‘Mad, bad and dangerous to know’: the (re)productive mapping of psycho-pathological landscapes

Traditionally, academic literature has focused on a macro-analysis of the social, political and geographical position of those with mental health distress (e.g. Foucault, 1965; Painter & Philo, 1995). Subsequently, service users have been positioned as a largely homogenous group who mainly reside on the boundaries of social integration due to the negative social representations of mental health impairment. For Parr (1997) this diffusion of who is and who is not socially acceptable when compared to the collective, is primarily based upon the pervasive use of labels surrounding mental illness resulting in exclusionary spaces allocated for service users. Territorial lines (real and imaginary) are therefore drawn resulting in the creation of residual space that have been endorsed for such troublesome groups to mutually interact (e.g. Crang & Thrift, 2000; Painter & Philo, 1995). It would be reasonable to suggest that a day centre is such a space. More saliently perhaps, these discourses imply that not only are users a largely homogenous group but reinforces their lack of creative ontology. For example, all service users who attend a day centre have one thing in common, namely mental health distress. As a result alongside illnesses such as cancer or coronary heart disease, the symptomology and the prognosis of mental health distress is viewed as a shared continuum. A level playing field where all those affected can empathise and support each other. This notion of mutuality can be taken one step further and even romanticised by suggesting that service users engage in consensual and non-judgemental social norms, in terms of appropriating the social inclusion of others. However, this reductionist approach negates the realities encountered by service users on a daily basis whereby differing medical ascriptions such as ‘depression’ and ‘schizophrenia’ can not only influence a service user’s own self-identity and behaviour but ultimately, the acceptance of other members. Parr’s (2000) research into the ‘hidden social geographies’ of day centres provides some insight in this area. Using covert, ethnographic methods, Parr found that contrary to the dominant ideologies endorsing the unproblematic nature of user’s engagement within this place, that socio-medical codings were enforced by the dominant group. Parr (2000) suggests that such codings are consensually agreed by members and staff especially with regards to the use of the body in the day centre setting, which can result in a complex (self)policing of bodily behaviours. Those who overstep the defined boundaries are subsequently isolated by their difference and are in effect excluded, ‘the other’ within ‘otherness’. Therefore the motions and movements of these geographies are mimetic in their nature, microcosms of space which emulate their macro counterparts but within different atmospheres. Much like the archer’s target, whereby the larger circles become smaller and more condensed but the nature and meaning of the shape remains symmetrical in content. The day centre can be such a cyclical territory, on the one hand located on the periphery in relation to the global. But actively creating its own method of expression and signification to maintain the cohesion of the selected group based on the dominant discourses of mental health (Buchanan, 2006). This area of service user life remains largely unexplored especially when discussing the consented narratives from service users. Using semi-structured interviews, 22 participants aged 50 years and above gave their own self-reflections on how mental health can shape the individual and collective use of space. In conclusion, this work indicates that rather than a discrete linear position between the ‘otherness’ of mental health distress and ‘civilised’ human geographies, this micro-spatiality remains a complex phenomenon when linked to certain diagnoses.