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Clearing a Path
A Psychiatric Survivor
Anti-violence Framework
This report was made possible by the City of Toronto
Access, Equity And Human Rights community grant
Thanks to grant trustee Parkdale Community Legal
Services
people who have helped shape this conversation
Diann Chea, Nadia Kanani, Alexandra Lamoureux, Tracy Lyn Mack, Jenna Reid, Tina
Shapiro, Tess Sheldon, Bob Rose, Anita Wasowicz, Victor Willis, Diane Wintermute
Empowerment Council, Habitat Services, Making Room Collective, Parkdale
Community Legal Services, Toronto Public Health, Ryerson University (School of
Disability Studies), York University (School of Social Work, Critical Disability Studies)
Financial contribution provided by the MTCU’s Campus Safety Initiatives for Women
Grant, administered by Ryerson’s EDI/Human Rights Services
For more information, please contact The Empowerment council (416) 535-8501,
ext. 33013
Citation information: Psychiatric Disabilities Anti-violence Coalition (2015).
Clearing a
path: A Psychiatric Survivor Anti-violence Framework
. Toronto.
3
Report Project Administrators
Lucy Costa – Empowerment Council
Andrea Daley – York University School of Social Work
Peggy-Gail DeHal Gunraj – Parkdale Community Legal Services
Working Subcommittee
Lucy Costa, Andrea Daley, Peggy-Gail DeHal Gunraj, Jennifer Eng, Rachel Gorman,
Danielle Landry, Stefania Mendolia, Chris Persaud
Participant Consultation Facilitators
Susan Bender, Lucy Costa, Andrea Daley, Peggy-Gail DeHal Gunraj, Chris Persaud
Transcript Analysis
Lucy Costa, Andrea Daley, Rachel Gorman, Stefania Mendolia, Chris Persaud
Mad / Psych Survivor Analysis
Lucy Costa, Danielle Landry, Stefania Mendolia
Revisions
Lucy Costa, Andrea Daley, Peggy-Gail DeHal Gunraj
Staff
Toby Samson – Researcher
Lisa Walter – Editor
Design and Layout
Lisa Walter
JANUARY 2011
First of a series of assaults against six vulnerable people living in Parkdale
4
Table of Contents
Forward 5
Background 7
Context 7
About violence against people with psychiatric disabilities 9
The formation of PDAC, its purpose and initiatives 11
The coalition comes together 11
Our approach 13
Community mobilization 16
Community consultations 19
Purpose of the consultations 19
Research approach 19
Method 20
Working with the data 20
The signifi cance of this data 23
WHERE TO NOW? 24
At this junction, at this time 24
Using a Psychiatric Survivor informed Anti-
violence Framework 26
Mobilizing Responses and Action 28
What remains to be done and by whom 29
Questions for organizations implementing
a psychiatric survivor anti-violence framework 31
Appendix 32
endnotes 38
Reference List 40
FEBRUARY 2011: Hamilton police fatally shoot Andreas Chinnery
MARCH 2011
Community meeting about Parkdale assaults
5
Forward
The heart of this report is a framework, an approach groups can use to engage in a
response to violence against people with psychiatric disabilities in their communities.
The psychiatric survivor anti-violence framework, as conceived by a working group of
the Psychiatric Disability Anti-violence Coalition (PDAC), is intended to provide guide-
lines in which to respond to and address the various forms of violence experienced by
persons with a psychiatric disability, in particular those who are further marginalized
by race, gender, income, status, and disability.
Psychiatric survivor1 history has long been shaped by community members’ struggle
for freedom from violence. Geoffrey Reaume, a psychiatric survivor historian, refers to
the word ‘survivor’ as “chosen to show there was much pride in our history of surviv-
ing discrimination and abuse inside and outside the psychiatric system, in advocating
for our rights and in our personal and collective accomplishments — that psychiatric
survivors are much more than a diagnostic label.” (Reaume, 2008. p. 2). As readers
will discover, psychiatric survivors have developed many strategies not merely to cope
with the effects of violence but to understand and prevent it. Regardless, this commu-
nity continues to experience violence in many forms with appalling regularity.
PDAC has noted that achievements that might serve as a foundation for the
community’s advancement tend to become obscured. When psychiatric survivors
collectively turn to their own resources and expertise to respond to incidents of
violence, that work no longer appears to exist. In part, this is due to the ways in
which activism primarily driven by poor community members has historically lacked
6
economic backing to mark and infl uence cultural capitol. Our own footsteps don’t
survive long enough to be retraced in the perilous landscapes of public policy or law.
This must change if people with psychiatric disabilities are ever to live without fear,
violence, and oppression.
Readers will note that this report does not place an emphasis on what must be done
to staunch the violence. In part, this is because while many possible solutions have
already been identifi ed (sometimes repeatedly), policy-makers have not implemented
many of these recommendations (see Kane, 2014; CBC, 2014). Furthermore, it
would be ineffective to painstakingly craft foundations for a road that is constantly
eroded by other forces: neglect, marginalization, and co-option by organizations with
greater social capital. The intention of this report is to squarely position the voices of
psychiatric survivors who have experienced violence at the centre of this discussion.
It also provides guidelines that individuals, communities, and organizations can
use to respond to and address violence experienced by persons with a psychiatric
disability.
In order to understand what they are doing to perpetuate the status quo, and change,
organizations must conduct a psychiatric survivor analysis. Until then, conditions
for psychiatric survivors will not improve. Therefore, rather than mandating specifi c
actions, this document will defi ne how action could be conceived and carried out,
and by whom. This is mirrored in the writing of this report, which focuses a great deal
on how PDAC worked as well as on what it achieved.
APRIL 2011
Memorial for assault victim George Wass
APRIL 2011
Parkdale Solidarity March
PARKDALE SOLIDARITY MARCH,
APRIL 2011
7
PDAC envisions that the psychiatric survivor anti-violence framework will enable this
work to be done meaningfully and sustainably. The challenge is that there is no ‘one-
size-fi ts-all’ approach. This report will evolve principles and goals for the framework,
while readers themselves will be responsible for delineating the terms that best
address their particular situations.
