Introduction

This chapter advances an account of the social model of disability (SMD) that questions impairment and the application of the model in the areas of mental health and distress. It does so by critically examining the relationship between impairment and the social, which, in a simplistic application of the social model, is often taken as unproblematic. The concerns voiced here cannot be resolved within the chapter, nor without the involvement of a mad and disabled constituency. That said, my purpose is to advance a critique that unsettles notions of impairment in both psy science (this is the term used throughout this chapter to denote the psychiatric and clinical psychological sciences) and the social model of disability. Whether or not this critique suggests the necessity of a different iteration of the social model for mental health remains to be seen, and it should not be read as a criticism of the achievements made for disabled people through the application of the social model so far. Rather, this chapter aims to crystallise what I believe is a crucial tension in advancing the rights of people with mental health problems who identify as disabled. This tension is that if medical and psy sciences lack the evidence to supply a cogent account of impairment in mental health, then the social model of disability, which relies equally on notions of impairment, is destabilised. The dilemma is whether the social model can, or should, overlook this unsettled impairment.

The shifting ground of impairment and disability.

The social model of disability is ensconced in disability and equality legislation, which considers long-standing psychosocial distress to be a disability while relying upon psychiatric diagnoses and classification. The social model is, moreover, widely acknowledged as the preferred way for disabled people to have their needs met and to articulate their experience. While the social model appears to have been embraced, legislation, policy and practice remain clinical, using the language of the helping professions. Take for example the following passage from an article in the British Psychological Society's (BPS) periodical The Psychologist: ‘Most of the time we think about clinical conditions, such as autism or ADHD or schizophrenia or depression, individually. Yet in reality it is extremely common for people to show more than one condition together’ (Ronald, 2014, 164, my emphasis).