Lydia Sapouna | University College Cork (original) (raw)

Papers by Lydia Sapouna

INTERNATIONAL MAD STUDIES JOURNAL VOL 2, ISSUE 1, 2024, 2024

This article draws from my involvement in critical social work education and my position as an as... more This article draws from my involvement in critical social work education and my position as an aspiring ally of the Mad movement in the Irish context. I use a reflexive auto-critique as a methodology to consider a significant shift in my engagement with Mad matters which has led to new ways of (un)learning critically about madness and distress in education and activism. This is a shift from celebrating criticality and inclusion strategies, and in particular service-user involvement in education, to problematising criticality and its potential to perpetuate power inequalities within mental health and education systems. It is a shift from viewing critical education as a process of knowing about distress and Mad people to a process of knowing with and from Mad people, service-users, and survivors. The emerging field of Mad Studies provides a conceptual framework to inquire about knowledge and knowers, to consider issues of co-option and epistemic injustice, to focus on pedagogies for unlearning, to ask questions about representational politics and the complexities of being an engaged academic and Mad positive ally. Guided by Mad Studies as a mode of analysis, I recognise that inclusion of madness in university curricula can work in ways that continue to pathologise and subjugate Mad people. This is an unsettling recognition that leads to an interrogation of my own praxis as an academic and an aspiring ally of the Mad moment. I propose that prefigurative politics are central in these considerations as genuine engagements with mental health matters need to model the changes we aim to achieve. Engaging with the tensions of inclusion politics, the complexities of madness, and the unsettledness this engagement generates, can be a source of knowing through epistemic humility and a resource for networks of solidarity.

Telling our own stories of our experiences of distress and madness, of oppression and treatment, ... more Telling our own stories of our experiences of distress and madness, of oppression and treatment, of survival and resistance, is a source of power for people who use or are forced to use mental health services. Storytelling has created a space for people, whose voices have been traditionally silenced, to be heard, affirmed, and to organise into collective action. However, recent trends suggest that these stories are becoming a commodity with mental health organisations and educational institutions using them primarily to promote their own agendas. Many stories matter. Stories have been used to disempower and to humanise. Stories can break the dignity of a people, but stories can also repair that broken dignity. (Adichie, 2009) We three women are activists (survivors, researchers, and educators) and, drawing from our experiences in the Scottish and Irish contexts, we discuss the need to constantly problematise what has been achieved through the user movement. We are frustrated because people who share their stories remain disadvantaged, often unpaid, unequal partners while organisations, professionals, and academics benefit through receiving funding and building a career path on the basis of user

My first encounter with the key ideas of Michel Foucault’s (1926–1984) classic text, Madness and ... more My first encounter with the key ideas of Michel Foucault’s (1926–1984) classic text, Madness and Civilization, was during my social work studies in Greece in the late 1980s. It was the time of the so-called psychiatric reform in Greece, fuelled by the exposure of the horrific conditions of Leros Psychiatric Hospital. This institution was located on a remote island and its purpose was to contain all patients from Greek psychiatric institutions who were deemed untreatable to a single space of confinement. My undergraduate dissertation was focused on the Greek psychiatric reform and the deeply imbedded institutional practices in the country. Fou-cault’sMadness and Civilization provided me with a framework to conceptu-alize confinement as a process of exclusion and ‘silencing of the mad’. In the case of Leros, for example, it was possible to move beyond condemnation of the appalling physical conditions and to identify the unspoken consent of Greek society to abandoning people in this in...

Community Development Journal, 2017

Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and ... more Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and writers who have made long-standing contributions to the debate about mental health and recovery. In this dialogue they exchange analyses of the achievements and lessons to be learned from mental health activism that has resisted dominant narratives of mental illness and that has created innovative, collaborative and critical spaces for the exchange of ideas, experiences and enthusiasms. The dialogue seeks to evoke the distinctive styles of activism adopted in each context, the successes engendered and the kinds of dilemmas and tactical choices navigated. Ann and Lydia have initiated a process of reflection and exchange, and out of this they have constructed a dialogical piece that highlights key organizational issues for mental health activists and for community based social movements more generally.

Arts & Health, 2014

Background: This article is based on the Arts+Minds research project which investigated the exper... more Background: This article is based on the Arts+Minds research project which investigated the experience of arts participation for mental health service users in Cork, Ireland, and the potential of integrating the arts into mental health care. Methods: Based on the principle of user-controlled definitions of recovery, the voice of service users was central in this research. The authors used participatory observation methods and conducted qualitative interviews with project participants (service users, artists and mental health staff) to explore the impact of arts participation on service users and service structure and culture. Results: The research demonstrated the transformative potential of the arts to create environments conducive to recovery through empowerment, connection-making, confidence-building, hope, story-telling and story-making. Conclusions: Moving beyond the general agreement on the positive contribution of the arts in mental health care, this article highlights some of the challenges of introducing creative forms of engagement and expression in traditional biomedical settings. It is argued that a meaningful partnership between the arts sector and mental health services is not just a technical measure but requires a radical shift in the way we understand, respond to and engage with human distress.