For instance, it is important that psychiatric survivors understand violence as
ongoing, and encompassing experiences shared by many diversely situated people
with psychiatric disabilities, and therefore demand more ‘action’ from service
providers, organizations and policy-makers and law.
PDAC extends this opportunity to move forward and deny the erasure of psychiatric
survivors’ expertise, knowledge, and achievements; with this report, readers will gain
some appreciation of what these are, but PDAC has no desire to rebuild a road that,
despite appearances, already exists. This is an invitation to prepare the way for new
milestones to be achieved, and to reignite the movement toward revolution.
Background
Context
From January 4 to April 5, 2011, an assailant wearing a black balaclava committed a
string of violent assaults on people with psychiatric disabilities in Toronto’s Parkdale
neighbourhood. One of the victims was 62 year-old George Wass, who was attacked
on the steps of his boarding house residence. Mr. Wass was taken to hospital, treated
JUNE 2011
Creation of PDAC
JUNE 2011
Ministry of Health announces divestment of the Psychiatric Patient
Advocacy Offi ce (PPAO) to Canadian Mental Health Association – Ontario
8
for broken ribs, facial cuts, and a black eye, and released the same day (Yang, 2011).
Several days later, he collapsed at home and died. A post-mortem concluded his
death had been caused by “blunt force trauma” (Donnelly, 2011). In all, six people
were assaulted before a suspected perpetrator, himself a boarding house resident2 in
the area, was arrested in May (Rush, 2011).
Meanwhile, the conversation that had been unfolding in the community went
beyond these assaults. People were talking about the ways other forms of violence,
like discrimination, play out in institutions and social structures; for example, how
psychiatric survivors experience illegal evictions due to government’s failure to invest
in supportive affordable housing.
Coincidentally, an example of discrimination was occurring in the neighbouring
city of Hamilton, as the city was attempting to prevent an eight-bed mental health
facility for girls from relocating a few blocks over. (Coleman, n.d.) The debate became
especially heated after a councillor employed some ugly rhetoric during a council
meeting to describe patients. After months of legal challenges, and with support from
the Ontario Human Rights Tribunal, the facility was eventually granted an exemption
to the city’s “radial separation” by-law. However, the nature and tone of the dispute
were disquieting to those who witnessed it (Coleman, n.d.).
Following the death of George Wass, a wide variety of people, including others who
had been assaulted, felt the need to confront the violence they had witnessed. As a
response to unanswered questions about why exactly Mr. Wass had died, as well as
JULY 2011
Changes to Ontario Special Diet Allowance
9
about the perpetrator and his mental health, holding yet another memorial or painting
another mural would have been inadequate.
Instead, they came together in the summer of 2011 and formed the Psychiatric
Disabilities Anti-violence Coalition. The purpose of this coalition was to engage in a
meaningful conversation about how to address the issue of violence against persons
with a psychiatric disability. We were a group of individuals with a vested interest in
initiating a community dialogue, and in offering a critique of the stereotypes these
public acts of violence had raised. This report documents that work.
About violence against people with psychiatric disabilities
Though the two instances described above are quite different from one another,
both represent forms of violence against people with psychiatric disabilities. For the
purposes of this report, ‘violence’ is defi ned as actions, words, attitudes, structures,
or systems that cause physical or psychological harm to a vulnerable individual, or
that cause such an individual to be placed in harm’s way (adapted from Fisher, Abdi,
Ludin, Smith, Williams, & Williams, 2000). ‘Structural violence’ describes social struc-
tures — economic, political, legal, religious, and cultural — that put vulnerable individ-
uals and populations in harm’s way (adapted from Gilligan, J., 1997 and Farmer, P.E.,
2004 as cited in Farmer, Nizeye, Stulac, & Keshavjee, 2006). Violence against people
with psychiatric disabilities occurs both through intended and unintended acts of vio-
lence and omission (Ontario Human Rights Commission [OHRC], 2012).
People with psychiatric disabilities face inordinate amounts of violence (Glied, 2013),
from “daily micro-aggressions to deliberate overt harms, whether or not the harm was
AUGUST 2011
Death of Charles McGillavray in Toronto police custody
“I want to talk about
shame... Trauma is
shaming... restraints
are degrading. As
some in institutions
lose their sense of
community, staff
become security,
they mistreat and
push around clients...
Shame shuts down
people’s rights.”
COMMUNITY CONSULTATION
PARTICIPANT, 2015
10
intended” (Costa, 2015). This violence is manifested in various forms; while some
may appear more shocking, all undermine the dignity of people and create real harm.
Acts dismissed by some as relatively insignifi cant, like certain kinds of ‘everyday’ dis-
crimination, often form a pattern of subtle oppression that society has become adept
at discounting (OHRC, 2012). People discriminated against in these ways often have
no recourse through the usual complaint or legal procedures (Thorneycroft & Asquith,
2015).
The literature about people with psychiatric disabilities leads to the inescapable
conclusion that certain barriers persist for very many vulnerable community
members, and further marginalize them (for example, see Urban Alliance on Race
Relations, 2002; Early-Onset Illness and Mortality Working Group, 2011; OHRC,
2012; Federal-Provincial-Territorial Working Group on Mental Health, n.d.; Centre
for Equality Rights in Accommodation, 2009). As an equity-seeking group, people
with psychiatric disabilities experience various forms of violence: racism; poverty;
homophobia and cissexism3; discrimination in employment and housing; verbal
and physical assaults, including disablist violence (Thorneycroft & Asquith, 2015);
and institutional violence in the form of policing, the criminal justice system, and
involuntary psychiatric confi nement in response to distress. Together or in part, these
can permeate a person’s life and are part of the matrix of oppression faced by many
marginalized persons with psychiatric disabilities (OHRC, 2012).
OCTOBER 2011
“40 is Too Young To Die”: report
OCTOBER 2011
Toronto police fatally shoot Sylvia Klibingaitis
11
The formation of PDAC, its purpose and initiatives
The coalition comes together
Though PDAC coalesced in response to the assaults targeting psychiatric survivors in
Parkdale, we who joined the coalition had, from our various perspectives, witnessed
a continuum of violence over the years. PDAC members were people with psychiatric
disabilities, advocates, academics, representatives of community service agencies,
community legal clinics, mental health organizations, and family and friends of
people who had died as a result of violence4.
