The social model of disability offers a radical alternative to the way we understand our mental health problems.
Rather than focusing on health problems as deficits or diagnoses, the social model asks what structural barriers such as lack of mental health care, access, discrimination and exclusion (whether intentional or not) affect people’s wellbeing.
The social model of disability still values the importance of receiving good medical care, but refocuses our attention on what societal barriers disable people, and what role society has to remove these barriers so that everyone can be included, and feel valued and respected.
To guide us through how this approach relates to mental health, we are delighted to welcome Vici Wreford-Sinnott who is a disabled writer/director for stage and screen, and an advocate for cultural equity for disabled people.
We begin the interview by playing a clip from the Disability and… podcast which you can find here.
Please note that this show does not constitute medical advice and is not a replacement for seeking professional help. You can find our more about the show and get signposting to support on our website anyamedia.net/livelyminds
W: If anything comes up in this show that you need help with right away, signposting to
support is available via our website, anyamedia.net/LivelyMinds
E: Hello my name is Ellie.
W: And my name is Will.
E: You are listening to Lively Minds, the podcast about mental health challenges that go beyond the ebb and flow of the everyday.
W: The podcast that is less about how we deal with our mental health and more about how we understand it in the first place.
E: In today’s show we will be meeting Vicky Wreford-Sinnott. Vicky is a disabled writer and director for Stage & Screen, an advocate for cultural equity for disabled people, and founder of disabled-led production company Little Cog. With nearly three decades of dedicated work, she crafts innovative narratives featuring disabled protagonists to challenge societal misconceptions and myths.
W: Today we will be chatting with Vicky to get her take on how disabled identity relates to mental health, what it means in terms of our understanding of the challenges we face, as well as the activism we can take part in to bring about positive change.
W: We will be talking a lot about the social model of disability and how it connects with mental health. Whilst the social model values the importance of receiving good quality health care, it challenges the idea that people are disabled by their impairments. Instead, it asserts that societal barriers such as prejudice, exclusion and lack of access are the true causes of disability. If you want to dig deeper into the origins of the social model of disability, check out our conversation with Professor Tom Shakespeare in episode 13.
W: Welcome to the show, Vicki. It’s great to have you here.
V: Oh, it’s an absolute pleasure. Thank you for inviting me.
W: So, Vicki, I was listening to you on the brilliant DisabilityAnd podcast, which I thoroughly recommend our listeners check out. And there was something that you said that really spoke to me. And I’m going to play the clip.
“Because I wasn’t born as a disabled person, although in terms of mental health, you could argue that I was. I just wasn’t aware of it until me teens, really. I didn’t know, I didn’t know I was different in that way until me teens. But I also didn’t know that mental health fitted under the disability umbrella at that time because nobody’s telling you. Do you know, even now, people ask, ‘Do I fit under that umbrella or not? Am I allowed to join this club or not?”
W: That was a clip from the Disability And podcast and I’ll put a link to it in the show notes. So to begin with, I would love it if you could expand a little bit more on what you mean by this.
V: I suppose there’s a couple of things going on in that comment. And the first of which is that I hadn’t come to any kind of identification with necessarily mental health or disability. I was in my teens and I had no context for the things that I thought were just quirky and sometimes incredibly sad and challenging about me.
So, you know, and I grew up in a time when we didn’t talk a lot about it in mental health terms. But then the other, the other thing is that once I was more knowledgeable, not in an academic sense or in a medical sense, but just in terms of what was going on with me, I think I also didn’t know that it fitted under the disability umbrella, so I didn’t know where I fitted. And at that time I had not been introduced to the social model of disability, which was a fundamental and pivotal turning point in both my life and the decisions I’ve taken around activism, but also just my understanding of, of my place in the world.
W: When Tom Shakespeare was talking to us about the relationship between disability and mental health, he made a distinction between disability as a label and disability as a badge. And it feels like as though you’re speaking to that idea as well in what you said on the DisabilityAnd podcast in the sense that by understanding your mental health challenges through the disabled lens and as you say, particularly through the social model of disability that that led to a new understanding for you. Would that be fair?
V: I think, I think that’s definitely true, yes. I think that being able to find a place to put the ideas, the thinking and also you know, what, what was really useful for me in terms of the social model of disability is that I know it’s not the solution to everything but what it provides me with and this is my take on it is, I think it’s possible to develop a framework for change from what the social model presents us with. It’s a very different way of, of thinking than for example the medical model which is where so many different conditions are, you know, positioned.
It’s about a clinical diagnosis, it’s about the things a person can’t do and I didn’t really see myself in that description. [laughter] I just found there was a huge gap in perception and the construction of identity because I’m really interested in how and why societies do construct different stereotypes around individual identities, particularly if they’re what we would call marginalised. It’s not a brilliant word, but you know, people who don’t fit dominant norms.
