Author: Leah Pattem. Photography: Flor Ordoqui.
Audio version
Last Saturday, 200 people marched for Orgullo Loco (Crazy Pride) from Atocha to the Ministry of Health. Two sisters aged just 8 and 12 stood right at the front of the protest, holding their signs up as high as they could so that everyone could see them. Their enthusiasm was making their mum, Emma Perez Ferrant, proud.
Two years ago, just as we were coming out of lockdown, Emma suffered a hypomanic stroke and entered a long period of depression. “It changed my life. You cannot imagine that kind of depression – you can’t even speak,” she explains.
“My psychiatrist didn’t want me to tell my daughters my diagnosis because she was afraid that they’d search the internet and read all sorts of scary things. But kids are much better informed nowadays than they used to be.” Mental health is becoming more and more normal to talk about, which is one of the main objectives of the Orgullo Loco movement: to destigmatise mental health and to encourage conversation around the topic.
“Crazy Pride” was born in Canada. On 18 September 1993, a group of psychiatric patients and activists marched through Parkdale in Toronto, demanding destigmatisation and recognition as members of the community. Today the movement exists in Mexico, Chile, Argentina, England, Switzerland, Romania, South Africa and Spain, first reaching Asturias in 2010 and then Madrid five years ago.
This year’s Orgullo Loco march, however, was themed around something they feel nobody talks about: psychiatric violence, which the Madrid branch claims occurs every day within the mental health system. As seen among a collection of patient testimonials on Orgullo Loco Denuncia, many have experienced being tied up, non-consensual electroshock therapy and drug use, isolation, and even restricted access to water. Some also claim to have experienced sexual assault while in care, and are reluctant to report it for fear of not being believed.
Kimberley Obongonyinge is a Black British Indian/Ugandan neurodivergent woman with a background in psychology and children and young people’s mental health. She is also the creator of popular Instagram account Black Behaviour, which tackles stigmas surrounding mental health, specifically for systemically oppressed groups. Kimberley explains: “Psychiatric sciences in the Global North have historically been involved in the oppression of marginalised groups. During the [Francoist] dictatorship, doctors experimented on LGBTQIA+ people as they believed homosexuality to be a mental illness.”
The Orgullo Loco movement is connected to the pride movement, and many of those marching on Saturday belonged to the LGBTQIA+ community. For them, psychiatric violence is – and carries – an ever greater risk due to systemic oppression. “Institutional discrimination creates significant barriers for individuals from marginalised collectives,” explains Kimberley. “Due to transphobia, a trans person may not feel safe, comfortable or confident accessing certain health services.”
Kimberley believes that, despite highlighting issues in present-day psychiatric care, we should be careful not to villainise it. She explains that, in her experience working with young people in psychiatric care, she has come across people who are a danger to both themselves and others. “There are individuals who need access to psychiatric spaces and professionals to support them.”
Emma believes that “the problem is the overstretching of public healthcare. They don’t have time to talk to you – you have five minutes per visit and waiting lists are at least six months long.” As a result, another priority for Orgullo Loco is raising awareness of the overuse of psychotropic drugs, which, as it turns out, is a lucrative market for the pharmaceutical industry.
In 2018, sales of anxiolytics in Spain totalled 101.4 million euros. According to a report by the International Narcotics Control Board (INCB), Spain is the largest consumer of benzodiazepines in the world, with 11% of the population taking at least one dose every day. The Organisation of Consumers and Users (OCU) criticised the handling of mental health in Spain, citing a lack of psychologists and a corresponding overprescription of drugs. The number of psychologists available in Spain per person is just a third of EU average. In direct contrast, while one in four people across the EU suffers from mental health issues, data from the Ministry of Health shows that, in Spain, this figure is one in three.
The overprescribing of psychotropic drugs is not just connected with state underfunding but also with the capitalist idea that we must return to work as quickly as possible. Although sick pay for salaried workers is initially set at 70% of their income, this figure drops to just 50% after six months – and it’s almost negligible for freelancers. It must be noted that 84% of people suffering from mental health issues are unemployed, although it’s not clear whether unemployment led to mental health issues or vice versa.
Last week, a tragic story of a double suicide made the headlines. Two sisters, aged 79 and 70, took their own lives the day they were due to be evicted from their home in Santander. At the last moment, anti-eviction activists from the Plataforma de Afectados por la Hipoteca (Platform for People Affected by Mortgages, PAH) had managed to stop the eviction, but the sisters didn’t become aware of this in time.
Suicide is seen as a mental health issue, but the cause of this outcome is frequently overlooked. In 2020, Spain reported more than 3,900 suicide cases, marking the highest death rates from self-harm in the country’s history and an increase of 7.4% compared with the previous year. The foundation argued that one of the reasons for the increase in suicides and self-injuries are the psychological disorders caused by social and economic problems amid the deadly COVID-19 pandemic.
In contrast, Emma was also part of the unemployment statistics. “I used to work in a managerial position but, due to my hypomanic stroke, I’m now working in a less stressful position, the same one I had in 2015.” Emma explains that she’s happy to have the work, but she admits that it’s been a huge backwards step for her, especially at the age of 46. “I got a divorce, I lost my job, and I lost my mind. I’ve had to reinvent myself.”
Because work is so connected to mental health and there is also a lack of trust in public mental healthcare, many people are increasingly turning to self-care. But as Kimberley explains, the link to our value as workers persists: “We often only practise self-care with the intention of being productive, or we feel we can’t engage with it because we feel like we need to be productive.”
Asking Kimberley more about her thoughts on self-care, she emphasises how even this form of care has played a role in the oppression of marginalised groups: “Self-care has been so warped from its initial purpose – beyond capitalistic and neoliberal, it’s become incredibly whitewashed. The modern self-care movement in the Global North actually started with the Black Power movement in the US in the 1960s and 70s, when the Black Panthers, lacking access to public health and wellbeing services due to systemic racism, recognised the importance of practicing self-care as a community. They understood that it was the only way they would be able to heal and to sustain their activism.”
The Orgullo Loco movement is activism – and a union. It’s a way for an oppressed community to form, strengthen and take care of itself, but also a way to pressure and push the institutional powers towards better healthcare for all. What Orgullo Loco has also succeeded in doing is to spark and nourish the public conversation around mental health.
Emma tells me that Orgullo Loco was her daughters’ first ever protest: “They love it,” she tells me. “Next, they want to go to a feminist protest” – and with that, the next generation of activists was born.
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