From our review of available literature and resources, we were aware that not much
existing community knowledge had been systematically published. For example, the
community’s knowledge about where and how to get support during times of loss
and violence is not available, meaning that people often have nowhere to turn to,
given minimal resources and supports. Information about the pathways of violence
and best practices for prevention strategies was lacking, and among that which had
been published, fi rst person narratives or lived experiences of people with psychiatric
disabilities were underrepresented.
This was despite the fact that signifi cant anti-violence organizing had been done by
groups such as the Queen Street Patients’ Council, Urban Alliance on Race Relations,
Parkdale Anti-Violence Education Working Group (PAVE), ACT UP, Black CAP, Anti-
Racist Action Toronto, No Force Coalition, and Ontario Coalition Against Poverty.
(Organizations such as METRAC and Toronto Public Health have also made notable
efforts to address violence beyond the psychiatric survivor community, but they fall
JANUARY 2012
Hamilton city council denies Carlton Hall request to relocate
12
outside the purview of this report). PDAC was born in the realization that despite
this powerful history of resistance, community capacity to respond to and prevent
violence had not signifi cantly grown, and in fact had diminished with the rise of the
non-profi t sector.5
In light of this, PDAC’s challenge from its inception was not only to evaluate what
needed to be done to address violence and improve safety for people with psychiatric
disabilities, but to do this in ways that would build sustainability. If the road to a safer
community had already been built several times, it was time to consider why traces of
it were so hard to fi nd.
Under the rubric of the question, “How do we envision making change happen?”
we identifi ed specifi c needs, including, of course, being able to respond to and
prevent violence. We also saw an opportunity to formalize the psychiatric survivor
community’s knowledge of anti-violence mobilizing, and at the same time, model for
others how to work with individuals in this community.
To this end, PDAC held a number of group consultations with community members to
access their knowledge and solutions for change, and, ultimately, to help us navigate
the conversation about how violence happens and is experienced. The consultations
were also in response to the commitment we had made to the community to fi nd a
way to mobilize their knowledge.
The funding we received from the City of Toronto’s Access and Equity Community
Grant program gave us the chance to formally document our dialogue with community
FEBUARY 2012
Toronto police fatally shoot Michael Eligon
APRIL 2012
Never Again!: coalition of people who’ve had violent encounters with police
13
members, specifi cally psychiatric survivors. It also allowed us to make good on our
intentions to capture and formalize the expertise within the community and amongst
coalition members. An administrative group of three members worked on the grant
application and the implementation of a work plan and provided administrative
support and leadership. They were supported by a working group of PDAC members
interested in bringing this work to fruition. (The larger coalition then evolved into a
network that meets three times a year to share our work, strategies, and discuss
emerging issues that are likely to be complex in nature.)
At the same time, PDAC sought to activate members of the psychiatric survivor
community in light of the urgency surrounding the assaults on individuals in Parkdale.
Additional public events that fostered discussion and dialogue among community
members were held periodically in the following months. These events helped
create some awareness and critical, politicized perspectives of the many ways that
community members experience violence.
Our approach
PDAC recognized that in order to understand the current context of violence, it was
important to attend to previous exchanges and historical interventions originating in
the psychiatric survivor movement.
As a fi rst step, we developed an analysis from inquest proceedings and other
materials, such as media accounts of deaths of people with psychiatric disabilities
by police. For example, PDAC member Jenna Reid analyzed 21 inquest reports,
noting how people with psychiatric disabilities are talked about, the type of language
December 2012
Ontario ends Community Start-up and Maintenance Benefi t
14
used in describing incidents, and what kinds of details were included or excluded.
Tracy Mack, another PDAC member, did a media analysis and cross reference check
to analyze discrepancies in media portrayals of people shot by police. Ultimately,
coalition members wove a snapshot of what the community already knew about
violence against people with psychiatric disabilities.
We also synthesized the community dialogue that had been unfolding into a list
of assumptions (see Appendix). Not only did this allow us to build on an already-
established foundation and help establish sustainability, it honoured and validated
earlier hard-won achievements. It gave us a shared place to begin our conversations
during consultations.
The next step in this process of consciousness raising was a series of community
consultations with participants who identifi ed as having a mental health issue. These
were designed and facilitated by the administrative group and a staff person hired to
assist with outreach and co-facilitation. These consultations were strategically located
in community-based organizations where people with a psychiatric or mental health
disability might feel comfortable.
As previously noted, substantial data about the lives of people with psychiatric dis-
abilities have been published, but the voices of psychiatric survivors — who have both
confronted the violence directed at them and created anti-violence critiques — have
been marginalized. Research led specifi cally by psychiatric survivors has been even
more scarce or made invisible when other “leads” have been placed at the forefront.
PDAC, using community consultations, conducted psychiatric survivor-led research6
MAY 2013
Rally and March to Stop Violence Against Women, in Regent Park
15
(Faulkner & Nicholls, 2003) facilitated in collaboration with our allies in the coalition.
Together, our aim was to stimulate psychiatric survivors’ own critical awareness of
the broad ways violence impacts each others’ lives and to re-invigorate stagnant con-
versations.
Throughout the active life of the coalition, we grappled with the question of how
best to synthesize our ideas and research, and put it to use on behalf of people with
psychiatric disabilities. Members of PDAC brought different perspectives to the work
according to both their social, structural, and professional locations. Winding our way
through many different views, reactions, and risks was a strengthening and clarifying
process. Importantly, at times it was also a source of disagreement and creative ten-
sion.
As PDAC’s work evolved, part of our effort was to continuously centre the voice and
ethos of psychiatric survivor experiences within the work. To this end, we formed a
small sub-committee of psychiatric survivors in order to tease out the threads of an
emerging analysis, and to frame it within a survivor perspective. This initiated our
work to create a psychiatric survivor anti-violence framework.
