If there is something (among many other things) that Maltese people excel at, it is the act of talking. Try queuing at the bank on a Saturday morning or waiting at the local hospital’s Outpatient Department and you will probably find yourself automatically relegated to listening to at least one fellow’s family history narrative.

This is often accompanied by enough gestures to put a master puppeteer to shame.  If you are accompanied by young offspring of your own, you may also gear yourself up to receive a few child-rearing tips that are thrown in for good measure.

While this trait within the Maltese population has a somewhat endearing quality attributed to it, the importance and power of discourse may be easily disregarded in terms of its ability to generate knowledge (whether accurate or not) and shape reality.

A prominent philosopher, Michel Foucault, dedicated considerable effort to an exploration of the link between the power of discourse and its effect on reality. To this end, he contended that accepted knowledge and scientific evidence are the influential factors that form an ‘absolute’ truth and this is what in turn leads to the subtle exertion of power in everyday life (Foucault 1963/1998).

Which brings us to the issue of mental health and the discourse related to this area.

In this aspect, words and terms are often given extreme importance, sometimes to an extent that they threaten to overshadow the very subject of discussion. 

For instance, in clinical and academic circles, heated debates over the right terms to use, typically featuring service users, patients, clients, rehabilitation, chronic care and other such nomenclature, are known to be a common occurrence, with each term being fondly guarded by its respective supporters.

Mental illness does not discriminate in terms of intelligence, status or money

Although this sometimes verges on time wasting, one may appreciate the need for political correctness especially in view of the morbid history of mental health.

In terms of laymen circles, it may be noted that recently local discourse on mental health may have taken on a more respectful and dignified tone. This may be partly due to the mental health promotional efforts that have featured over the past five or so years.

However, let us not be fooled into believing that mental health snobbery has been eradicated from our country. While terms such as imbecile, miġnun and Ta’ Frankuni may no longer serve as the occasional cool providers of humour during dinner parties and nonchalant conversations, innuendos and non-verbals may still be saying a lot and merit caution.

Thus poorly (or sometimes cleverly) concealed snobbery and disgust at individuals in society who exhibit symptoms related to mental health difficulties may be the new type of subtle yet stigmatising discourse that we are currently facing.

Here I am not even referring to some mental health-themed carnival float that sparked national fury. It is actually more subtle than that and sometimes seen even in those who are actually trying to promote mental health such as, for instance, when engaging in a custodial/patronising approach that portrays another individual as being extremely vulnerable, completely dependent on others and in need of constant protection and management.

 Also know as the ‘Him/Her Down There v The Me Up Here’ scenario.

Such attitudes may perhaps be explained by inadequate education on the subject. However, there may be a deeper rationale to it and this is where reference to Foucault’s works and literature on deviance may shed light. Interestingly, Foucault explained how in society there has always been a ‘void’ that needs to be occupied by an undesirable societal issue such as a particular physical condition (e.g. the dreaded leprosy) or homeless individuals:

“Leprosy disappeared, the leper vanished, or almost, from memory; these structures remained. Often, in these same places, the formulas of exclusion would be repeated, strangely similar two or three centuries later. Poor vagabonds, criminals, and “deranged minds” would take the part played by the leper...” (Madness and Civilisation, Foucault).

On a similar note, Durkheim (1938) described why deviant conditions or behaviour are actually needed since they give rise to the bonding felt within a society when all members react in a similar manner to different (deviant) behaviour. 

Therefore, on reflection, perhaps when condemning deviant behaviour or showing an attitude of superiority towards conditions like mental health problems, a sinister and latent part of the instigator would be rejoicing that: “I am holier than thou.. I am safe because I am unlike you... but like the majority of society… and so I am accepted.”

Conclusively, mental illness may be facing such snobbery because: it makes the instigators feel better about themselves due to their perception they are ‘unlike’ that person who they are looking down at; the instigators themselves may have a latent or overt fear of the very same condition that they consider as inferior.

This is rather amusing because this self-protecting mechanism does not really protect anyone from becoming mentally ill him/herself.

Nowadays we know that mental illness does not discriminate in terms of intelligence, status or money and so, at least in relation to these variables, everyone is susceptible.  Perhaps it would be rather wise then to think twice before indulging in superior damaging attitudes and discourse.

Paulann Grech is a lecturer at the Department of Mental Health, Faculty of Health Sciences (University of Malta).

This is a Times of Malta print opinion piece