The Subaltern: Illuminating matters of representation and agency in mental health nursing through a postcolonial feminist lens

Inpatient mental health nursing operates with an overarching goal to support people living with mental health challenges by managing risk of harm to self and others, decreasing symptoms, and promoting capacity to live outside of hospital settings. Yet, dominant, harmful stereotypes persist, constructing patients as less than, in need of saving, and lacking self-control and agency. These dominant assumptions are deeply entrenched in racist, patriarchal, and Othering beliefs and continue to perpetuate and (re)produce inequities, specifically for people with multiple intersecting identities relating to race, class, gender, and culture. This paper explores the relevance of postcolonial feminism, particularly Gayatri Spivak's concept of Subaltern-conceptualized as groups of people who are denied access to power and therefore continue to be systematically oppressed and marginalized-in illuminating the problematic and dominant assumptions about people living with mental health challenges as lacking agency and requiring representation. Through an understanding of Subalternity, this paper aims to decenter and deconstruct dominant colonial, patriarchal narratives in mental health nursing, and ultimately calls for mental health nursing to fundamentally reconsider prevailing assumptions of patients as needing representation and lacking agency.