PDAC’s position is that in order for substantial, lasting improvements to be made, the
psychiatric survivor anti-violence framework must be acknowledged and integrated
into the work of organizations that are based on equity-seeking structures and inter-
ested in anti-discrimination practices. This is work that can and should be led by the
individuals who use organizational services and should draw from pre-existing litera-
ture in the fi eld, include mentors and allies. It is also important to recognize the inter-
JUNE 2013
Hamilton police fatally shoot Steve Mesic
16
secting nature of violence in order to not only accept the complexity, but to fi nd posi-
tive interventions and ways to work with perpetrators (especially if they themselves
have a disability).
Whether actively or passively, intentionally or unintentionally, many organizations and
institutions fail to address violence in the lives of people with a psychiatric disability,
or those experiencing extreme emotional distress. A common example of this is when
a service tries to address a client’s issue by making referrals to another service,
which may be helpful or may cause further barriers. In light of numerous cutbacks to
the public sector, this kind of measure on its own is not a viable option; moreover, it
contributes to existing harms and inequities.
Community mobilization
One of the hallmarks of PDAC has been our attachment to the community of psychiat-
ric survivors. In fact, one of the events that led to the creation of PDAC was a commu-
nity solidarity rally and march held in Parkdale on April 16, 2011.
PDAC organized three public events in addition to the community consultations. One
was a meeting about policing and the psychiatric survivor community, which coin-
cided with the annual 2012 Mad Pride Celebrations7
. PDAC hosted a four panel mem-
ber discussion:
1. REMEMBRANCE OF INQUESTS PAST –
According to our reading of inquests into
police shootings in Ontario since 1997, 21 out of 32 people who were shot
JULY 2013
PDAC: Mad Pride presentations
JULY 2013
Toronto police fatally shoot Sammy Yatim
JULY 2013
Toronto announces closure of Seaton House
17
had psychiatric histories and/or were experiencing distress at the time of the
shooting. (33 now including Andrew Loku and Jermaine Carby) (Reid, 2013)
2. VIOLENCE IS A DISABILITY JUSTICE ISSUE –
An exploration of how the Accessibility for
Ontarians with Disabilities Act (AODA) and the UN Convention on the Rights of
Persons with Disabilities (UNCRPD) should work for us in the struggle against
poverty and violence (Landry, 2013).
3. KILLING US SOFTLY?
– A critical look at the use of tasers and the implications
of more police being armed with tasers. Police are also being trained to deal
with consumer/survivors by watching videos about us. What will this mean?
(Kanani, 2013)
4. R-E-S-P-E-C-T –
A discussion exploring best practices for respectful interaction
and non-violent intervention? Let’s start to get a community-based working
defi nition of how to engage with people in distress, so we can respond to
the way police and hospital staff are being trained, and avoid escalating.
(Gorman, 2013)
The events were well attended and included a robust discussion from participants
and assisted us to remain focused in our ongoing goal to keep conversations about
violence alive.
Similarly in July, 2015, following our consultations, we organized a community “report
back” event during the week of Mad Pride. This event included presentations by
Stitching a Social Safety Net, ARCH Disability Law Centre, ODSP Action Coalition,
DECEMBER 2013
Coroner’s inquest into death of Ashley Smith: homicide
NOVEMBER 2013
Toronto police fatally shoot Ian Pryce
18
and PDAC members. A shared meal and art installations by PARC’s Making Room
Collective were also part of the gathering. Several topics of conversation were
prominent:
• To educate or not to educate? Education for police and the public has been
provided for over 30 years without signifi cant improvement for psychiatric
survivors;
• Whether violence against people with psychiatric disabilities is a
consequence of stigma or of discrimination?
• An anti-violence framework could serve as a “bill of rights” for how we should
support each other, and a means of describing what’s missing from the world
we want to live in.
To sum up, when psychiatric survivor communities experience violent events, they
often respond emotionally, and struggle to mount a response that addresses the
scope of the tragedy. PDAC’s work has been borne of a need to do more than paint
yet another mural or attend another memorial. In addition to seeing all our gatherings
as opportunities for encouraging critical self-awareness and engaging in critical
dialogue, we have endeavored to use them to look back on the road so far and to
contribute to the community’s next steps.
FEBRUARY 2014
Coroner’s inquest into deaths of Sylvia Klibingaitis, Michael Eligon, and Reyal Jardine-Douglas: homicide
19
Community consultations
Purpose of the consultations
From October 2014 to May 2015, PDAC hosted a series of consultations. These
provided an opportunity to expand on and provide depth to the coalition’s refl ections
and understanding, and at the same time to support this community to reassert its
own learning.
Research approach
The project used psychiatric survivor-led research that involved partners in the
research process and recognized the unique strengths brought by each. Community-
based participatory principles, such as promoting co-learning, attending to social
inequalities, and disseminating fi ndings guided the work throughout. From our ethi-
cal perspective, we were consulting with experts in the community8, whom we com-
pensated for their contributions of time and knowledge. We wanted participants to
know we understood the great value of their contribution and that we viewed them
as experts, not token voices for a funder’s report. It was also important to start the
discussion by validating the importance of individual experiences, though we empha-
sized building on them by inviting participants to share strategies for change. We
facilitated this by introducing the list of assumptions we had already prepared (see
Appendix), while providing room for people to narrate their experiences of violence
and the impacts on their rights and sense of self.
JULY 2014
“Police Encounters With People in Crisis”: Iacobucci report
20
Method
We conducted a series of community consultations, each located in community-based
organizations, after having distributed information through them about the purpose of
the consultations and details about how people could participate.
The fi rst consultation was a two-hour pilot; participants and facilitators explored
the issue of violence with the group using a series of open-ended questions (see
Appendix), and received feedback about the consultation method.
Based on the pilot, we chose to investigate six focal points of interest that had been
raised by participants in relation to the overall topic of violence against people with
psychiatric disabilities: women, trans people, immigrants/newcomers/people of
colour, housing, institutions, and public space. Given the historic psychiatric patholo-
gizing of these groups, it made sense to consult separately with them in order to
better understand the specifi c ways in which violence is experienced bases on social
location. However, during each group we acknowledged, and heard from community
members, that experiences of violence are not tied to discrete social locations but
that the nature of violence differs because of the unique ways that multiple social
locations interact. In total, 67 community members contributed to a total of seven
consultations (including the pilot).
