes depict three different relationships of the mentally suffering; 1. the relationship with treatment 2. the relationship with the “normal people,” and 3. the relationship with the mental illness itself. Interestingly, Spongebob is used to represent symptoms, diagnoses, and feelings, as well as the self; in other words, they are used to illustrate the conflict and dialogue between the mental illness and the person behind it.

Loneliness and disconnectedness are highlighted as important ‘risk factors’ for suicide within much suicide research. However, these conceptions tend to be framed in individualised, psychologised ways. An individualised focus on loneliness and disconnection fails to engage with the social, structural and institutional conditions, which produce exclusion and disconnection (for example through racism, homophobia, transphobia, ableism, classism, sexism, among others). This presentation draws on long-term ethnographic engagement with community-based organisations supporting people experiencing mental health challenges, as well as in-depth qualitative interviews with people affected by suicide (via an attempt, bereavement, or in a professional capacity). Drawing on narrative, thematic and abductive analysis, we explore the ways in which social exclusion produces and is produced by forms of social disconnection and loneliness. Alongside processes of social exclusion, we also explore how community-based forms of non-clinical support that promote long-term accompaniment and empathy offer essential means of re-connecting people experiencing suicidality. Considering processes of loneliness, exclusion and disconnection as social rather than individual invites consideration of how these are produced within broader social systems. We demonstrate that a focus on social exclusion, rather than individualised loneliness and disconnectedness creates different possibilities for engaging with and responding to suicide.