And so I think that initially, my mental health, I didn’t even think of it in terms of like a health condition as such.
V: Yes, it had a really significant impact on my life, but as I was realising that it was a mental health condition, I also discovered the social model of disability, which meant that I didn’t look to blame myself and I didn’t look to necessarily the medical profession initially for help and that might make me unusual I’ve got no idea but I don’t I never have had a lot of faith in the medical profession and you know I do think that psychiatry remains in its infancy, I think it’s guesswork a lot of the time, that’s not to diminish the, you know, the years that people put into their studies in that area. But I, I really feel uneasy with psychiatry trying to be definitive about something that I genuinely don’t think it fully understands yet.
And so, I think I might have possibly gone off on a few tangents there. But I think that they’re all strands that have an impact on how, how I perceive mental health, my mental health, and how I perceive it in the context of discrimination, societal attitudes and stigma, and therefore how we make change happen as a result of that. And so for me, it’s never been uncomfortable to put mental health under the social model umbrella. That’s always felt like a completely natural place
to be and I know not everybody thinks in that way and not everybody, you know, has that experience.
It is complicated I think probably why, you know, why I do that and why perhaps other people
don’t see that affinity. I think a lot of that is to do with stigma around both mental health
and particularly the word disability, I think it’s that there’s such negative connotations still societally if you are not lucky enough to have been supported through a process of acceptance, a process of, you know, education whereby the stigma can be picked apart, you know we can unpick why societies have particular impressions and expressions of negativity around mental health and, and disability. And I think they’re inextricably linked.
W: Once you started understanding your mental health challenges through the social model of disability, what did that, on a practical basis, mean in terms of how it changed things for you?
V: I think understanding that first of all, a clinical diagnosis is not a deficit. You know, it doesn’t, it doesn’t mean that you are a deficit model of a human being. For me, that’s part of being a human being. And all of us at some time in our lives will probably have a diagnosis or a condition develop, you know, 70 percent of us are going to become disabled as we age. It’s a natural part of life. And so I think I’ve been lucky enough to view it in that way.
And in terms of how it changed things for me, I didn’t need to keep it a secret anymore. It meant I could speak to other people about it. It wasn’t just quirky, desperate sadness that had no explanation. And I mean, it wasn’t all sadness some of it is just complete celebratory madness, you know, as well. And I’ve learned to embrace those parts of me as, you know, but in terms of how it changed things under the social model, I realised that I didn’t necessarily need to be cured, although it would be really nice not to ex, continually experience the worst parts of a mental health condition.
V: But also that when I talked about the social model having a framework within which we could like, have understanding or bring about change. That, it genuinely for me, opened my mind and the possibilities of the support that needed to be in place. So rather than that medical model world where you know “oh she’s this she can’t do that and she can’t do that”. Well hang on a minute let’s look at what we can do in a much more accessible framework to make the world work for Vicky
V: or for other people with mental health conditions and, you know, and I don’t see obviously symptomatically mental health is different to other conditions but actually I see the access requirements that need to be met as being on a par with any other condition whether that’s a physical condition whether it’s a sensory condition and so that just helped me and I don’t know if that’s because I’m naive. [laughter] I don’t know if that’s because it’s a very simplistic way to, you know, perceive the social model but it, it has worked for me. It doesn’t mean that it’s cured my mental health problem and that’s not what it’s there for. I have to wrestle with the appalling services that exist and, but actually the social model could do something about that. Was the whole medical profession open to a different perspective on individual health.
W: Let’s go to a short break and we’ll be right back.
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W: One of the things I mentioned in the podcast with Professor Tom Shakespeare was that when I talk about myself in terms of disabled identity, I talk about how I have mental health problems. I struggle to identify, I guess, with the social model of disability, in part because I don’t really think that there are barriers that are put in my way. And I think that part of the reason for that is because I’m relatively privileged. The things that I need put in place to manage my mental health are things that I have a lot of autonomy and self agency to be able to put into place. I am managing my mental health on a daily basis, but I, I’m very lucky in that I have the autonomy to be able to do that. And that actually there could be somebody else in the world who has exactly the same diagnoses as I do, but who absolutely is disabled through the social model, because they don’t have the agency and the autonomy to be able to put any kind of self-care in place, which I am, I am able to. You know, I’m a senior co-founder of the organisation that I’m part of, and so I’ve got that autonomy. But if somebody has a boss who doesn’t understand, for example, and they’ve got exactly the same conditions that I have, I could imagine that becoming an absolute nightmare for them. And absolutely, there’d be barriers put in the way by their employer, which would cease, we could stop them from being able to live a fulfilled life.
