By Tracey Mitchell

Summary

Activist-academic collaborations – the marriage of street smarts and scholarly skills – were impossible in the asylum era. Even today, they are rare. This exhibit introduces Eugène Leblanc, director of an innovative support group in Moncton, New Brunswick, and Nérée St-Amand, professor of social work at the University of Ottawa. The two men have been researching, writing, and publishing together since they met in 1987. Learn about their projects and savvy critique of the mental health system.

Introduction

On Thursday October 3, 2013, I woke up in a Montreal hotel room, caught between Saskatchewan and Quebec time zones after a late night arrival the previous day. As I was eating breakfast, Eugène Leblanc boarded a plane in Moncton, and a few hours later, Nérée St-Amand took his seat on a train in Ottawa. We would all meet in Montreal later that day, our busy schedules allowing us just twenty-four hours to lay the groundwork for a public record of Eugène and Nérée’s unique and successful activist work, a partnership that would not have been possible in the asylum era.

Over the next day, I learned about the important contributions that Eugène and Nérée have made on their own and together over a period of over twenty-five years, including creating a book, an activity centre, and much more. This is a collaboration that allows the two men to overcome barriers that would stop them if they worked alone. We recorded seven hours of interviews in French and English, and scanned documents and letters which the men had brought.

Had the research been conducted over the phone, then the stories, images and pieces of paper would have been gathered, but I would not have understood so well how these two men challenge each other and grow as people because of their work together. Immersed in their collective history, twenty-four hours with Nérée and Eugène made me think differently about mental health. Hearing their stories changed me. It is no surprise that twenty-five years of working together has impacted them greatly.

Tracey Mitchell, Saskatoon

Eugène Leblanc is director of Moncton's Groupe de Support Emotionnel Inc (GSEI) and editor/publisher of Our Voice/Notre Voix(OV/NV), a bilingual magazine by and for psychiatric survivors. Nérée St-Amand is professor of social work at the University of Ottawa. Since 1987, when Nérée first hired Eugène to work in the fledgling GSEI, the two men have researched, written and published together, crafting a mode of political engagement that is both deeply critical of the current mental health system and carefully strategic in offering alternatives.

Nérée and Eugène’s relationship has evolved into a mutually accommodating connection. They are equal allies. Eugène says Nérée is the only academic that he has worked with who has proven to be sympathetic to the cause of psychiatric survivors, and who has been critical of psychiatry and the mental health system, not only in words but in deeds. He adds that Nérée was an emotional support, acting as a second psychiatrist in the early years that they worked together. Nérée describes Eugène as a key that unlocks doors,noting that Eugène keeps him organized when they work together.

Their important collaborations include the formative stages of GSEI; satisfaction surveys about the New Brunswick mental health system filled out by psychiatric survivors in 1993 and 2003; co-writing articles for Our Voice/Notre Voix and other publications; and co-authoring Dare to Imagine: From Lunatics to Citizens in 2008, a book about the history of mental health in New Brunswick. As radicals Eugène and Nérée have at times felt isolated, but their partnership fosters strength and confidence. Eugène says, "That's how the marriage of academic expertise with street-level experience works: getting together and creating ideas, attempting to transform people's convictions on mental health".

An Uncommon Alliance

black and white sketch of smiling young man

Eugène in his early 20s.

Eugène grew up in the Acadian community of Memramcook, New Brunswick. A critical and inquisitive child, he was the youngest of six in a poor family. He was born with a cleft palate and lip. His mother was advised by nuns and others that he would grow up “mentally retarded,” would never speak and should be sent to a Boston institution for developmentally disabled children. Eugène endured five surgeries, eight years of orthodontic treatment and schoolyard bullying, all of which led to childhood depression. As a kid, he dreamed of travelling, creating a magazine, and helping people. But surely to do these things he would have to go to university, an impossibility for a young man struggling with serious depression? By 2003, however, Eugène had managed to realize all three dreams, and had also received the New Brunswick Human Rights Award from the Lieutenant Governor of the province.

Eugène on his childhood & cultural background

Eugène's life experience has led him to a critical perspective on mental health systems and policies. He says:

I've never been able to identify with illness-based mental health organizations, people who promote an illness, who want to educate you on the symptoms of an illness... I can't wrap my head around caregivers - being the managers or entities that we need to account to on how we've incurred our expenses and activities. We go to caregivers when we are sick, but when we are not sick, I wish they would leave us alone. Those are structural flaws in the mental health system that should be remedied”

- Eugène

Eugène on “structural flaws in the mental health system that should be remedied”

Nérée was raised in Madawaska County, New Brunswick, near the Quebec and U.S. borders. Mental health for him was first a family issue: in 1975 his aunt Emma was sent to a psychiatric institution. Visiting her, Nérée could see that she wasn’t crazy. Like many of her fellow female patients Emma was simply stuck in a difficult marriage and overwhelmed by the burdens of mothering a large Catholic family.

