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The Mental Health Landscape Is Rife with Identity Politics

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In today’s mental health system, identity is very imaginary, conversely authentic, and rife with identity politics. Step inside the vast channel speeding up a shadowy volcanic fury of academic malaise and speculative clinical jargon, a truth lingers dormant. Somewhere along this ride is the authentic self. Somewhere, culturally re-appropriated and manufactured for that very use is the most ethical and moral way forward. To be ourselves unencumbered by the artificiality of Western psychiatry is impossible given the definitions in use. Our chosen pathway comes from revealing our true identity from the darkness and guides us gently, perhaps hastily, but ever safely forward out of illness towards healing, health, and wellness.

I want to make two terms visible and define them: ‘passing’ and ‘covering.’ Covering is the act of downplaying a part of our identity to reap the benefits of belonging to the dominant or majority group. Passing is the act of concealing to hide or disguise a piece of someone’s identity to seem as if (insert pronoun) is ‘naturally’ a part of the dominant group.

Now, all these words can have hyphenations, brackets, and quotation marks if we dig deep enough into the wellspring of identity markers, tracers, and signs in mental health. For this discussion, let us excavate just enough meaning to get a ‘working’ understanding of the language so the reader can repurpose these ideas and take them in (insert pronoun) journey through the system.

These terms evoke other concepts. Right to ‘ownership’, ‘diversity’, ‘equity’, and ‘inclusion’. The capacity to interfere and disable discrimination based on lived experience and belonging. To make these seconding concepts more meaningful, I want to share an anecdote from my experience as a peer specialist working on an ACT (assertive community treatment) team with shared clients.

The vocational specialist and I had a good connection with a particular client. Given we were on a team and helping this client work towards a goal, both of us workers tried to align our interventions to reach this goal: acquiring a pair of shoes for the client. To make matters more complicated, the client had a history of ‘splitting’ team members and having them work at cross purposes. The splitting came off as innocent. Minor, cutting remarks about other team member’s abilities in front of select members of the team. This had the effect of complicating our understanding of the client’s mental status in the end. When conflicting reports appear for one client, it takes some re-engagement and reassessment to get treatment back on track. 

I was expecting this. I was no stranger to working on my own when I was either the sole ally in a client’s life or the only team member working with a few clients on the roster. My position on the team was somewhat analogous- given my disclosed lived experience and my clinical role. Many do. To fulfill my job responsibilities and work, I would have to cover one identity in favor of another to do the work without stepping into a dangerous dual role. With dual roles and a complicated identity game I was playing, I did not expect the client to turn my lived experience and use it as a bargaining chip to position my teammate and me against each other. This is how it went down. This vocational specialist I am citing came into mental health as his second career. He was a police officer before joining our ACT Team. 

Police officers don’t come from a homogenous population. All walks of life become cops. And yet, all cops must assume this single identity as an officer of the law above personal reproach. In this sense, officers must cover aspects of the essence all the time to pass as this monolithic police force. In terms of ACT teams, most of our clients, especially the client we were working with, had a history of trauma from police intervention. The vocational specialist was competent to keep this information to himself, at least, until it could be unpacked at a later date if it ever surfaced. The question is: if you are not a peer, is there ever a reason for lived experience, other ‘identities’ to appear when practicing in mental health? 

One day, I stumbled into a minefield of questions regarding the vocational specialists’ training and history after one of his visits went sour. Given we a team and work to patch up rapport gaps with mutual clients, I allowed myself to walk into the minefield of identity, exposure and got very hurt in the process: ‘Why was he asking me all these questions?’ The client asked me. 

I explained to the client that he was doing what he knows, given his training and style. He wanted to learn more about you (the client) to serve better and make sure the client reached the goal ultimately went the plan and the shoes obtained. ‘He was a police officer before he came to the team, and this is him learning how to serve you better: a cop. Oh no! I’ll never speak with him again (inconsolable cries and muttering).’ Indeed, this is an example where identity politics can devolve into a sordid game of ‘othering, ‘and later, in this mental health example, ‘splitting’. 

My mistake was I shared someone else’s experience in life to engage with a client on my level and terms. In doing so, the team member whose identity I revealed no longer had space or the option to pass or cover to complete his job work and engage with clients successfully. In a clumsy, albeit gungho attempt at team diplomacy, I revealed the team member’s history before working on our team, possibly putting him at risk of violence and certainly disengagement in the rooster when working mutually with this client. 

While I had the best intentions, I did now ‘own’ my team members’ history, and I had no right to disclose it to others. My team member had every right to cover as a former job as a cop (albeit with some visible pushback and clumsiness) to keep his safety intact and continue passing as a viable ACT team employee. Now, here is where things took an even darker turn for our team. Despite processing all of this as a team together, the incident continued to leave a lasting mark. The vocational specialist fed into the client splitting and refused to relate with me or work with me any further.

Now, the futility of this is apparent, but the long-term and ultimate global implications must be reviewed here. When we use identity politics to scorn and ‘disable’ pathways for ongoing dialogue, communication, and discussion, we let our niche and bold identities become the very flags hailing our surrender to microaggressions and infighting in mental health.

Maxwell Guttman, LCSW teaches social work at Fordham University. He is also a mental health correspondent for Psychreg.


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