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The Need for Mad Studies in Higher Education

A scarcity of research concerning mental illness in education invites dialogue.

Key points

  • "Sanism" can result from bias and stereotyping.
  • Students with mental illnesses process complex information to make sense of their psychological experiences.
  • Further research is needed to illuminate the intersection of mental illness and education.

Mad Hatter: “Have I gone mad?”

Alice: “I’m afraid so. You’re entirely bonkers. But I’ll tell you a secret. All the best people are.”

-Burton, Alice in Wonderland, 2010

Mental health disorders are a principal indicator of disability, with some 450 million people worldwide suffering from a chronic mental illness (Procknow, 2017). As more sufferers enroll in post-secondary schools and education programs, adult educators are actively addressing mental health in classrooms (Carette et al., 2018; MacKean, 2011; Procknow, 2017). Given this increased throughput, there has arisen a need for research to focus on learners affected by mental disorders. As a result, these “mad” studies suggest a relationship between education attained and mental health distress. Those with lower education levels and those who are over-educated for their current jobs tend to report greater psychological distress (Bracke et al., 2014).

Adult education literature has focused on several areas connected to mental health issues, namely: identity development, andragogy, public pedagogy, arts-based education, and sanism in work environments (Procknow, 2017). In this article, I present a few thoughts about key elements of mad studies in higher education, a definition of sanism, the search for meaning, and a call for more research.

Judeus Samson / Unsplash
Learning about yourself can be confusing, but it's critical for self-development.
Judeus Samson / Unsplash

What is sanism?

Sanism (SAYN-ism), sometimes referred to as “mentalism,” generally refers to the oppressive discrimination of people who are diagnosed, limited by, and/or treated for mental disorders (Procknow, 2017; Weller, 2012, p. 55). Like other forms of prejudice, sanism often arises from misinformed assumptions about other groups of people. These presumptions can then surface when “others” exhibit particular behaviors or characteristics that reinforce false stereotypes. Common examples include saying, “She’s crazy,” when walking by a homeless person talking to herself, or avoiding people who behave erratically.

One of the side effects of sanism on “mad” people, like me, is discounting the suffering we experience. When I mention to people I have obsessive-compulsive disorder (OCD), I sometimes hear: “Oh, yeah, I’m so OCD, too. I’m a clean freak!” While their sentiment is well-intentioned, the triteness almost negates the years of suffering and counseling my wife and I have experienced. In another instance, I had to change my career path because my organization’s policy dictated that I couldn’t return to my assigned duties until I was asymptomatic with OCD for one year after stopping medications. The medical policy exhibited an ignorance of the nature of OCD—that there’s no cure—while disregarding that some of the disorder’s traits (e.g., attention to detail, focus, following checklists) better prepared me to fulfill those same duties (see also Culkin & Culkin, 2021).

Search for meaning

The search for meaning constitutes an individual journey. Adult students who identify as mentally ill need more than information to process meaning in their lived educational journeys. They often use complex knowledge management pathways to acquire and process relevant information about their psychological experiences and well-being (Carette et al., 2018).

Once a person receives a diagnosis—often after years of struggles—life changes. In my case, I went straight to the library to read about my now-named nemesis, OCD. That was about 20 years ago. Since then, I have journaled about my reflections while going through therapy and found that the act of writing was healing in itself. My wife and I even named this third person in our marriage, “Herb” (no offense to those so named). When we saw no other resources to assist us on our continuing journey, we wrote OCD and Marriage (2021) and presented at the annual conference of the International OCD Foundation (IOCDF). It truly has been life-altering for us to help others with similar experiences by sharing our story.

Call for further research

Some have called for greater inclusion of mad studies in professional education classrooms—e.g., occupational therapy, counseling, social work, etc. (Newman et al., 2019). Future research could focus on how adult educators can engage learners at the intersection of mad identity and other marginalized communities (Procknow, 2017). It is no surprise that many people find meaning at the intersection of their own mental illness and education.


My reflections about mad studies in higher education included a definition of sanism, the search for meaning, and a call for more research. How has sanism affected your life and relationships? What are some things you can do to enhance the meaning of your lived experiences?

You are not alone.


Bracke, P., Van de Straat, V., & Missinne, S. (2014). Education, Mental Health, and Education – Labor Market Misfit. Journal of Health and Social Behavior, 55(4), 442-459. doi: 10.1177/0022146514557332

Burton, T. (Director). (2010). Alice’s Adventures in Wonderland [Film]. Disney.

Carette, L., De Schauwer, E., & Van Hove, G. (2018). “Everywhere We Go, People Seem to Know”: Mad Students and Knowledge Construction of Mental Illness in Higher Education. Social Inclusion, 6(4), 207–217.

Culkin, D., & Culkin, M. (2021). OCD and Marriage: Pathways to Reshaping Your Lives Together. Specialty Press, Inc. isbn: 9781937761295

MacKean, G. (2011). Mental Health and Well-being in Post-secondary Education Settings: A Literature and Environmental Scan to support Planning and Action in Canada. Proceedings Papers of the 2011 CACUSS Pre-conference on Mental Health. Retrieved June 9, 2023.

Newman, J., Boxall, K., Jury, R., & Dickinson, J. (2019). Professional Education and Mad Studies: Learning and Teaching About Service Users’ Understandings of Mental and Emotional Distress. Disability & Society, 34(9-10), 1523-1547.

Procknow, G. (2017). Silence or Sanism: A Review of the Dearth of Discussions on Mental Illness in Adult Education. New Horizons in Adult Education and Human Resource Development, 29(2), 4-24.

Weller, P. (2012). New Law and Ethics in Mental Health Advance Directives: The Convention on the Rights of Persons with Disabilities and the Right to Choose. Routledge. isbn: 978-1136159565

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