Nérée on how his aunt “opened the door to the hospital” for him

Two years later, Nérée began his PhD dissertation, bringing the intellectual and personal halves of his life together in a study of 500 patient case files from New Brunswick mental health institutions. Negative personal experiences with the church, the education system, the health system, and the mental health system, made him increasingly critical and radical. Says Nérée:

All of these things put together gradually made me realize that there's something wrong with practically all of these institutions. We have to change the ways we think and act, and redo society in ways that will be more humane, more egalitarian, more fair to deprived and disadvantaged people. That's when I turned to alternatives, and that's where I am now in terms of trying to find other ways of living and of creating a culture and a society that has learned from history, that may not repeat history.

- Nérée

Nérée becomes radicalized and increasingly critical of institutions

Smiling middle-aged man with glasses, bookshelves behind

A recent photo of Nérée.

In 1986, as a faculty member at the University of Moncton, Nérée assigned student Annette Despres to do a street-level study of psychiatric survivors, many of whom had been recently deinstitutionalized. Out of this field experience emerged the Groupe de Support Émotionnel, with Eugène as a central figure of this newborn organization.

Two men and a woman in the middle - all smiling

Nérée, Annette Despres, and Eugène reunite in 2008 when 'Dare to Imagine' is launched in Moncton.

Crafting an Academic/Community Partnership

Nérée and Eugène met after Eugène came across the Groupe de Support Emotionnel Inc. (GSEI) and was offered the job of Coordinator of Activities. Eugène recalls feeling important going to Nérée's - fancy office in the late summer of 1987.

Nérée, Eugène and colleague Annette Despres describe how Nérée and Eugène first met

Now, Eugène sometimes recruits Nérée to write articles for Our Voice/Notre Voix when an issue would be aided by an academic perspective. Eugène is a better promoter, is more practical, and keeps Nérée organized. Nérée is more capable of analyzing and interpreting texts and can make strategic use of the clout that his education and his academic position give him.

Both Nérée and Eugène have positive things to say about their work together:

That's how the marriage of academic expertise with street-level experience works: getting together and creating ideas, attempting to change and transform people's convictions on mental health.

- Eugène

Because I have a PhD doesn't make me any smarter than anyone because these people that we're talking about, a lot of them, they have so much experience and so much suffering behind their voice, and behind their testimony or behind their poem. So that's what's been happening between Eugène and me is that it's a cooperation, and it's an education for me, and maybe to some extent I was able to tell him a bit about how the academic world works.

- Nérée

Nérée: “It's an education for me”

An Activist Agenda – Co-Created Knowledge

GSEI is one of twenty-seven activity centres in New Brunswick. Though the centres share common principles, Eugène believes GSEI is different. After a few years of working there, Eugène began to realize that even though he could identify with the people he was working with, he had too much power over GSEI activities. Deciding to transfer the power of the director to GSEI members themselves and extend the work of the activity centre into the community, and recognizing that chronic poverty is often a contributing factor in mental health problems, Eugène created a linked program of volunteer opportunities at the local SPCA, the YMCA, the general hospital, and the wider community, thus giving people the motivation and the opportunity to work their way back into the market economy.

Listen to Eugène describe how he works to empower others and “transfer the power of the director to the members themselves” at GSEI

Man and woman standing smiling in front of buildng holding award plaque

Eugène receives the Mary Huestis Pengilly Advocacy Award in 2013.  Lori Young, then President of the New Brunswick Mental Health Activity Centre Association on the right.

Black and white graphic of telescope and the night sky above, "The publication with the vision"

Our Voice / Notre Voix, 20th Anniversary Issue

The newsletter Our Voice/Notre Voix was founded by Stephen Stiles in 1987. Stiles produced two issues before passing the project to Eugène, who has run the publication ever since. Eugène sees mental health services as a consumer product and Our Voice/Notre Voix as a way of evaluating that product, and sharing experiences and observations about mental health services. Eugène believes that Our Voice/Notre Voix is successful not only due to the content but also due to the style. The pages are well designed with good graphics, it comes in the size and style of a professional magazine, but also has a homemade appeal. He argues:

The reason why we're losing the narrative right now to the control of outside influences is because they know how to package their message....That's why Our Voice/Notre Voix stands out, because it is packaged in a way that makes people pay attention. We need to create strategies and building blocks to make sure that people pay attention to the cries and the plight of people who are trying to fit in a system that believes that one-size-fits-all.