Critical and Radical Social Work, 2016

Mental Health Social Work in Ireland

Critical and Radical Social Work, 2016

Over recent years new social movements have emerged to address concerns about a dominant bio-psyc... more Over recent years new social movements have emerged to address concerns about a dominant bio-psychiatric approach to mental health care. Key 'actors' in such movements are diverse, representing people who describe themselves as service users, survivors, patients, members of the mad community, carers, family members, practitioners, professionals, academics, and members of the public. Drawing from the Irish experience, this paper provides an overview of the emergence and subsequent work of the Critical Voices Network Ireland (CVNI). We give examples of initiatives aiming to critique and transform mental health systems in Ireland, followed by a discussion on the development of the CVNI as a critical platform and some observations about the politics of transforming the Irish mental health system. key words mental health • medicalisation • psychiatry • critical networks • collective action

Community Development Journal, 2012

Social Work Education the International Journal, 2020

As a social work lecturer I have, over the years, developed strong links with service-user/surv... more As a social work lecturer I have, over the years, developed strong links with service-user/survivor groups in an effort to contribute to a more context-focused and democratic approach to mental health education and practice. User narratives of psychiatric survival have been central in organizing resistance toward dominant constructions of ‘mental illness’. Within education, user narratives have created spaces for co-production with a transformative potential, as traditionally silenced voices can be heard and affirmed.

However, recent debates suggest that such narratives are often used by mental health and educational systems to promote their own agendas. In this context, user narratives are no longer considered a transformative act of co-production or resistance. They are a commodity servicing primarily the interests of these systems. This paper adds to these debates through a self-reflexive discussion on my experience of including user/survivor narratives in Irish social work education, as user narratives remain insufficiently critiqued in this context. I consider the significance of power operations in the contexts where narratives are shared and heard and argue for the need to honor what has been achieved while problematizing what may be lost through the inclusion of service-user narratives in social work education.

KEYWORDS: Mental health, service-users, narratives, co-production, co-option

Journal of Ethics in Mental Health, 2019

Telling our own stories of our experiences of distress and madness, of oppression and treatment, ... more Telling our own stories of our experiences of distress and madness, of oppression and treatment, of survival and resistance, is a source of power for people who use or are forced to use mental health services. Storytelling has created a space for people, whose voices have been traditionally silenced, to be heard, affirmed, and to organise into collective action. However, recent trends suggest that these stories are becoming a commodity with mental health organisations and educational institutions using them primarily to promote their own agendas. Many stories matter. Stories have been used to disempower and to humanise. Stories can break the dignity of a people, but stories can also repair that broken dignity. (Adichie, 2009) We three women are activists (survivors, researchers, and educators) and, drawing from our experiences in the Scottish and Irish contexts, we discuss the need to constantly problematise what has been achieved through the user movement. We are frustrated because people who share their stories remain disadvantaged, often unpaid, unequal partners while organisations, professionals, and academics benefit through receiving funding and building a career path on the basis of user involvement. While this is an unsettling position, we believe that we can make the best of it by being critical rather than cynical, by staying hopeful and engaged with the constantly changing demands of activism.

Community Development Journal, 2017

Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and ... more Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and writers who have made long-standing contributions to the debate about mental health and recovery. In this dialogue they exchange analyses of the achievements and lessons to be learned from mental health activism that has resisted dominant narratives of mental illness and that has created innovative, collaborative and critical spaces for the exchange of ideas, experiences and enthusiasms. The dialogue seeks to evoke the distinctive styles of activism adopted in each context, the successes engendered and the kinds of dilemmas and tactical choices navigated. Ann and Lydia have initiated a process of reflection and exchange, and out of this they have constructed a dialogical piece that highlights key organizational issues for mental health activists and for community based social movements more generally.