Working with the data
The small working group of PDAC members coded the community consultation tran-
scripts, and identifi ed common themes both within each group and across them.
Quotes were pulled from each transcript and mapped out in order to continue discus-
“Most people don’t
know their rights or
how to say No. If you
are not well, how can
you even understand
what that means?
There are lots of
things people don’t
understand. If they
are not well, they
can’t speak up and
have a voice.”
COMMUNITY CONSULTATION
PARTICIPANT, 2015
21
SEPTEMBER 2014
Peel police fatally shoot Jermaine Carby
sion and analysis. Our work together was not to simply identify themes and patterns
and, as detached scientifi c researchers, distancing ourselves from the implications of
our work. Our goal was to pull together a clear analysis, to elaborate what we already
knew, didn’t know, and needed to know in order to foster change in the communities
we respect and love.
To this end, after an intense process of refi nement, our transcript working group syn-
thesized the following eight considerations of how violence relates to the experiences
of psychiatric survivors: 1) opportunities for naming the violence; 2) social discourses
of violence; 3) alienation; 4) solidarity; 5) time; 6) space; 7) normalization; and 8)
meaning-making.
1. NAMING THE VIOLENCE refers to community members’ descriptions of forms and
types of violence. Participants described many forms and types of violence
that might be categorized as interpersonal, structural, and noted particularly
signifi cant structural violence as it occurred within, or in relation to, institutions.
Participants gave examples of the ways in which health care experiences are
experienced as a form of structural violence.
2. DISCOURSES – This theme refers to how community members used the language
of specifi c discourses, such as patriarchy, to describe injustices and harm.
Patriarchy was identifi ed by some community members as responsible for the
prevalence of interpersonal violence in the lives of women with psychiatric
disabilities, as well as lack of public response to this form of gender oppression.
DECEMBER 2014
Coroner’s inquest into death of Kulmiye Aganeh in custody: death from medication toxicity
FEBRUARY 2015
PDAC: community consultations
22
3. ALIENATION prevents community from successfully organizing against violence; it
is a result of people being separated from each other by structural violence, and
the experience of isolation and exclusion as a primary form of discrimination. This
issue extends to why formal complaint processes are not utilized by people who
have experienced violence, and the overall feeling that nobody is listening.
4. SOLIDARITY – Refers to descriptions of how people protect and/or stand up for
each other, care for others by sharing information and support. Some community
members stated that solidarity was important in their lives to help cope with
violence; for others, the compulsive need to help others given pervasive levels of
violence within community resulted in “burnout.”
5. TIME – Refers to experiences of being required to endlessly wait - for services,
necessities and justice, for example. The impact of the preoccupation with ‘effi -
ciency’ within the non-profi t sector was described by community members as play-
ing out in their lives in a variety of ways; including, for example, having to wait for
an appointment when in crisis and not getting the time needed with professionals.
This often resulted in people suffering dire consequences.
6. SPACE – Refers to descriptions of spaces as sites of violence and/or temporary
reprieve from violence, and the reshaping of public and private spheres includ-
ing the changes in character of neighborhoods through gentrifi cation. Community
members described the way ‘helping’ spaces, including hospitals and mental
health agencies, are experienced as harmful because of discriminatory and dis-
APRIL 2015
Salvation Army Hope men’s shelter in downtown Toronto closes
“Why is it, do we think,
that women are expe-
riencing more violence
whent hey have a psy-
chiatric matter, con-
cern? ...You’re easier
to mistreat and that
person doesn’t get a
consequence because
when we’re not com-
pletely well we’re less
able to look after our-
selves, and speak out
for ourselves.”
23
missing interactions with professionals when seeking support. Exclusion from
public space as a result of gentrifi cation-related change was a common topic.
7. NORMALIZATION describes a phenomenon in which violence against people with psy-
chiatric disabilities is seen as unremarkable and unworthy of being reported, “just
the way it is.” This, in itself, is a form of violence that is taken for granted. Par-
ticipants noted the insidiousness of normalization of violence; it occurs to some
degree through the practices of our institutions, denying people the supports they
require when they are victims of violence.
8. MEANING-MAKING – Refers to the way psychiatric survivors avail themselves of con-
cepts to describe their experiences; for example, turning to references from mass
media and culture. This also includes how service providers interpret what service
users/clients say about their experiences.
The signifi cance of this data
The importance of our fi ndings isn’t tied to the question of novelty, indeed, as
expected, people knew and confi rmed many of the same kinds of transgressions,
abuses, and neglect found in the existing reports and literature. PDAC didn’t embark
on the community consultations as an attempt to unearth missing information.
Rather, we addressed people’s need to come together; to have a voice, individually
and collectively, on these issues; and to appreciate their own authority. This need
was continually raised in our community gatherings. As one consultation participant
observed, “Sometimes silence is violence.”
COMMUNITY CONSULTATION
PARTICIPANT, 2015
24
What became apparent from the community consultations was that:
• This population is well-versed on the nature of the violence that permeates
their lives;
• They recognize that a coordinated plan aimed at individual, systemic and
structural levels is necessary to bring lasting improvements, and;
• Despite many years of sustained effort, their recommendations have largely
been ignored and, as a consequence they continue to contend with the same
forms of violence that has historically plagued the community;
• They recognize and respond to the need for mutual understanding and
support within community. As a result of the community consultation process
a group of women from the newcomers/people of colour group continue to
meet every Friday to continue talking.
Recognizing this long-standing neglect, PDAC determined the consultations were not
needed to build new paths of learning, but rather to delineate the stones of a road
that has long existed.
WHERE TO NOW?
At this junction, at this time
For the last three decades, psychiatric survivors have strived to articulate the
nuanced ways their lives have been impacted and shaped by others’ perceptions and
prejudice. The literature about how psychiatric survivors have organized for change is
extensive, locally and internationally.