- Eugène

Two smiling men standing next to each other holding publications

Nérée and Eugène in 2003.

Eugène and Nérée collaborated on mental health satisfaction surveys in 1993 and 2003. The 1993 survey had a 76% completion rate. Eugène and Nérée agreed that participants be given a few dollars to share their experience. Among the results a few characteristics stood out about the participants:

  • poverty was widespread
  • most were on high doses of medication
  • they felt disconnected from psychiatry
  • they felt more at ease in self-help groups than in individual therapy in psychiatrist's offices

Once Eugène and Nérée found this information, they used Our Voice/Notre Voix to circulate their findings. The survey gave Eugène and the group credibility.

The 2003 survey was more in-depth than the 1993 survey and was completed on-line. There was criticism that interviewing activity centre users created a bias toward those services and against psychiatric services; but Eugène argues that surveys done by the mental health establishment are also context-biased and that it's important for this research to be done in activity centres too.

Nérée and Eugène share the process and results of the 1993 Consumer Satisfaction survey

Dare to Imagine

Book cover with map of New Brunswick and title "Dare to Imagine: From lunatics to citizens"

The English cover of Dare to Imagine

In 2005, Eugène and Nérée began writing what was to become Dare to Imagine - From Lunatics to Citizens: A Survivor's History of Mental Health in New Brunswick. It was important to them that this be the story of people who had experienced the system, not academic history as recounted by psychiatric experts. In Eugène's words:

[We set out] to recount not just the stories, but the struggle of the people who wanted to create programs and services for like-minded individuals… We worked outside academic formats, using experiential references to show how others overcome the stumbling blocks and everything that goes against them.

- Eugène

According to Nérée,

“It was a nice success story. With very little time and money, it was a challenge to tell the story in French and English of what was going on in New Brunswick. And to deal with complex historical and psychiatric concepts and present them in a way that was accessible to people.”

- Nérée

Mary Pengilly Diaries

Of all the work that Eugène and Nérée have done over the years, one of the projects of which they are most proud is Eugène's uncovering of the diary of Mary Huestis Pengilly, a New Brunswick woman who was institutionalized in the “Provincial Lunatic Asylum” in St. John for six months starting in October, 1883. After her release from the hospital, she traveled to Fredericton to the home of the Lieutenant Governor and presented him with a copy of the diary she had kept while in the hospital. The same diary was published in 1885.

Eugène found a copy of the Pengilly diary while doing research at the provincial archives for Dare to Imagine. While working on the book, Eugène and Nérée also shared the Pengilly story, and a play about her life was performed in 2008, around the same time the book was released. For them, there is a clear parallel between the Pengilly diary and Our Voice/Notre Voix – both are about giving voice to the silenced.

Poster advertising performance of Diaries from the asylum by Normand Robichaud, April 2008, Moncton

Publicity poster for Dairies From the Asylum play

stage performance with woman with long white hair and grey dress standing to stage right and woman with nurse's cap sitting at desk with typewriter

A scene from the 'Diaries From the Asylum' Production

Eugène & Nérée talk about Pengilly's story and the Diaries from the Asylum play

The Mental Health Commission and Beyond

The Mental Health Commission of Canada is a make-work project for consultants, researchers, academia and the hospitality industry. It produces and promotes much knowledge, but how this knowledge trickles down to positively affect the rest of us is another thing. It is in essence another world. For example, New Brunswick has about 2000 people in its activity center network, but if you were to ask these people, "What has the Mental Health Commission done for you? I don't think the reply would have much impact.

- Eugène

The Mental Health Commission of Canada (MHCC) is a ten-year national project mandated to improve the mental health system and reshape public attitudes and behaviors regarding mental health. Eugène has been part of The Hallway Group which acts as a consumer/survivor advisory council to the commission on topics solely related to stigma. Arguing that the commission is mainly a protectorate of corporate bio-pharmaceuticals, Eugène believes that it prefers individual stories to collective advocacy that goes against the mainstream narrative on mental health issues.