V: That really strikes a chord with me in a number of different ways. And I think that sometimes, if we’re in a position to develop our own agency, then we do. Historically, within the disability arts movement, for example, or the disability rights movement, we’ve set up our own environments that are accessible. We have been very DIY in that sense because that’s one of the ways that we ensure our processes are accessible. And we do that either in collectives or we do it as individuals. We do it as artists, you know, if we want to work as artists.
I think, I do think that you’re right. I think there is, there’s, the question of privilege is in there but whether that’s about autonomy or whether that’s about the degree to which we’re impacted by our conditions, which is variable and change…
E: In different contexts.
V: And changes over time. So certainly I know that if… Because I’ve spent 30 years trying to carve out a model of working that works for me. And so my theatre company is definitely not an NPO of the Arts Council. And, I have been the director of an NPO, sorry, that’s a National Portfolio Organisation. And as a disabled person, it wasn’t accessible, it did not work for me. So I spent a long time creating a model of work that works for me. And I would say, yes, maybe that is, I’m privileged because I’ve had the, had the support to do that, I’ve had the vision to do that, or you know, there’ll be various things that have coalesced to allow that to happen.
The problem that I have with it is not how I manage my mental health condition. And this is for disability and whether mental health fits under the disability umbrella the social model and neurodivergence as well is, is the discriminatory factor.
V: So this is the external thing that is out of our control. We can give ourselves agency within a certain sphere, but I do think that our power of influence will reach a glass ceiling at some point that is to do with discrimination and the underestimation of disabled people or people with mental health conditions, or neurodivergent people. So the, the common fact, one of the most common factors around the term disability for me is that we are discriminated against because of our conditions and the fact that whatever our condition is or whatever the diagnosis is, that isn’t perceived as fitting into the norm of what a human being is, which is so preposterous, you know, again, go back to my original point about it’s just a natural part of life.
And so for me, I, I know that there will be various points, no matter how well carved out my accessible career is or my accessible life is, I will experience discrimination. I will be, you know, I will be misjudged. People will have baggage and they will believe some of the stigma and the stereotypes around mental health. You know, people have, have been frightened of me as a parent, people have labelled me as a certain kind of mother without knowing me. I had no agency over that.
And so I think for me, there are, there are areas of our lives where we don’t have the last say, and we don’t, we’re not free of that discrimination. And so that’s a very important ingredient for me, and that’s what the medical model of disability represents for me is it’s, a mode of viewing disabled people in a really negative, negative way. And, you know, it’s obviously, it’s not a model of disability on a par with the social model of disability. They’re serving two very, very different purposes. And I know that people with mental health conditions or conditions, I have conditions that relate to pain. And I’ve heard some people say, “Well, maybe we need a bit of both.” I, I want nothing to do with the medical model of disability. I want good medical treatment for my, when I’m symptomatic, but not in the context of the medical model of disability, which is purely discriminatory, in, in my opinion.
W: Ellie, is there anything you want to…?
E: Yeah, I was a bit quiet then, because I was just thinking, well, a lot of things, but one was that I’m not, because I suppose my sort of journey in relation to identifying as disabled, only really as a continuous thing that has led me to where I am now, only really took place when I had like a sudden influx of new bonkers physical health conditions that then made a very sudden difference to how I was living up until that point. And I, I remember experiencing exactly what you said about when I discovered the social model of disability. It was like, “haaaa!” Like a big light had shown and I was just like, “Oh my gosh, I suddenly understand everything differently and feel this weird sense of calmness!” But I don’t actually… I was quiet because I was trying to work out how I think my mental health fits into the social model in particular and it’s quite difficult to do but I think that’s because these that, I can’t, I find it really hard to pull out my mental health from other intersectional identity points that, you know, and I loved what you were saying about what we all have in common in identifying as disabled is discrimination, because it’s almost like a reverse way of identifying because actually what it is that makes you feel part of that community isn’t some kind of individual observation about yourself, it’s actually a shared experience of something that someone else is doing to you, so the discrimination. I find it hard to separate that from like other intersectional aspects of identity so like sexism and mental health in terms of the specific sort of social barriers that are faced, I think are so entwined that I was struggling to sort of pull out just mental health on its own but I mean that’s just, that’s part of you know, that is part of my mental health I suppose in a way as well isn’t it? it’s, but yeah it is, it was just really interesting
That’s what I was thinking about.
V: It is, it is complex and it’s multi-layered and I don’t, I don’t certainly don’t profess to have all the answers. I can only, you know, talk about how, how I have navigated my thinking around this, particularly as somebody who also has, you know, I have intersectional identity within disability because I’ve got a range of conditions. Um, and sometimes I wonder if that, it’s going to be an interesting word, “helps” to kind of put everything into a particular kind of context.