Critical and Radical Social Work, 2016

Over recent years new social movements have emerged to address concerns about a dominant bio-psyc... more Over recent years new social movements have emerged to address concerns about a dominant bio-psychiatric approach to mental health care. Key 'actors' in such movements are diverse, representing people who describe themselves as service users, survivors, patients, members of the mad community, carers, family members, practitioners, professionals, academics, and members of the public. Drawing from the Irish experience, this paper provides an overview of the emergence and subsequent work of the Critical Voices Network Ireland (CVNI). We give examples of initiatives aiming to critique and transform mental health systems in Ireland, followed by a discussion on the development of the CVNI as a critical platform and some observations about the politics of transforming the Irish mental health system. key words mental health • medicalisation • psychiatry • critical networks • collective action

A review of Michel Foucault’s (1926-1984) classic text, Madness and Civilization. A discussion on... more A review of Michel Foucault’s (1926-1984) classic text, Madness and Civilization. A discussion on the relevance of this work to grassroots movements in mental health.

This paper discusses an approach to mental health education that aims to prepare students to beco... more This paper discusses an approach to mental health education that aims to prepare students to become critical practitioners with a vision and skills to understand human distress in life contexts. This approach questions traditional knowledge-formation in mental health as it is not focused on psychiatric diagnoses as a tool to learn about ‘mental illnesses’. It also involves rethinking issues of power, language and identity by encouraging students to question what is often experienced as an oppressive, coercive mental health system and by putting the voice of service-users/survivors in the centre of practice. Such an education often clashes with the ethos and practice of current mental health services which, despite heralding a recovery agenda, remain in their majority medical in focus. Drawing from the author’s experience in mental health education, the paper highlights the potential of educational processes to transform hegemonic practice and the challenges and opportunities contained in this process.
Key words: mental health, social work education, critical practice, power, identity

INTERNATIONAL MAD STUDIES JOURNAL VOL 2, ISSUE 1, 2024, 2024

This article draws from my involvement in critical social work education and my position as an as... more This article draws from my involvement in critical social work education and my position as an aspiring ally of the Mad movement in the Irish context. I use a reflexive auto-critique as a methodology to consider a significant shift in my engagement with Mad matters which has led to new ways of (un)learning critically about madness and distress in education and activism. This is a shift from celebrating criticality and inclusion strategies, and in particular service-user involvement in education, to problematising criticality and its potential to perpetuate power inequalities within mental health and education systems. It is a shift from viewing critical education as a process of knowing about distress and Mad people to a process of knowing with and from Mad people, service-users, and survivors. The emerging field of Mad Studies provides a conceptual framework to inquire about knowledge and knowers, to consider issues of co-option and epistemic injustice, to focus on pedagogies for unlearning, to ask questions about representational politics and the complexities of being an engaged academic and Mad positive ally. Guided by Mad Studies as a mode of analysis, I recognise that inclusion of madness in university curricula can work in ways that continue to pathologise and subjugate Mad people. This is an unsettling recognition that leads to an interrogation of my own praxis as an academic and an aspiring ally of the Mad moment. I propose that prefigurative politics are central in these considerations as genuine engagements with mental health matters need to model the changes we aim to achieve. Engaging with the tensions of inclusion politics, the complexities of madness, and the unsettledness this engagement generates, can be a source of knowing through epistemic humility and a resource for networks of solidarity.

Telling our own stories of our experiences of distress and madness, of oppression and treatment, ... more Telling our own stories of our experiences of distress and madness, of oppression and treatment, of survival and resistance, is a source of power for people who use or are forced to use mental health services. Storytelling has created a space for people, whose voices have been traditionally silenced, to be heard, affirmed, and to organise into collective action. However, recent trends suggest that these stories are becoming a commodity with mental health organisations and educational institutions using them primarily to promote their own agendas. Many stories matter. Stories have been used to disempower and to humanise. Stories can break the dignity of a people, but stories can also repair that broken dignity. (Adichie, 2009) We three women are activists (survivors, researchers, and educators) and, drawing from our experiences in the Scottish and Irish contexts, we discuss the need to constantly problematise what has been achieved through the user movement. We are frustrated because people who share their stories remain disadvantaged, often unpaid, unequal partners while organisations, professionals, and academics benefit through receiving funding and building a career path on the basis of user

My first encounter with the key ideas of Michel Foucault’s (1926–1984) classic text, Madness and ... more My first encounter with the key ideas of Michel Foucault’s (1926–1984) classic text, Madness and Civilization, was during my social work studies in Greece in the late 1980s. It was the time of the so-called psychiatric reform in Greece, fuelled by the exposure of the horrific conditions of Leros Psychiatric Hospital. This institution was located on a remote island and its purpose was to contain all patients from Greek psychiatric institutions who were deemed untreatable to a single space of confinement. My undergraduate dissertation was focused on the Greek psychiatric reform and the deeply imbedded institutional practices in the country. Fou-cault’sMadness and Civilization provided me with a framework to conceptu-alize confinement as a process of exclusion and ‘silencing of the mad’. In the case of Leros, for example, it was possible to move beyond condemnation of the appalling physical conditions and to identify the unspoken consent of Greek society to abandoning people in this in...