JULY 2015
Toronto police fatally shoot Andrew Loku JULY 2015
PDAC: Parkdale Solidarity meeting
25
Despite this history of activism and community organizing, there is an urgent need to
address the pervasive lack of understanding about what people with psychiatric dis-
abilities can contribute, and the years of activism and work they have already done.
Because their expertise is not recognized as such, their meaningful participation in
system planning, responses to crises, and accountability has been only marginal.
More often than not, psychiatric survivor voices are relegated to ‘participatory’ mod-
els that are tokenistic at best; for example, when people are invited to participate in
ways that assume their ‘disability identity’ will suffi ce to do political and social change
work.
The barrier to change is not a lack of information about, or consultation with, psychi-
atric survivors. Neither is there a scarcity of insights based on various proceedings
about how to move forward. At a Toronto conference called
Saving Lives: Alternatives
to the Use of Force by Police
, it was pointed out several times that “the reports and
recommendations from all the task forces and commissions that have reported over
the last 20 years have, in essence, been buried” (Urban Alliance on Race Relations,
2002, p.19).
Therefore, the coalition concludes that if we are to collectively turn a corner in
addressing the endemic violence experienced by people with psychiatric disabili-
ties, future work must be premised on the use of a psychiatric survivor anti-violence
framework. Without inclusivity at all levels, discrimination and stigma-bearing prac-
tices are perpetuated.
26
Using a Psychiatric Survivor informed Anti-violence Framework
Lilith Finkler, a psychiatric survivor, introduced the term “psychiatric survivor analysis”
to describe the importance of a theoretical framework to urban planning design. She
argued that a psychiatric survivor analysis is one in which the impact of social and
political processes on psychiatric survivors is considered central, rather than periph-
eral to, scholarly understanding.
We propose that a psychiatric survivor anti-violence framework sets guidelines to
examine, analyze, and respond to violence in the community. Common principles
should assist individuals, communities, organizations, and allies to work collectively
to address violence against individuals/communities of people with psychiatric dis-
abilities. They should also orient priorities for action, recognizing critical diversities in
experiences of equity and social justice (e.g., race/racism, sexuality/heteronormativ-
ity/sanism).
In response to a crisis of violence, a psychiatric survivor anti-violence framework will:
1. EXAMINE
• Previous reports on similar incidents;
• Previous inquests and recommendations;
• Related reports; for example, poverty reports or equivalent social determi-
nants of health work;
• Relevant legal jurisprudence and organizational or government policies;
• Previous research already done on similar issues or incidents.
27
2. ANALYZE
• Inquest and report recommendations (whether implemented or not);
• Questions of funding relevant to previous efforts;
• Who benefi ts from addressing or not addressing issues of violence;
• First person narratives and authorities in identifi ed impacted communities;
• Impacts of violence beyond identity markers such as race, gender, disability,
etc., towards analysis of how violence goes beyond categories and often in-
cludes the shifting of boundaries.
3. RESPOND
• Plan to build on what psychiatric survivors and researchers have written or
stated in research literature and other materials;
• Assist and motivate organizations to develop and evaluate their psychiatric
survivor anti-violence framework and implementation;
• Put forward and articulate consequences and implications of change for
whom/what (i.e. organizations)
We invite further refl ection and development of these elements of the framework,
particularly through the actual experience of applying it. We can offer only guidelines
for using this frame, given that each user will be faced with its (or his or her) own
unique context and situation.
OCTOBER 2015
Ontario postpones changes to Employment Benefi ts OCTOBER 2015
Trial of Sgt J. Forcillo in murder of Sammy Yatim begins
28
Mobilizing Responses and Action
The coalition identifi ed the following areas as priorities and goals for implementing a
psychiatric survivor analysis to address violence against individuals with psychiatric
disabilities. They include:
1. MEDIA RESPONSIBILITY
• Media responses to issues and incidents of violence must make the connec-
tion to broader issues (e.g., racism; service providers’ preoccupation with ‘ef-
fi ciency’) and take time to include them;
• Media must recognize that linking violence to individuals, and inattention to
broader issues, is problematic and should avoid framing stories as singular,
individual problems devoid of the political context;
• Must examine on an ongoing basis its prejudices and biases towards individ-
uals with psychiatric disabilities, as well as question assumptions about who
they consider to be “the experts” and their assumed neutrality.
2. TRANSPARENCY AND ACCOUNTABILITY
• Disclosures should include how much money has been spent in previous
initiatives to resolve a recurring problem; e.g., who are recipients of salaries,
programs, research funding, etc.?
• All efforts should be made to make transparent not only which previous at-
tempts to address violence have worked, but which ones have failed, and
why. This should also include details of funding and resources utilized;
NOVEMBER 2015
Coroner announces inquest into the death of Ian Pryce
29
• Use communication strategies that help restore the trust and confi dence of
vulnerable individuals;
• Engage in procedural truth telling, and commit to specifi c actions, goals, or
responses.
What remains to be done and by whom
If the anti-violence organizing work already done by psychiatric survivors can be
thought of as the paving stones of a road, it is no understatement to say that there
are still many boulders standing in the way of future development.They’ve been there
a long time. Psychiatric survivors’ pressing needs — and indeed, their right — to safety
and wellness demand that we use novel approaches to break them down.
Perhaps the fi rst consideration is the need for policy-makers to accept what psy-
chiatric survivors have already built and use this as a foundation for change. At the
same time, they must acknowledge the biases which have lead them to conclude that
people with psychiatric disabilities are incapable of this kind of practical and intellec-
tual leadership, and that their achievements are therefore non-existent. This form of
discrimination is particularly widespread.
Familiar roadblocks such as lack of committed funding, organizational policy con-
straints, and apathy cannot be allowed to stand as unchallenged assumptions about
“the way things are.” Furthermore, systems that reinforce and perpetuate these road-
blocks must also be confronted.
30
A psychiatric survivor-centred analysis is key to binding this work to a coherent and unifying
structure. It is incumbent on any organization that interacts with psychiatric survivors or has
an impact on their well being to develop their own analysis. PDAC submits the psychiatric
survivor anti-violence framework as the tool to accomplish this, capable of doing heavy lift-
ing to clear away obstructions, lay a foundation, and pave a safe and dignifi ed future for the
community.
