Mental cases

Laurie Hall remembers the time, about 20 years ago, she went on a trip to a clothing store with two nurses from Whitby Mental Hospital Centre, where Hall was a patient at the time.

The staff were pushing for her to buy some frilly blouses that Hall did not want. The ensuing negotiations led to a deal being struck: one frilly blouse in exchange for one captain’s hat that Hall wanted.

Hall says she never wore the blouse, but the captain’s hat was always on her head.

Looking back on her 14 years in the mental health system, Hall says staff frequently connected her sexuality with her mental health issues. Her lesbianism and interest in men’s clothes was treated as something that needed to be fixed. She needed to be feminized.

“I was given the message I needed more flowery clothes,” says Hall, a former executive director of A-Way Express. (The courier service is a business which provides employment to psychiatric survivors, a term used by people who have gone through a psychiatric institution system to describe themselves.) She now does some contract work for A-Way, and some people also consider her something of a poster child for the psychiatric survivor community.

Homosexuality is no longer considered a disorder in the psychiatric profession’s main guidebook, The Diagnostic And Statistical Manual Of Mental Disorders, Fourth Edition (DSM-IV); it was removed from the book in 1973.

But the book does have a “not otherwise specified” category some psychiatrists can use to diagnose people having difficulty adjusting to their sexual orientation.

Some people say this diagnosis is still triggered because of homophobia in the system; but those in the system say such treatment is a thing of the past.

Diana Capponi, herself a psychiatric survivor and a lesbian, says being queer can be a dangerous topic of discussion in the mental health system. She says that when doctors and other psychiatric staff encounter a person with mental illness, they are more than willing to throw sexual orientation into the mix.

“It depends on who you talk to,” says Capponi, who is the coordinator of the Ontario Council Of Alternative Businesses, the organization that channels government funding to businesses that support psychicatric survivors. “There’s no written policy. It’s subjective.”

Capponi says she knows of people who have been hospitalized for their sexuality with the goal of behaviour modification – getting them to stop their same-sex attraction or cross-dressing.

Dr James Cantor, a researcher into sex and biology at the Centre For Addiction And Mental Health, says no one he knows in the mental health system would problematize sexual orientation.

“There’s no reason to try to change [sexual orientation],” Cantor says, “and there’s no evidence it can be changed.”

Cantor has been involved in the field since 1990. It may not seem like a long time to gather information about the authenticity of these kinds of stories. But he was an officer at the American Psychological Association in the US, and there came into contact with many gay and lesbian people in the profession – all of them keeping an eye out for systemic homophobia.

“I was seen as a central clearing house of this kind of information. The subject would come up and we’d all talk about it and no one had ever seen it,” Cantor says. “The mental health profession is the most liberal of the highly educated professions.”

Theodora Dimou just finished a stint as manager of promotions at the Raging Spoon café and catering service (at 761 Queen St W), which is supported by the council. She says her recent experiences with the mental health system were homophobic.

Dimou talks guardedly about the month she spent confined in hospital.

“I was in hospital and I had to have a hearing to get out,” Dimou says.

She says police arrived at the café she once owned and “formed her” – meaning they had been given the authority to seize her because she was considered a danger to herself – handcuffed her and took her to hospital.

Dimou is unwilling to go into specifics about the events leading up to the arrival of the police at her door. But she feels authorities were notified and took action in part because she told her family she was in love with another woman.

“I don’t think people should be in hospital because of sexual preference. In this day and age, I can’t believe this is an issue,” she says.

Dimou says that after a month in the hospital, she had a release hearing. Before it started, she says her lawyer warned her, “You know they’re writing down everything you say. Do you know you said you’ve had it with men?”

Dimou was upset that her declaration of being finished with men was assumed to be relevant to her mental health issues.

Carol Dunphy, the present executive director of A-Way, has bad experiences with the mental health system going back aways.

Dunphy, who moved to Toronto from Newfoundland in 1986, had been hospitalized in the 1970s for major problems with depression. She found herself in a locked ward, was drugged to the point of having seizures, and made what she calls a “feeble” suicide attempt.

She was sent to the “Mental” in St John’s where she says Nurse Ratcheds – like the cruel Louise Fletcher character in the film One Flew Over The Cuckoo’s Nest – abounded.

After a lot of time and distance between herself and Newfoundland, Dunphy says she managed to have photocopies of her psychiatric file released to her, and last summer in a lovely, cathartic ceremony in Muskoka she burned it.

But then she laughs and says she kept an extra copy for her files. The nurses had written that she had homosexual tendencies.

“And of course, I didn’t know,” she says sarcastically.

Though he can’t speak to these specific cases, Cantor says many stories of homophobia in the system lose their credibility on closer examination.

“I’m kind of skeptical,” Cantor says. “The only times I hear of it, there’s somebody on Oprah, somebody on Jerry Springer. I only hear it from people who have something to gain.”

Could it be staff left over from the bad old days aren’t following current policies and procedures?

With support staff, “I’ve never really run into a homophobic instance ever,” says Cantor. “Any time I hear friction, it’s from one of these [radio and TV show host] Dr Laura types, people who aren’t trained in psychology or psychiatry, people who have only a tangential connection to the work.”

Bad institutional experiences aren’t the only thing Hall, Dimou, Dunphy and Capponi have in common. They’re all lesbians who have become leaders in projects supporting psychiatric survivors.

They’re all aimed at providing employment for, as Dunphy says, “people who have been down through the crazy trenches.”

The businesses are based on the idea that psychiatric survivors don’t just need to take their medicine and make their beds. They need a place to live, a job to pay the bills and a healthy dose of laughter daily about who they are and what they’ve been through.

At these workplaces, the laughter can often be about the shared queer sexuality of many of the employees.

“If you’re a survivor plus you are a dyke or gay, there’s a whole other cameraderie,” Dunphy says.

At A-Way and the Raging Spoon, humour seems to be an essential ingredient.

“We were able to offer a safe place to joke about sexuality,” says Capponi.

“That’s what’s so great about being at the Spoon. A lot of people have been ‘formed’ because they are gay,” says the Spoon’s Dimou.

Hall echoes the assessment there are a large number of gay men and lesbians in the survivor community, many of them in leadership positions.

“The biggie is you don’t have to hide. There is so much shame attached to mental illness. Put on top of that the shame of sexual orientation,” Hall says.

“One of the biggest problems is it [the mental health system] looks at the symptoms and not the problems. Once you get into that system, everything becomes more pathologized. It’s very difficult to break away from that,” she says.

“There’s a majority that thinks the mental health system should be called into account,” Hall says.

In a way, gay men and lesbians in the psych movement are perfectly positioned to lead that charge.

“The leadership thing has to do with already having had the experience of fighting for your rights through the gay and lesbian community and fighting for yourself, too,” Hall says.

Hall, who handed over the executive director reins of A-Way to Dunphy last November, says the business model has drawn mental health providers from all over the world, including Estonia and Hong Kong, to A-Way’s offices on the Danforth wanting to export the idea.

They’ve also inspired a film. In May, Hall, Capponi, filmmaker Laura Sky and others will take Working Like Crazy, an NFB documentary about psych-survivor businesses, on a tour through England, Ireland and Scotland.

“We had a tremendous amount of interest. The survivors love it. They love the possibilities,” Hall says.