Community Development Journal, 2017

Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and ... more Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and writers who have made long-standing contributions to the debate about mental health and recovery. In this dialogue they exchange analyses of the achievements and lessons to be learned from mental health activism that has resisted dominant narratives of mental illness and that has created innovative, collaborative and critical spaces for the exchange of ideas, experiences and enthusiasms. The dialogue seeks to evoke the distinctive styles of activism adopted in each context, the successes engendered and the kinds of dilemmas and tactical choices navigated. Ann and Lydia have initiated a process of reflection and exchange, and out of this they have constructed a dialogical piece that highlights key organizational issues for mental health activists and for community based social movements more generally.

Arts & Health, 2014

Background: This article is based on the Arts+Minds research project which investigated the exper... more Background: This article is based on the Arts+Minds research project which investigated the experience of arts participation for mental health service users in Cork, Ireland, and the potential of integrating the arts into mental health care. Methods: Based on the principle of user-controlled definitions of recovery, the voice of service users was central in this research. The authors used participatory observation methods and conducted qualitative interviews with project participants (service users, artists and mental health staff) to explore the impact of arts participation on service users and service structure and culture. Results: The research demonstrated the transformative potential of the arts to create environments conducive to recovery through empowerment, connection-making, confidence-building, hope, story-telling and story-making. Conclusions: Moving beyond the general agreement on the positive contribution of the arts in mental health care, this article highlights some of the challenges of introducing creative forms of engagement and expression in traditional biomedical settings. It is argued that a meaningful partnership between the arts sector and mental health services is not just a technical measure but requires a radical shift in the way we understand, respond to and engage with human distress.

Critical and Radical Social Work, 2016

Mental Health Social Work in Ireland

Critical and Radical Social Work, 2016

Over recent years new social movements have emerged to address concerns about a dominant bio-psyc... more Over recent years new social movements have emerged to address concerns about a dominant bio-psychiatric approach to mental health care. Key 'actors' in such movements are diverse, representing people who describe themselves as service users, survivors, patients, members of the mad community, carers, family members, practitioners, professionals, academics, and members of the public. Drawing from the Irish experience, this paper provides an overview of the emergence and subsequent work of the Critical Voices Network Ireland (CVNI). We give examples of initiatives aiming to critique and transform mental health systems in Ireland, followed by a discussion on the development of the CVNI as a critical platform and some observations about the politics of transforming the Irish mental health system. key words mental health • medicalisation • psychiatry • critical networks • collective action

Community Development Journal, 2012

Social Work Education the International Journal, 2020

As a social work lecturer I have, over the years, developed strong links with service-user/surv... more As a social work lecturer I have, over the years, developed strong links with service-user/survivor groups in an effort to contribute to a more context-focused and democratic approach to mental health education and practice. User narratives of psychiatric survival have been central in organizing resistance toward dominant constructions of ‘mental illness’. Within education, user narratives have created spaces for co-production with a transformative potential, as traditionally silenced voices can be heard and affirmed.

However, recent debates suggest that such narratives are often used by mental health and educational systems to promote their own agendas. In this context, user narratives are no longer considered a transformative act of co-production or resistance. They are a commodity servicing primarily the interests of these systems. This paper adds to these debates through a self-reflexive discussion on my experience of including user/survivor narratives in Irish social work education, as user narratives remain insufficiently critiqued in this context. I consider the significance of power operations in the contexts where narratives are shared and heard and argue for the need to honor what has been achieved while problematizing what may be lost through the inclusion of service-user narratives in social work education.

KEYWORDS: Mental health, service-users, narratives, co-production, co-option

Journal of Ethics in Mental Health, 2019

Telling our own stories of our experiences of distress and madness, of oppression and treatment, ... more Telling our own stories of our experiences of distress and madness, of oppression and treatment, of survival and resistance, is a source of power for people who use or are forced to use mental health services. Storytelling has created a space for people, whose voices have been traditionally silenced, to be heard, affirmed, and to organise into collective action. However, recent trends suggest that these stories are becoming a commodity with mental health organisations and educational institutions using them primarily to promote their own agendas. Many stories matter. Stories have been used to disempower and to humanise. Stories can break the dignity of a people, but stories can also repair that broken dignity. (Adichie, 2009) We three women are activists (survivors, researchers, and educators) and, drawing from our experiences in the Scottish and Irish contexts, we discuss the need to constantly problematise what has been achieved through the user movement. We are frustrated because people who share their stories remain disadvantaged, often unpaid, unequal partners while organisations, professionals, and academics benefit through receiving funding and building a career path on the basis of user involvement. While this is an unsettling position, we believe that we can make the best of it by being critical rather than cynical, by staying hopeful and engaged with the constantly changing demands of activism.