DECEMBER 2015
PDAC: “Clearing a Path” report launch
31
Questions for organizations implementing
a psychiatric survivor anti-violence framework
1. How well is your organization oriented to the problem of violence for people with psychiatric disabilities. What is the
current knowledge of violence against people with psychiatric disabilities? What factors have shaped your under-
standing? How do you identify relevant sources of information?
2. What processes (networks, community relationships, etc.) are in place to be kept abreast of relevant sources of infor-
mation and reports (e.g., inquest recommendations, poverty and social determinants of health reports, etc.)?
3. Why are you conducting the analysis? How will you use the analysis? ( important as this will impact process) How do
you support a psychiatric survivor-led process of analysis? How are people with psychiatric disabilities involved in
analysis? What community relationships are required in order to ensure a survivor-led process?
4. How well do you integrate or link your analysis to existing sources of information (e.g., reports examined at the begin-
ning under ‘examine’)? What does your analysis say about violence against individuals/communities of people with
psychiatric disabilities that supports the existing sources of information?
5. Do you identify actions for change? Do you clearly indicate who is responsible for the identifi ed actions for change?
6. Do you emphasize the need for ongoing psychiatric survivor-led change processes that duly recognize and compen-
sate their knowledge, work already done, and ongoing contributions?
7. What are some strategies to incorporate a psychiatric survivor anti-violence framework into policy and initiatives such
as risk management practices?
8. What are some strategies that you can develop in order to deal with workplace tensions and competing rights to en-
sure that you do not invalidate psychiatric survivor history, work and experiential knowledge?
32
Appendix
COMMUNITY CONSULTATION LIST OF ASSUMPTIONS AND QUESTIONS
PDAC HUMAN RIGHTS AND EQUITY PROJECT
A discussion about violence against people with psychiatric disabilities
Our general assumption about violence against people with psychiatric disabilities:
1. When we talk about violence, we are talking about physical assault and emotional harm, as well as
systemic power relations that increases the risk of harm and assault.
2. People with psychiatric disabilities (PWPD) experience systemic discrimination, as outlined in the
Ontario Human Rights Code (OHRC).
3. Because we believe that PWPD are exposed to the increased risk of harm and assault due to systemic
discrimination, because as outlined in the Ontario Human Rights Code discrimination exists if there is
harm, regardless of intention.
4. Violence against PWPD occurs both through intended and unintended acts of violence and through
omission.
5. Toronto, similar to other North American cities, has a history of racist policing. Racialized people,
especially Black and lndigenous communities, have been and continue to be targeted in specifi c ways.
6. The climate of racism and poor bashing exposes poor and/or racialized PWPD to a greater risk of harm
and assault.
7. Gentrifi cation exposes PWPD to a higher risk of harm and assault.
8. Police perpetrate violence against PWPD particularly racialized communities.
9. People with psychiatric disabilities experience higher rates of violence.
33
Assumptions relating specifi cally to women:
1. Women labelled with psychiatric disabilities may be more likely to have experienced gender-
based including childhood sexual abuse, sexual assault and rape in adulthood, and intimate
partner violence. These various forms of gender-based violence may be implicated in women’s
experience of major depression, anxiety, substance use, and posttraumatic stress and
psychosis.
2. This suggests the likelihood of high rates of gender-based violence experiences among women
labelled with psychiatric disabilities.
3. As indicated above, people with psychiatric disabilities including poor, racialized, and
Aboriginal women likely experience greater risk of both direct and institutionalized harm and
assault.
4. These experiences of direct and institutionalized harm and assault might include:
• being given certain diagnoses (borderline personality disorder)
• being forced in to hospital and criminal justice system (forensics)
• being forced to take treatments (e.g., medications, ECT, birth contol – Depo Provera
• access to, and the amount/level of, treatment received (over-medicated, multiple
medications, no response to reported violence)
• being mistreated by people working in community services and hospitals (not
supporting fi rst person accounts, not being included in decision-making)
• physical, emotional, mental, fi nancial, and sexual assault
Assumptions specifi cally relating to transgendered people
1. Transgendered people labelled with psychiatric disabilities may have been more likely to
experience violence including transphobia, which may be implicated in experiences of major
depression, anxiety, substance use, posttraumatic stress and self-harming behaviours.
2. Not getting access to resources required for social and medical transitioning because trans
identity and/or expression is understood as a symptom of a psychiatric disorder.
34
3. mental health service providers not exploring the impact of experiences of transphobia and
discrimination on mental health or problems in living.
4. Mental health care service providers not using one’s chosen name and pronouns
5. Diffi culty accessing mental health services because of discrepancies between health card
identifi cation and chosen name.
6. Being forced into hospital and criminal justice system (forensic).
7. Being deemed as not credible or believable, or as questionable, when reporting incidents of
violence to police; having police question details of violence inrelation to psychiatric label and
medication and trans identity.
8. Being mistreated by people working in community health services and hospitals (not
supporting fi rst-person accounts, not being included in decision-making).
9. Physical, emotional, mental, fi nancial and sexual assault.
Assumptions relating specifi cally to immigrants, newcomers, and people of colour
1. Migration often means having experienced multiple countries or temporary ‘homes’ including
diffi cult locations such as refugee camps and hostels.
2. Precarious status or non-status individuals cannot access social services and health
programs
3. Xenophobia, racism, and gender discrimination are often coupled with experiences of
immigrating.
4. Many (if not most refugee claimants) have experienced trauma in the migration/immigration
process, which is furthered by the trauma of relocating to a new country.
5. Language and cultural differences pose barriers in accessing social supports and adapting to
communities.
6. Social isolation and loss of connection with family and friends
7. Navigating systemic processes to secure status, housing, health and educational supports
can be fraught with barriers and experiences of discimination.
35
8. People of colour are more likely to be targets of racist attitudes which deny experiences of
mental health differences and can lead to acts of violence perpetrated
9. Precarious status or managing good emotional health while going through the immigration
process where one’s future is uncertain.
