Challenging the “High-Functioning”/”Low-Functioning” Divide

I’ve been thinking a lot about the ways that people with any sort of mental disability get divided into “high-functioning” and “low-functioning” categories.  These categories get described in lots of different ways—people who “have issues” versus those who are “really crazy,” “mental illness” versus “serious mental illness,” and so on, but it boils down to the same division.

Partly I’ve been thinking about it because I asked to join a support group for LGBT people with mood disorders and got told no. The provider explained that most of the people in the group were really “low-functioning,” that since I had a job I clearly wasn’t “low-functioning,” and that I probably wouldn’t be “a good fit” or “comfortable” there.

Partly I’ve been thinking about it because I’ve been trying to help a friend get access to mental health benefits. While this person hasn’t been able to work and has recently been hospitalized for psychiatric treatment, they’re still getting told that their mental illness isn’t severe enough for them to qualify for benefits. The people who denied them benefits explained that most of the people who got benefits were “really crazy.” As an example, they described homeless people talking to themselves on the street and getting harassed by police.

I know that those of us who are perceived as “high-functioning” have some real privilege compared to people who are perceived as “low-functioning.” For one thing, we’re less likely to get harassed by cops. I also know that there are huge differences among the ways different people experience madness and mental disability. I also think that the division really hurts all of us.

This division prevents us from associating with people who get labeled as being on the other side of the line, which really disrupts potential for community-building, solidarity, interdependence, and resistance. Would the members of the support group I wanted to join be uncomfortable with my presence because I have a job? If so, I would accept it, certainly—I respect people with less class privilege deciding to create a space for themselves. I suspect, though, no one ever consulted them. What might we have been able to build together if we had been permitted to mingle?

Those us who get perceived as high-functioning get pushed and disciplined into walking this particular line. We often get denied services and accommodations because institutions decide we don’t _really_ need them. If we try to emphasize or explain the ways in which we really are mentally ill to try to get what we need to survive and (maybe even, dare we dream—thrive?), we often get shamed for it. We also get encouraged to try to pass as normal as much as possible, partly because of how the people who get labeled as low-functioning often get treated: stigmatized, institutionalized, fired, kicked out of school, targeted by police, and all sorts of other kinds of violence. In an effort to protect ourselves from that sort of mistreatment, we sometimes stay closeted about being crazy at all, which means we’re often invisible even to other crazy people, even if we work, study, or live together.   We may push ourselves to “act normal” even if it’s really damaging to us, and we may even join in on the oppression of other crazy people to try to firm up the divide between us and them. Even people who encourage me to be out about being trans in the workplace discourage me from coming out about mental illness.

The division is artificial. How well I function varies day by day (sometimes hour by hour) and context by context. I also get away with a lot more crazy behaviors than I could if I weren’t white and professional.  With my private office and flexible hours, if I end up just standing and staring at a wall for a couple hours, then curling up in a ball in a corner  and trembling for a few more, no one has to know. I do still have to get work done, but I get a lot of leeway in the process. At any of a long list of low-wage jobs, that type of thing would get me fired. For that matter, it might get 911 called. And if I were on welfare, I’d probably get called “noncompliant” and my benefits would get shut off.

The “really crazy” behavior that the people in the government agency that denied my friend benefits was talking to oneself out loud in public. I certainly have periods of greater agitation when I speak to myself out loud in public. I’ve never noticed the same extreme behavior in bystanders that I’ve noticed when homeless people and people of color speak to themselves out loud in public. Maybe people have edged away from me a little, but I feel pretty confident I would have noticed if everyone walked from the end of subway platform where I was standing to the other, or if a cop started bothering me. Probably people assume I’m talking on a cell phone and they’re just not noticing the microphone, or assume I’m a bit “off” but not “scary.” And that is all about my white skin and professional clothes, not about my mood or thoughts or behaviors.

I don’t want to erase real differences of experiences, but I wish we could be a bit more nuanced and consensual about it.

I want a world where we can all get what we need and get treated with dignity, where institutions don’t get to decide who deserves what based on what label they put on us.

I want a world where we all get to support each other with everything we’ve got.

Leave a Reply

Your email address will not be published. Required fields are marked *