But it’s interesting to hear you talking about like where do we, you know, the sexism, the misogyny, the whether it’s homophobia or a transphobia. We, know know, we all know it’s capitalism ultimately that’s at the root of much of this. So anything that’s looking towards social reconstruction is really interesting for me. And maybe it’s because I’m keen to make things fit or I want, you know, I like to compartmentalise things that I’ve been, you know, just been able to make that work in that sense.
But again, it’s, it’s thinking about the social model as a tool of liberation, as a framework for change within which you can, you know, build a range of strategies. And, you know, lots and lots of disabled people of the 80s and 90s who did the hard thinking around this, I think knew it wasn’t a static, a static thing, that it would change and evolve. But there were so many different ideas coalescing at once through activism, through academia and through medicine itself I suppose. But it isn’t easy to extracur every strand of ourselves I suppose.
But the environment that we live in, the culture and the society that we live in is overwhelmingly ableist and we’re encouraged constantly to be introspect, to look into ourselves, to see what our problems are and what our… And I don’t mean this in the sense of… I think there’s another bigger conversation about the role that the external factors in society have on our mental health and I do think that’s a really important conversation, whether they’re part of the cause or… And I don’t think it’s just our mind and brain, I think our body, the complexity of our intersectionality is, is woven into that. I think we have internalised, we can’t avoid it, the stigma that’s there around disability. And we do, we’re all on a different journey, we’re all on a different path, and at some point, we realise that the label has impacted us
V: for a very long time, but that perhaps we might like to wear a badge now that embraces the positives, the joy. So being disabled for me isn’t just about being discriminated against, it’s about solidarity with the whole movement, with the whole community,
again embracing the cultural and historical phenomenon of disability, which for me is so exciting and interesting
and is so underrepresented culturally. But if we did have bigger stages or galleries or whatever, the rest of the country would be excited by that as well.
V: And we’d be able to, you know, going to shift some of the stigma. But it’s hard not to hold that inside ourselves. So I’m glad, I’m, yeah, I’m glad to be, have been able to transform some of that into kind of embracing the community and the positives of being part of an incredible community.
E: Yeah, I definitely see that as a positive that I can pinpoint in my life the point at which I sort of, you know, like I’ve made the best friends since becoming more involved in like the disability arts movement and met more amazing people, not even just sort of who identify as disabled, including people who don’t, and it just, like, it’s made, yeah, there’s so much positive and, you know, there’s been this exhibition, I mean, it’s just closed, but at the People’s History Museum in, in Manchester called Nothing About Us Without Us, so it’s been like a big two-year project and the exhibition is of the history of disability rights movement basically and there’s been a fantastic program of events alongside it and just sort of it’s, it’s just been a bit like everyone that I’ve met over the last kind of, I don’t know how many years, eight years or so, has been that, and every single event has just been so joyous and brilliant and like that is a wonderful thing about the community and the creativity and problem solving and thinking outside the box, partly some of that because we have had to, because of all the barriers put in place by society. But it is really wonderful. I just think, yeah, it’s important to remember that.
W: I think what’s been really interesting about this conversation is that we were going to talk also about your work as an activist. We’re going to now delay that until another podcast where we can really go into depth on that. But what’s been really interesting about this conversation
is that, in a sense what we’ve been talking about is that in order for us to be able to become activists and to support change for disabled people, for people with mental health challenges, we have to first of all be able to frame our own experiences within ourselves. We have to first
of all come to terms with our own identity, with the way that we understand our own challenges that we’ve been through.
V: Absolutely. I think it’s important that we think about, you know, where we position ourselves. A lot of the time we just naturally beat ourselves up because we’ve been taught to do that, unfortunately. And there’s so much more that we need, you know, there is no support out there in terms of accepting our own identities or where we might sit. I could, could not have become a politicised activist until I had satisfied where, you know, where I fitted in the world.
V: And also that I experienced the relief that it’s not about blame, it’s not about deficit, that actually it’s another way of looking at this completely. And that other way of looking at things is not freely available to people. We don’t get a handbook when we become a disabled person. And we certainly don’t get educated about it in school, urm, quite the opposite, you know? So I think, yes, there’s a lot of, a lot of, and I think that’s why the disability movement, the disability communities actually come together, is because we, you know, see that there’s something in shared experiences and solidarity.
W: Great Michelle.
E: Thank you so much.
E: Thanks so much everyone for listening. Please do tune in again in two weeks for another episode of Lively Minds, the mental health podcast.
W: Please note that this show does not constitute medical advice and is not a replacement for seeking professional help. You can find sign posting to support on our website, anyamedia.net/livelyminds.
E: Make sure you keep up to date with our shows by subscribing wherever you get your podcasts.
W: Take care and bye for now.