Young people are especially vulnerable to psychiatric abuse and involuntary incarceration because as minors their legal rights are limited. Also, the ways in which girls resist patriarchy are often pathologized by families and mental health workers. The following section highlights the special issues that psychiatrized girls face.

This comment cropped up in a recent discussion with a young woman I know. She was describing her feelings of panic, distress, and rising despair over her circumstances. In her mid-teens, she was parenting an infant, involved with a physically, sexually, and verbally abusive male, living in poverty and dealing with an extensive sexual and parental abuse history.

"Oh?" I said. "I've known you for a long time, you've always seemed pretty together to me. What makes you say that?"

"Because I am, they diagnosed me. They told me I'm mentally ill and I probably have been all my life; that s why I'm depressed and cry all the time and can't control my anger."

"But don't you think there are good reasons for all those things? I'd expect all that stuff and more from someone who's being beaten up by her partner and is dealing with the stress you are."

"No, seriously, I'm mentally ill. It explains why I'm like this. I have to take drugs for it and everything."

Young women in care and custody all over North America are receiving diagnoses like this one every day. A first diagnosis is now vying for position with a first period as the adolescent rite of passage for many young women who are incarcerated, or live in state/community care. It's not hard to understand how it happens: a child is apprehended by the state due to abuse, her social worker hears her complain of physical ailments, emo-tional turmoil, and self-perceived inability to manage stressors, and refers her to a doctor.

Or perhaps the referral comes from the group home staff where she will eventually end up. They note that she is frequently sad or tearful, that she often becomes agitated, that she has periodic emotional and angry outbursts. Instead of acknowledging that group home environments are often combative and unsafe, reflecting on the effect of separation or abandonment by parents, or considering the effect of years of physical or sexual abuse, they decide she needs to see a doctor or a psychiatrist.

Or maybe she's been charged with assault or uttering threats for fighting back when being physically restrained by one of those group home staff (this accounts for a high number of the first violent offences seen among teenage girls in state care). At some point in her passage through the judicial system she will make a pit stop in a doctor or psychiatrists office, either because it was ordered before sentencing, or because it's mandated after she arrives in the custodial facility. Often she'll end up there because she is seen as combative, "non-compliant," or defiant. These labels can be attached for things as basic as objecting to arbitrary and contradictory rules, standing up for herself or friends when being targeted or wrongly accused, the always-ephemeral, difficult-to-define accusation of "being an instigator," or, ironically, refusal to take prescribed medications.

Once in the doctor's office the progression is fairly predictable. A doctor listens to the list (or simply refers to reports by the social worker or custodial staff), turns to the ever-handy DSM-IV, and matches her complaints up to a made-to-order "disorder," such as Generalized Anxiety Disorder, ADHD, Panic Disorder or the overwhelmingly popular "Oppositional Defiant Disorder." Or perhaps it will be nothing so fancy and she will, like approximately 75% of young females in custody, simply be labeled "depressed." Maybe her problems will been viewed as more serious: perhaps she'll describe experiencing out-of-body feelings, hearing and seeing things (hallucinations), or believing that she's about to be attacked at any moment (paranoia). If that's the case, she may more likely be labeled schizophrenic or perhaps bipolar, with psychosis. In any event, the outcome is assured: she will leave the office clutching a prescription for a psychotropic drug, and with a brand-spanking-new diagnosis to go along with the other things already on her "permanent record."

All of which would be fine, if she were really ill. However there are other labels that have been applied to the symptoms described above, long known to those who work with abuse survivors; labels such as dissociation, flashbacks, and hyper-vigilance-all common and well-documented effects of abuse routinely experienced by women, and routinely used by psychiatry to prove that there is something biologically wrong with the woman who's experiencing them.

It is widely acknowledged by both corrections and psychiatric professionals that the vast majority of young women in custody have experienced some form of physical or sexual abuse (reported figures vary between 72-90%, depending on type of incarceration, location, and ethnic background). It is also widely acknowledged that the experience of incarceration (and group homes mimic the conditions of incarceration in most aspects) has distinct and deleterious psychological effects on both humans and animals. Where the system breaks down, however, is in our utterly illogical response to this knowledge. Instead of acknowledging her responses as reasonable reactions to a pattern of abuse or addressing the anxiety- and aggression-promoting conditions of care and custody, we instead measure the behavior of the individual woman, and diagnose her with a disorder. We somehow determine that a "reasonable" individual with her background and in her circumstances would remain cooperative, cheerful, and, above all, "compliant."

This is not a new pattern in our assessment of women who express discontent. Psychiatry has a long history of pathologizing women's responses to abuse and oppression, and it has not moved far from the path. For well over a century, women who have displayed behavior considered "unbecoming to a lady" (by male standards) have been labeled disordered or insane by prevailing psychiatric opinions. The extremes of this labeling have historically resulted in committal to psychiatric hospitals, electroshock therapy, drugging, forced sterilization and even lobotomy, for such high crimes as "promiscuity" and "hysteria." Although some of these arcane methods have fallen into disrepute (but not all; EST is still being used, and is again on the increase), they have just as often been replaced by their chemical counterparts; psychiatric drugs. In the Mother's Little Helper 1950s, a housewife complaining to her doctor of depression, lack of fulfillment, or despair could expect to be sent home with a prescription for Valium and the promise that being a better wife, and taking pride in her housekeeping, would make her feel better. Today, when children and young women express their fears, anger, sense of injustice, frustration or despair, they are told they are mentally ill, and given a prescription for a mood-altering medication.

Ironically many girls and young women grasp onto their diagnosis as relieving proof that "it is not her fault." If she has a disorder, then all this "disruptive" or "crazy" behavior is not because she's an inherently bad person (which she secretly fears and believes), it's because she has a disease. The result of this is to foster in her a belief that "normal" functioning is impossible, due to her supposed mental illness, and to avoid, yet again, normalizing her valid response to abuse, and assigning accountability to her abuser. In this way psychiatry continues to uphold the time-honored tradition of blaming the female victim, by characterizing the effects of the crime against her as her own biological abnormality, treatable by altering her brain chemistry.