10. Discrimination based on status can factor in labelling, treatment options, and effective
treatments and supports.
Assumptions specifi cally related to housing
1. Lack of affordable housing with appropriate supports in Toronto contributes to continued
substandard housing options as well as ongoing violence.
2. Lack of affordable housing:
• increases safety/security issues, and/or discrimination
• forces people to stay in dangerous accomodations where they experience violence
and/or discrimination
• contributes to increased violence and evictions.
3. People labelled with psychiatric disabilities experience illegal evictions when landlords force
them out of housing and do not fi le for a legal eviction through the housing tribunal.
4. People labelled with psychiatric disabilities face discrimination when trying to secure a prviate
rental unit, especially those who are considered low-income/unemployed who are consumer/
survivor of the mental health system:
• experience discrimination when interviewing or applying for housing due to income
status or mental health status
• the power imbalance between landlords and tenants also contributes to more
discrimination
5. People labelled with psychiatric disabilities need more supportive affordable housing options.
36
Assumptions related specifi cally to public space
1. Shelters, group homes, and supportive housing can be considered public space.
2. The privatization of public spaces exposes people labelled with psychiatric disabilities to a
higher risk of harm and assault.
3. The remaking and gentrifi cation of neighbourhoods exposes people labelled with psychiatric
disabilities to a higher risk of harm and assault.
4. The increase in ‘Not Criminally Responsible’ (NCR) designations for minor offenses increases
people labelled with psychiatric disabilities to a higher risk of institutional and police
intervention.
5. The increase in discrimination based on immigration status/non-status exposes people
labelled with psychiatric disabilities to a higher risk of labelling and further status
complications
6. The reduction in community services that are safe spaces around status/non-status people
exposes people labelled with psychiatric disabilities to greater risk of harm and assault.
Assumptions related specifi cally to institutions
Violence happens in institutions via:
1. Practices
• coercion, security guards
• physician orders are narrow and discriminatory
• over-reliance on medications as a solution
• lack of trauma-informed care
• policies that guide questionable practices (e.g., covert medication, tobacco, search
and seizure, urine testing);
• crowding, seclusion, neglect
37
• Community Treatment Orders, including lack of information about rights and other
matters
• homophobia, sexism, racism, etc. in subtle forms
2. Law:
• bureaucratic barriers to access to justice; inaccessibility of legal process
• law-breaking – not following or interpreting law as written (e.g., lack of following
informed consent); liberty on hold when waiting to be transferred, etc.
• clinical opinion in charts as opposed to fact writing (e.g., “She appeared aggressive”)
• numerious deaths/inquests which are limited to coroner’s discretion
• problems with the Consent and Capacity Board and the Ontario Review Board
3. Technology:
• documents and processes which govern clients are narrow and impact what clients
may or may not be able to access
• strict diagnostic categories and built-in assumptions with these categories
• privacy breaches/concerns (e.g., information being shared with the wrong provider,
etc.)
• digital divide between those who can access technology and those who cannot
• tools of various kinds for monitoring (e.g., hierarchy of who deserves care)
• funding available for technology as opposed to individuals
4. Other:
• research practices; messaging that is PR/corporate-driven
• as documented in the Ontario Human Rights Commission report, “Minds That Matter”
• support for aging population lacking and more support needed
• overemphasis on the brain to the exclusion of other research.
38
endnotes
1. The term “psychiatric survivor,” as well as “consumer,” emerged from the ’80s
onward and were used by individuals who had experiences in the psychiatric system,
denoting a particular political identity to their relationship with psychiatric systems.
However, over the last three decades, identity politics within the community has
evolved; individuals now use numerous terms to refl ect political and non-political rela-
tionships, and the intersection of identities to the psychiatric system(s). For the pur-
poses of this report we use psychiatric survivor and psychiatric disability interchange-
ably. The latter particularly refl ecting the entitlements allotted based on designation
of ‘disability.’
2. In its analysis of these crimes, PDAC took pains to avoid demonizing the per-
petrator, and rejected hyperbole like that used by the corporate news media (e.g.,
Toronto’s Sun dubbed the attacker, “the Parkdale Killer.” [Lem, 2011])
3. Cissexisms address discrimination for trans people that is similar to what is
termed “heterosexism” for LGBQ people. Please see Eric Anthony Grollman (2012).
4. The Empowerment Council, Parkdale Community Legal Services, Parkdale Activity
Recreation Centre, School of Disability Studies-Ryerson University, York University,
Habitat Services, Toronto Public Health, and community activists have played promi-
nent roles.
5.Though the non-profi t sector had initially hoped to attend to issues of social injus-
tice, given the evolution of funding structures, emphasis on “value for money” and
“effi ciency” has enabled the state to exert more control over what can and can not
39
be said about conditions of racism, poverty, and other forms of exclusion in communi-
ties.
6. “User- (or survivor-) led research is, essentially, research directed by, or led by, ser-
vice users or survivors. What we mean by ‘user-led research’ is research in which ser-
vice users get the opportunity to decide on the issues and questions to be looked at,
as well as to design and carry out the research. ... Service users may not themselves
be carrying out the research if they are active in steering it in some way, but they will
be setting the agenda, designing the project and deciding on the questions and top-
ics to be addressed by the research. Ideally service users will be interviewing people,
since we believe that this can lead to better outcomes, but they can also be taking
part in analyzing, writing up and disseminating the results.”
7. Mad Pride Day originated in Parkdale where people living in poverty demanded bet-
ter living conditions and affordable housing. It has evolved into a public celebration
where collaborative planning and activities celebrating creativity are central to creat-
ing a sense of strength and unity among psychiatric survivors. By coming together
this sense of solidarity reinforces a shared identity and sense of community. Mad
Pride is now celebrated in many countries around the world.
8. PDAC discussed at length the difference between the terms ‘consulting,’ ‘conduct-
ing focus groups’ and ‘interviewing participants.’ We decided to on ‘consultation’ in
order to move away from the traditional ‘researcher’ and ‘subject’ positions; ‘con-
sults,’ for us, implies more equality.
40
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Psychiatric Disabilities Anti-violence Coalition 2015
