Psychopathology at School: Children’s Behaviour and Mental DIsorder

Author(s):

Julie Allan(presenting / submitting)Valerie Harwood

Conference:

ECER 2014

Network:

04. Inclusive Education

Format:

Paper

Session Information

04 SES 01 B, Diagnosis and Labelling: Implications for Children, Their Identities and Their Education

Paper Session

Time:

2014-09-02

13:15-14:45

Room:

B014 Anfiteatro

Chair:

Liz Todd

Contribution

This paper considers the pattern, that extends across Europe and beyond, of the rising numbers of children whose behaviour is recognised and understood as a medicalised condition, such as Attention Deficit Hyperactivity Disorder (ADHD), rather than simply as poor behaviour. Questions concerning mental disorders in very young children have been a topic of debate (Carter et al, 2004; Emde et al, 1993), with unease as to whether it is possible to diagnose the very young. There has been intensification in the specialization of infant mental health, the creation of psychiatric classifications tailored to the ‘developmental needs’ of infants and young children and growth in treatments that are commonly used by adults and older children. Very young children, for example, are being prescribed more psycho-pharmaceuticals, such as stimulants, antipsychotics and antidepressants, than ever before (Zito et al, 2007).

The paper examines the phenomenon, developed by the authors, of psychopathology and considers the extent of its influence of on the lives of children and young people. Psychopathology marks out subjects as either having or being at risk of mental disorders. For instance, framing the movements of children as manifestations of mental disorder (such as not sitting still) is an example of psychopathologization in practice within the school environment. The suggestion that behaviour is being psychopathologized gives pause to ask about the consequences of the application of mental disorders in schooling contexts and the potential for exclusion that may arise. It is useful to question what is happening when for example, a boy’s activity is interpreted by a teacher as being ‘ADHD’. In this instance is it the case that the activity is a non-psychopathological problem or is it a problem of psychopathology?

The paper charts the ways in which mental disorders have become commonplace in childhood and youth, from birth through to college and university. It highlights the interface between these educational periods, the education institutions and how regularization of learning is closely tied with conceptions of mental normality, and by consequence, to mental disorder. The paper is based on a recent book, Psychopathology at school: theorising mental disorder in education (Harwood and Allan; published by Routledge) and associated publications (Allan and Harwood, 2013; Harwood, 2010a & b; 2011).

The paper draws on the work of Foucault to argue that psychopathology has become instrumental in schools and that schools play an instrumental role in the expanding the new psychopathologies of children and young people. Foucault’s emphasis on truth, power and the constitution of the subject (Foucault 1983, 1997, 2000) is used to explore how psychopathology at school is produced and has productive effects. Our discussion of psychopathology and schooling is guided by Nealon’s (2008) development of Foucault’s concept of intensification. We use this concept of intensification to analyse the various ‘periods’ of schooling: from the cradle to the crèche; the primary years; the high school years; and higher education, considering for each of these: the points of arousal to concern, relations/networks of power, disorders of interest, modes of practice, and desired consequences/outcomes.

In working with these arguments our standpoint is informed by the view that critique is vital to education as a political activity (Harwood & Rasmussen 2013). In this respect we engage with Arendt’s (1968) emphasis on the importance of critique and ‘thinking’ to confront the problematic, ‘to what degree is thinking being brought to bear on psychopathology?’ Extending on this engagement with critique, we also utilize the ideas of territorialization and deterritorialization developed by Deleuze and Guattari (1987) in order to understand the challenges by professionals to psychopathology.

Method

The analysis of psychopathologization in schools reviews existing research on global patterns of diagnosis and treatment of mental disorder, particularly in relation to the risk factors associated with ‘race’, class and gender. The analysis also draws upon three interconnected studies undertaken by the authors. The New Outsiders was focused on sites in four Australian states (Western Australia, South Australia, New South Wales and Victoria) where there were both high rates of prescription medications for attention deficit hyperactivity disorder and significant social and economic disadvantage. The study was broadened to include interviews from two locations outside of Australia: in Cambridgeshire, England, and in the Greater Bay Area of San Francisco and interviews were held with professionals working with the young people. The Imagining University Education focused on perspectives on university for young people who live in communities in comparable low SES regions of Australia (in Victoria, Tasmania, New South Wales, South Australia and Queensland) all with low rates of university participation. Across these sites young people were interviewed over a period using semi-structured interviews in youth settings such as youth centres. Participants were recruited through youth sector and related agencies with youth professionals often joining interviews. The Medicalization of Child Behaviour was conducted in Scotland, where the pace at which child behaviour has been medicalized appears to be slower than in other parts of the United Kingdom and in Australia and North and South America. For this study we carried out semi-structured interviews within one health board and two education authorities in one geographically defined region of Scotland, which had lower than expected rates of ADHD diagnosis (not disclosed to maintain anonymity).

