Changing the Connotations of Disability: Mental Health and Higher Education

By R Srivatsan

This note explores some issues that arose in my mind in a recent engagement with disability theory and activism in the fields of mental health and higher education.

The Bapu Trust Workshop on Mental Health and Development in Pune (March 18-19 2016) had several fruitful discussions over different topics including development, law, and methods of research.  However, the most interesting were on the implications, for the mentally distressed, of Article 19 of the United Nations Convention for the Rights of Persons with Disabilities, which provides the disabled opportunity to choose place of residence; access to all forms of special support services; and equal access to community services and facilities available to the general population. Key to the hope and excitement was the possibility of replacing medical treatment aimed at (an often coercive) cure of what was hitherto called ‘mental illness’ with the positively designed and institutionalized accommodation and care to overcome disability. As Bhargavi asked, what would the changes in the design of mainstream social structures have to be to accommodate the mentally distressed?

On April 16, 2016, a People’s Tribunal was conducted to bring to the notice of the public the discrimination, injustice, and atrocities of the administration of the University of Hyderabad and the police.The occasion was the student protest against the return of the vice chancellor (who was seen as responsible for Rohith Vemula’s suicide) to take charge of the university under police cover. Institutional dereliction of duty, clashes, police violence, and the incarceration of students and two of the faculty ensued.

Amita Dhanda proposed to the tribunal structural changes to repair enormous lacunae in institutional function. She argued that provision of access to students from disadvantaged backgrounds (see Dhanda’s essay on reasonable accommodation in this issue) would need to go beyond mere formal reservations at entry, to positive affirmative action that ensures real inclusion and caring accommodation. To this end, she argued that the disability perspective celebrates human difference and social pluralism and that, it would be productive to “draw from disability rights jurisprudence to enlarge the learning universe of the universities” (personal communication).

Three perspectives of disability

Classically there seem to be three perspectives from which disability has been examined.

First (the order is rhetorical rather than hierarchical) is the perspective of the moral philosopher, Martha Nussbaum (2006), who explores how to design and build an inclusive and accommodative society for all human beings.

Nussbaum raises the problem of accommodation by design of social structure and law by analyzing the deficits of the Contractarian theory of citizenship in the work of John Rawls.  She lays bare the problems of such theories by probing the founding assumptions of the Social Contract—between men “equal in capacity and capable of productive activity”. Nussbaum then points to the disabling consequences of these assumptions for women, children, the elderly, those who suffer impairment, and those who belong to parts of the world which as whole nations are disabled in the Western imagination. Yet, as she argues, the history of Social Contract in the modern revolution for individual equality against feudal hierarchies makes the equality assumption an inalienable part of that theory.

Nussbaum proposes that a theory of inclusion of the disabled should be based on maximizing capability to ensure civic entitlement, rather than on the contractual assumption of equality, thus providing ground for Danda’s observation, “what is good for persons with disabilities is good for all of humanity”.

Second is the perspective of a socially disabled/physiologically impaired thinker, Anita Ghai (2003), who speaks of the specificities of impairment and a disabled life.  Ghai, based on her experience as a disabled woman, explores the social and cultural frameworks of the stigmatization of disability. Particularly memorable is her observation that “within India, disability is often understood culturally as retribution for past sins” (p 34). This observation shows clearly that disability has an echo in the mythology of the caste hierarchy, where an individual is born into a lower caste as retribution for sins in a previous birth, thus attaching the concept of disability to a punitive social structure determined by caste. This provides a caste-historical context to understand Dhanda’s argument that substantive affirmative action for the marginalized should go beyond formal reservations at entry.

Ghai’s dual focus on physiological impairment and social disability throws into relief one further development in the broad discourse of disability. An example is Tom Shakespeare’s (2006) criticism of the argument that social structures are the causes of disability (see following paragraph). Shakespeare foregrounds the hard and often highly painful reality of physiological impairment that cannot be removed by modification of social structures, and thus advocates retaining the specificity of impairment and making a demand on society for thoughtful accommodation.