For the first four years of the Commission, Nérée was appointed as a member of the Family and Friends Committee. Nérée thinks that the commission is a privileged system with a lot of political and professional visibility. For a while he was happy and proud to be part of one of the eight standing committees of the commission. However, he says that work of his committee, which was comprised of family members, was practically disregarded. He believes that eventually the MHCC regretted appointing him after a full-page article appeared in the National Post, questioning why Nérée, with his critique of mental health systems, was part of the commission. According to Nérée, the MHCC work on homelessness and housing was good work, but it cost a lot of money to determine something that had been well-demonstrated in research for the past 30 years: When homeless people have a home, they are better off.

Eugène and Nérée have a strong shared critique of mental health systems and policies and yet have managed to not burn too many bridges in the course of their work. Nonetheless, their radical perspective can sometimes lead them to feel marginalized. Eugène notes:

“I often feel that I'm in a war room all by myself, trying to be a good tactician and trying to survive. As I get older, I have more clarity and more strength in my views about mental health. I meet a lot of people who support me being in the war room, but few of them want to come inside. Those who do don't last because they criticize people rather than criticizing ideologies and values.”

- Eugène

In New Brunswick, Eugène’s analytical stance is much less common and therefore more isolating than it would be in Toronto or Montreal. Nérée compares Eugène's story to that of Richard Bach's story Jonathan Livingston Seagull, noting that an individual will often feel alone in what they are thinking and saying for a long time before s/he meets like-minded people. Such isolation and exclusion can create “shocks” that make temporary retreats necessary, but eventually people with common perspectives will find one another and a movement will emerge:

“How do you change the whole system? Our Voice/ Notre Voix and Eugène are living proof that change can happen. But it's a long [haul]. In 1987 if we had raised our fists and taken out the “guns,” we'd be dead ourselves probably or gone shortly after. But there was this model of incremental or developmental change that was used. The vision doesn't change, except that it's sharper now than it was at that time, because Eugène and I, we both know more about the politics of these things than we knew then.”

- Nérée

Nérée didn't initially agree with the name of GSEI or the “ear” logo of OVNV. He thought that the logo should have been a fist and wanted both the group and the newsletter to be more militant. He kept quiet at the time, feeling that it wasn't his decision to make. Now, he argues that if they had gone with the more militant name and approach he favoured, the organization and publication may not have survived.

A man standing before others at a book launch

Nérée at Groupe de Support Émotionnel book launch.

Eugène, too, has learned about the art of diplomacy and respectful disagreement. He says:

“Our Voice is a way of conveying experiences.... A common error of those who lead the mainstream mental health system is that they think we're in the business of agreeing. We're not in the business of agreeing, we're in the business of conveying experiences and if those experiences are good, that's a plus. If those experiences are not good, it's an opportunity to pause and change.” (Eugène)

Describing an illustration of diplomatic disagreement, Eugène talked about being asked to introduce the provincial minister of health at a 1989 event. Two days before the event was to take place, Eugène received a letter saying that the GSEI program was being cut. Rather than embarrassing the minister in a speech condemning this action, he instead gave the speech he originally intended, but wrote a letter to the minister a few days later, copying everyone who had been in the room. His tactic worked and funding was restored.

A man standing before a room during a book launch

Eugène at Groupe de Support Émotionnel book launch.

Both Eugène and Nérée feel that it's not just the system that needs to change for mental health provision in Canada, and the world, to be adequate. Rather, all of society needs to change.

In Eugène's words:

“One thing I've learned...is that this whole business of mental health is more than just medication, diagnosis, psychiatry. Really, what mental health is about is how you organize your village, your town, your city, your province, your country. In the absence of progressive social and economic planning, you have lots of stress, a lot of issues. Really, I see good mental health as those who work on a social level to create better outcomes for people. I suppose that's what I've tried to do on a very small and humble scale. I've tried to organize my little community in a way that if it was replicated over and over and over again, it could perhaps achieve some valuable results.”

- Eugène

Nérée adds:

“This formula of working together for a common cause can demonstrate to professionals that they should work WITH people, accept their priorities and the directions they choose, rather than being leaders that treat them as clients or patients, not so smart because of their lack of formal education or social status. Like Eugène, many ex-psychiatric people have lots of wisdom and much to offer if given some room to breathe. This experience demonstrates that we, professionals, have to change and adapt if we want a real mental health system that is attentive to people and their potential and not just to disease.”

Nérée

a storyboard showing the evolution of mental health

Groupe de Support Émotionnel Storyboard of Evolution of Mental Health.