The Social Construction of LDs and Mental Health

Simone's thoughts on the social construction of learning difficulties and the mental health of people with learning difficulties.

Simone Aspis


Prevalence of mental health conditions is much higher amongst disabled people with Learning difficulties (LD) and Autism (ASC) than the neuro-typical population. It is estimated one third of people with LDs and ASC will have a mental health condition. Over the past decade the number of people detained under the Mental Health Act is rising - alarming rate up by 47% in 10 years. One of the reasons for the increased use of state sponsored sectioning powers is amendments made by the Mental Health Act 2007 to the Mental Health Act 1983.

The definition of mental disorder was removed and therefore leaving it undefined so that anyone with a mental disorder as defined under the International Classification of Diseases (ICD) published by the World Health Organization (WHO) could fall under the Mental Health Act provisions. Over the years, there has been increasing numbers of new mental disorders being constructed through medicalising what would have been considered within the normal patterns of being, thinking and behavouring of humankind. Now, mental disorder has been extended to cover individuals patterns of learning departing from cognitive norms such as dyslexia, dyspraxia and dyscalculia.

Classifying certain types of being, thinking and behaving in western world as a “mental disorder” involves value judgements on what constitutes “normal” and “abnormal” by psychiatrists. “Correct” ways of being, thinking and behaviouring in a western society is culturally and socially constructed; Homosexual was classified and declassified as a mental disorder in response to society’s changing opinion about sexual orientation. More recently transsexualism is no longer considered as a “gender identity disorder“ associated with mental illness.

Many of the mental health conditions which disabled people with LDs/ASC develop are often caused by a clash between their own and neuro-typical peoples brains who are wired to follow cultural patterns of being, thinking and feeling and living in an nero-liberal society. So if society wants disabled people with learning differences and their patterns of being, thinking and behaving to be accepted, then WHO could remove Learning Difficulties conditions from the list of mental disorders. Thus, mental disorder conditions falling under the mental health act are socially constructed; a person’s experience of their mental wellbeing can be interpreted in a various ways, leading to disputes over different mental disorder diagnosis. For instance, disabled womens patterns of being, thinking and behaviouring could lead to an autistic, borderline emotionally unstable personality or psychotic mental disorder diagnosis or without a diagnosis by various psychratrists.


The Mental Health Act makes it so easy to allow the State to detain disabled people with LDs and ASC without ever needing a psychiatric diagnosis. All psychiatrists have to do is determine whether a Patient with LDs behaviour is of an abnormally aggressive nature or is considered as seriously irresponsible social misconduct and a risk to oneself or others when determining if a person’s mental disorder is sufficient enough to warrant compulsory hospital treatment. What constitutes as abnormally aggressive behaviour or seriously irresponsible social conduct is undefined and therefore can mean anything and everything.

The standard is determined by “social norms”, i.e. normal level of acceptable aggressive behaviour or seriously socially irresponsible misconduct amongst the general population of neuro-typical people. The law does not require the medical profession to consider the external causes but only the presentation of the person’s behaviour at the point of admission. As we become increasingly more intolerant towards peoples differences, what constitutes as normal becomes more narrow.


In the MHA 1983, Available Appropriate Treatment does not need to have a therapeutic benefit for the patient. Many disabled people with Learning difficulties and autism are forcibly injected with highly toxic anti-psychotic drugs for psychotic conditions to treat anxiety, impulsivity, irritability and aggression arising from unmet needs. The medication’s side effects are very detrimental to the patient’s mental and physical health (including massive weight gain) whilst losing control over their body and mind, alters personality and interferes with personal identity and life-style. When not medicated, inpatients will undertake a whole range of therapeutic activities aimed at changing patterns of thinking, being and acting with no allowance to how institutions and other powerful forces impact on their wellbeing. Scrutiny does not end at the hospital gates, it continues whilst the patient is in the community where patient’s every move is assessed, monitored and reviewed and is used to determine their progress towards discharge and their freedom.

The psychiatric regime is rooted within the individualised and medical model of disability/mental disorder where its focus is on fixing, mending and curing, leaving the patient following neuro-typical patterns of being, thinking and feeling.

By Simone Aspis (Changing Perspectives and Free Our People Now Advocate)

I am a disabled person (with learning difficulties) who is acting as an advocate for detained in-patients with learning difficulties and autism who want to be released from psychiatric hospitals. I have over 20 years experience campaigning for disabled peoples’ human and civil rights, working for People 1st, the United Kingdom’s Disabled Peoples Council and the Alliance for Inclusive Education and Not Dead Yet.