Third is the disability theorists’ critique of society, and here the example I choose is Lennard Davis (2013), who argue that in order to understand the problem of disability, one must understand the historical emergence of the norm and of the normal individual in modern capitalist society, i.e., “the notion of progress, industrialization and the consolidation of the power of the bourgeoisie…[O]ne of the tasks for a developing consciousness of disability issues is the attempt…to reverse the hegemony of the normal and to institute alternative ways of thinking about the abnormal” (p 12).This perspective stresses the need to examine how the able-bodied (and ‘minded’) individual emerges as the norm of the disciplinary requirements in modern industrial society, such that there is indeed the disabled as its ‘abnormal’ other. Note that this adversarial critique of disciplinary society’s construction of disability differs from Nussbaum’s critique of the implicit assumptions of normality in Contractarian theories of citizenship and her formulations for governmental redress. It is this conceptual attack on the norm that is critiqued by impairment theory (see previous paragraph).

Dissensus: The necessary ambiguities of ‘disability’ on the ground

It would be useful to recap the two events I have described, in mental health and higher education, in relation to these positions.

On the one hand, mental health activists come with experience of the long and dreary struggles against the corrective, curative, and often coercive perspectives of biomedical psychiatry.  At root, their hope is that what may seem today like chronic, sometimes permanent, impairment of mental capabilities should not, in a better world, lead to permanent incarceration. It should rather be accommodated by design in open society by linking their disability (see next paragraph for full connotations of this term) to the general structure of the UNCRPD, while affirming their positive difference from the social norm of disciplinary conformity.

On the other hand, while Dhanda has recommended disability jurisprudence as a rich source for affirmative action policy in India, I am not sure if there are many Dalit or Adivasi activists/intellectuals who would like to affiliate themselves to the term ‘disability’, which retains its negative connotations in lay language—a person who is disabled is someone who is not normal or is incapable of full function in some way. However, activist and theoretical discourse has given the term ‘disability’ a connotation of one actively disabled by society, just as Andre Gunder-Frank in the 1970s transformed the term ‘underdeveloped’ to mean those nations actively forced into underdevelopment.  Indeed dalit politics has, through a sustained critique of the lacunae in formal reservations, demonstrated upper-caste attempts at active subjection, persistent social discrimination, and the substantive failure of the promise of equal citizenship. The structural similarity of social critique from the both disability and dalit/minority perspectives offers some hope.

However, whether with mental health activism or with the dalit/minority politics, there is a different kind of ambiguity. In spite of the liberal intentions of administrative policy, atavistic and recalcitrant passions in implementing agencies regularly wreak havoc through wanton discrimination. Thus ‘good and progressive’ policy provides government an alibi of virtuous intention, which unfortunately is negated by ‘bad and reactionary’ implementation’s ambiguous, sometimes catastrophic, results. In this scenario, those fighting the disability/discrimination battle must employ an ambiguous strategy too—seeking justice in policy through inclusive design and accommodation, and simultaneously being relentlessly critical of governmental structures and agential practices that undercut inclusion on the ground. Policy naivete and progressive hubris on the one hand and passive assent to malevolent non-implementation on the other must be strongly theorized as integral to the contemporary shape of collusion against accommodation. Without such a strategic ‘duplicity’ that challenges the ambiguity of good governmental intention and the everyday encounter with structural prejudice, the battle is lost before it begins. It remains for ‘normal’ advocates to align with this difficult and ambiguous disability strategy of a demand for justice and a simultaneous critique of a passive acceptance of social forms that deny it. The difficulty in doing so is that critique will be leveled at the advocates’ implicit prejudices too, something an insecure ‘normal’ well-wisher may be unable to cope with.

Acknowledgments: I am grateful to Shilpaa Anand who invited me to contribute to this issue. The editors’ comments were extremely useful. I also thank A. Suneetha who provided critical feedback on the draft. 

References

Lennard J Davis, “Introduction” The Disability Studies Reader (New York: Routledge Publishers, 2013)
Anita Ghai, (Dis)embodied Form: Issues of Disabled Women (New Delhi: Shakti Books, 2003).
Martha Nussbaum, Frontiers of Justice: Disability, Nationality, Species Membership (Cambridge, Mass: Harvard University Press, 2006).
Tom Shakespeare, Disability Rights and Wrongs Revisited (New York: Routledge Publishers, 2006)

Bio:
R Srivatsan works in political theory, development, and health care at Anveshi Research Centre for Women’s Studies.

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