Expected Outcomes

The risk of psychopathologization is greatest for certain groups and we report heightened levels of diagnosis associated with the risk factors of ‘race’, social class and gender. The patterns of psychopathologization, through each of the phases of schooling are reported. The enthusiasm for resolving mental health issues of very young children (or the risk of these) is operationalized under the rubric of ‘intervention’, with such interventions including those yet to be born. By primary school the acceptance that things have now been ‘set on course’ generates a period where practices - such as separation (separate schools, classrooms), pharmaceutical treatments, and training programmes (for parents; within schools) - swing into full-scale operation. At secondary school, a more sombre tone emerges that is concerned with ‘ameliorating’ problems believed to be ‘entrenched’, with practices that have a ‘palliative focus’ and which control a condition and minimize its impacts. At the point of colleges and universities, psychopathology becomes linked with the troubled student with depression, and with a concern for the dangerous potential for potency. One of the significant consequences of psychopathologization is that diagnosis obscures other interpretations of children and their behaviour. It also detracts from considerations of what is best, educationally, for individual children. Once a diagnosis is in place, or even while there is a suspicion that a diagnosis might be warranted, attention is deflected from how to educate and onto how to manage the child. We contend that the presence of cultures of mental disorder across the life worlds of childhood establishes a pattern that encourages reliance on narratives of mental disorder to account for childhood normality or non-normality. The possibilities for alternative educational responses that negate the diagnosis of mental disorder are considered and an argument is made for the need to put pedagogy ahead of the diagnostic reflex.

References

Allan, J. and Harwood, V. (2013) ‘Medicus interruptus in the behaviour of children in disadvantaged contexts in Scotland’, British Journal of Sociology of Education, published online 27 April. Arendt, H. (1968b) Between Past and Future: eight exercises in political thought, New York: Penguin Books. Carter, A., Briggs-Gowan, M. and Davies, N. (2004) ‘Assessment of young children's social-emotional development and psychopathology: recent advances and recommendations for practice’, Journal of. Child and Adolescent Psychiatry, 45: 109-34. Deleuze, G. and Guattari, F. (1987) A Thousand Plateaus: capitalism and schizophrenia, London: The Athlone Press. Emde, R., Bingham, R. and Harmon, R. (1993) ‘Classification and the diagnostic process in infancy’, in C.H. Zeanah (ed.) Handbook of Infant Mental Health, 2nd edn, New York: Guilford Press. Foucault, M. (1983). ‘The subject and power’, in H.L. Dreyfus and P. Rabinow (eds), Michel Foucault: beyond structuralism and hermeneutics, 2nd edn, University of Chicago: University of Chicago Press. Foucault, M. (1997a) ‘Subjectivity and truth’, in S. Lotringer and L. Hochroth (eds) The Politics of Truth: Michel Foucault, New York: Semiotext(e). Foucault, M. (2000) ‘Truth and power’, in J.D. Faubion (ed.) Power, The Essential Works of Michel Foucault, vol. 3, New York: The New Press. Harwood, V. (2010a) ‘Mobile asylums: psychopathologisation as a personal portable psychiatric prison’, Discourse: studies in the cultural politics of education, 31(4): 437-51. Harwood, V. (2010b). The new outsiders: ADHD and Disadvantage. In L. J. Graham (Ed.), (De)Constructing ADHD: Critical guidance for teachers and teacher educators (pp. 119-142). New York: Peter Lang. Harwood, V. (2011) ‘Connecting the dots: threat assessment, depression and the troubled student’, Curricululm Inquiry, 41(5): 586-609. Harwood, V. and Allan, J. (2014) Psychopathology at school: Theorizing mental disorder in education. London: Routledge. Harwood, V. and Rasmussen, M.L. (2013) ‘Practising critique, attending to truth: the padagogy of discriminatory speech’, Educational Philosophy and Theory, 45(8): 874-84. Nealon, J. (2008) Foucault Beyond Foucault: power and its intensification since 1984, Stanford, CA: Stanford University Press. Zito, J.M., Safer, D.J., Valluri, S., Gardner, J.F., Korelitz, J.J. and Mattison, D.R. (2007) ‘Psychotherapeutic medication prevalence in medicaid-insured preschoolers’, Journal of Child and Adolescent Psychopharmacology, 17(2): 195-203.

Author Information

Julie Allan (presenting / submitting)

University of Birmingham

Education

Birmingham

Valerie Harwood

University of Wollongong, Australia

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