Community Development Journal, 2017

Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and ... more Anne O’Donnell and Lydia Sapouna, based in Scotland and Ireland, respectively, are activists and writers who have made long-standing contributions to the debate about mental health and recovery. In this dialogue they exchange analyses of the achievements and lessons to be learned from mental health activism that has resisted dominant narratives of mental illness and that has created innovative, collaborative and critical spaces for the exchange of ideas, experiences and enthusiasms. The dialogue seeks to evoke the distinctive styles of activism adopted in each context, the successes engendered and the kinds of dilemmas and tactical choices navigated. Ann and Lydia have initiated a process of reflection and exchange, and out of this they have constructed a dialogical piece that highlights key organizational issues for mental health activists and for community based social movements more generally.

Critical and Radical Social Work, 2016

Over recent years new social movements have emerged to address concerns about a dominant bio-psyc... more Over recent years new social movements have emerged to address concerns about a dominant bio-psychiatric approach to mental health care. Key 'actors' in such movements are diverse, representing people who describe themselves as service users, survivors, patients, members of the mad community, carers, family members, practitioners, professionals, academics, and members of the public. Drawing from the Irish experience, this paper provides an overview of the emergence and subsequent work of the Critical Voices Network Ireland (CVNI). We give examples of initiatives aiming to critique and transform mental health systems in Ireland, followed by a discussion on the development of the CVNI as a critical platform and some observations about the politics of transforming the Irish mental health system. key words mental health • medicalisation • psychiatry • critical networks • collective action

A review of Michel Foucault’s (1926-1984) classic text, Madness and Civilization. A discussion on... more A review of Michel Foucault’s (1926-1984) classic text, Madness and Civilization. A discussion on the relevance of this work to grassroots movements in mental health.

This paper discusses an approach to mental health education that aims to prepare students to beco... more This paper discusses an approach to mental health education that aims to prepare students to become critical practitioners with a vision and skills to understand human distress in life contexts. This approach questions traditional knowledge-formation in mental health as it is not focused on psychiatric diagnoses as a tool to learn about ‘mental illnesses’. It also involves rethinking issues of power, language and identity by encouraging students to question what is often experienced as an oppressive, coercive mental health system and by putting the voice of service-users/survivors in the centre of practice. Such an education often clashes with the ethos and practice of current mental health services which, despite heralding a recovery agenda, remain in their majority medical in focus. Drawing from the author’s experience in mental health education, the paper highlights the potential of educational processes to transform hegemonic practice and the challenges and opportunities contained in this process.
Key words: mental health, social work education, critical practice, power, identity

This chapter considers the role of social work in the current context of mental health care. Ment... more This chapter considers the role of social work in the current context of mental health care. Mental health care in Ireland has a long tradition of institutionalisation and while contemporary policy and practice herald a community-based, recovery-oriented approach there is still a strong emphasis on biomedical models of responding to human distress. Within this predominantly medical framework of thinking and practising, mental health social workers often consider themselves powerless to articulate a valid ‘social’ approach to mental distress. The chapter will argue that social workers need to think ‘outside the box’ and engage with the emerging critical approaches in mental health. These approaches address concerns such as the inhumane physical conditions in hospital units, over-reliance on and excessive use of medication, lack of meaningful community-based alternatives to hospitalisation, involuntary treatment, abuse of professional power, and lack of information and choice in relation to ‘treatment’ options. These approaches recognise that a bio-medical strategy in mental health care today will at best provide temporary symptomatic relief (which may be valid as a first step), but may compound, exacerbate and even cause further deep distress. Furthermore, there are concerns that current responses to distress fail to capture the complexity of human experiences by ignoring the underlying grief, heartbreak and trauma in people’s lives. These new approaches also recognise that people need to be fully engaged in all aspects of their own recovery. Key actors in the development of this new thinking are diverse, but represent people who describe themselves in such terms as service users, survivors, patients, members of the mad community, carers, family members, practitioners, professionals, academics and the lay public, all of whom are dissatisfied with current forms of care and its underpinning bio-medical philosophy. It will be argued that these approaches are reflective of and compatible with the value-base of social work. By engaging in a paradigmatic shift and by forming meaningful partnerships with service users/ people with self-experience, social work can reclaim its social identity and respond to human distress in a way that is user-centred, respectful, aware of context, and based on human rights.