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Convergencia
versão On-line ISSN 2448-5799versão impressa ISSN 1405-1435
Convergencia vol.31 Toluca 2024 Epub 19-Ago-2024
https://doi.org/10.29101/crcs.v31i0.22200
Articles
#Madpride: a Movement for Collective Visibility and Empowerment on Social Media X
1 Universidade de Santiago de Compostela, España, paulafrieiro.padin@usc.es
2Universidade de Vigo, España, sabela.perez@uvigo.gal
3Universidade de Santiago de Compostela, España, lorena.anon@usc.es
4Universidade de Vigo, España, arioboo@uvigo.es
This work aims to analyze Mad Pride as a social movement for visibility and empowerment on social network X. The methodology involves a content analysis of social media, tracking the hashtags #orgulloloco and #madpride over a one-year period. A total of 403 identified posts were analyzed. Results from the main categories of analysis show that content related to Mad Pride is distributed as follows: visibility and activism (46%), resources and support (22.6%), grievances (22.5%), and professional perspective (8.9%). This study provides an in-depth analysis of narratives related to Mad Pride on social network X. The movement is important in valuing the diversity of experiences and perspectives of individuals with mental health conditions and those whose experiences fall outside of social norms. Additionally, it challenges the biological perspective of psychiatry, and it plays a crucial role in shaping public health policy.
Key words: mental health; mad pride; social networks; madness; social movement
El objetivo del presente trabajo es analizar el orgullo loco como movimiento social de visibilización y empoderamiento en la red social X. La metodología sigue un análisis de contenido en redes sociales; se ha realizado un seguimiento del hashtag #orgulloloco y #madpride durante un rango temporal de un año. El total de publicaciones identificadas fue de 403. Los resultados, a partir de las categorías principales de análisis, mostraron que el contenido sobre el orgullo loco se distribuye de la siguiente manera: visibilización y activismo (46%); recursos y apoyos (22,6%); denuncias (22,5%) y perspectiva profesional (8,9%). Este estudio proporciona un análisis profundo sobre las narrativas relacionadas con el orgullo loco en la red social X. El movimiento desempeña un papel esencial para valorar la diversidad de experiencias y perspectivas de las personas locas y de aquellas cuyas experiencias psíquicas se encuentran fuera de la norma. Al mismo tiempo, desafía de manera crítica la perspectiva biologicista de la psiquiatría. Además, juega un papel fundamental en la acción política de la salud pública.
Palabras clave: salud mental; orgullo loco; redes sociales; locura; movimiento social.
Introduction
The prevailing medical model of “mental illness” seeks to reduce madness to a purely medical phenomenon, amenable to scientific explanation and investigation. This model posits that a diagnosis of bipolar disorder, schizophrenia or borderline personality disorder, for instance, masks a multitude of lived experiences, narratives and stories (Netchitailova, 2022) . Nevertheless, the view of madness as something to be explained and rationalised originated during the Age of Reason, in the Enlightenment. Subsequently, in 1967, Michel Foucault initiated research into madness in the social sciences. In this context, Foucault posited that the way we perceive madness is shaped by the social constructions of a given era (Foucault, 1967).
Regarding the movement and concept of antipsychiatry, as a response to the biomedical model, it gained momentum in the 1960s. The movement emerged as a political and countercultural current during an era characterized by sensitivity and resistance to various forms of oppression and social domination of madness (Pérez-Soto, 2012) . According to Castel (1984) , antipsychiatry emerged alongside new forms of critical analysis of institutions, power relations, and violence, as well as in response to the processes of labeling and stigma in mental health.
It is also important to note that initially, the questioning of anti-psychiatry focused on the practices of confinement and the asylum. However, later on, the neoliberal boom in the field of mental health boosted the predominance of the pharmaceutical industry market, through the so-called chemical asylum (Cipriano, 2017) . Consequently, the focus of care was characterised by the exponential increase in the consumption of psychotropic drugs in advanced capitalist societies (Cea-Madrid and Castillo-Parada, 2018; Whitaker, 2015) .
In response to the aforementioned context, movements emerged composed of individuals with lived experiences of madness, as well as activists and professionals from the social and healthcare sectors who adopted critical approaches and advocated for human rights (Clay, 2005; Hoffman, 2019; McKeown et al., 2014) . Notable among these groups are the Ex-patient or Psychiatric Survivor Movement, which originated in the United States; the Hearing Voices Movement, which emerged in the Netherlands; and Mad Pride, which began in Canada. Additionally, there are movements created and led by professionals, such as the Delirious Revolution in Spain, the Democratic Psychiatry Movement initiated in Italy, and approaches like Open Dialogue, initially promoted in Finland. The Psychiatric Survivor Movement is the most longstanding, having arisen from the wave of civil rights movements in the late 1960s and early 1970s. This latter movement is particularly focused on the dissemination of personal narratives detailing the psychiatric abuse endured.
Conversely, other movements, such as those of voice hearers, also seek to depathologize the experience of hearing voices. This is achieved by normalising them and acknowledging that hearing voices can exist (Huertas, 2021) . In this way, they seek to transform the relationship of people who hear voices to their voices, rather than seeking to eliminate them altogether (Morrison et al., 2004; Schrader et al., 2013) . The various actions alluded to share common themes, which can be broadly categorised as seeking to challenge the power of psychiatry, challenging hegemonic psychiatry as an expert system, as well as protecting and defending rights or ensuring the promotion of personal self-determination (Beresford, 2020) .
Subsequently, and through collective action, individuals who have experienced mental illness are believed to be able to support each other in an environment of shared experiences. In this way, they seek to develop a support system without the supervision of mental health professionals (Chamberlin, 1998; Clay, 2005) . It should be noted that although crazy activism may reflect a certain collective identity, views may differ considerably. This is because there is no uniform characteristic of madness-related experiences, with the exception of cases where distress or stigma have been experienced (Rowland, 2015) .
At this point, the focus shifts to Mad Pride, the central theme of this work. Mad Pride is a large-scale, international movement composed of mental health service users, former users, and allies. The movement asserts that individuals with mental health conditions should be proud of their identity. In this regard, Mad Pride activists aim to reclaim terms such as "mad" by removing their pejorative connotations and transforming them into positive descriptors. The movement, which was established in 1993 in Toronto, has since held annual visibility events on the streets of that city and many others, with the exception of 1996 (Reaume, 2008) .
It was in the 1990s, with the emergence of Mad Pride, that a more critical activism began to be observed in the field of mental health. This activism has since been characterized by being led by individuals with personal experience in the matter, similar to what has occurred with the independent living movement promoted by people with disabilities (Guzmán-Martínez et al., 2021) . This new rights promotion approach thus began to create meanings for dissent and the politicization of madness from a first-person perspective. It is also important to recognize the participation in this process of feminist activists such as Judi Chamberlin and Kate Millett. The role of these figures has been crucial in applying the political identity of "psychiatric survivor women" or "mad women" as a form of feminist resistance (Guzmán-Martínez et al., 2021).
Additionally, Mad Pride is a paradigm that values and celebrates traits, experiences, characteristics, thoughts, states, and feelings that are classified as mental illnesses in the DSM, the Diagnostic and Statistical Manual of Mental Disorders. In this regard, the movement asserts that experiences of madness manifest across the full spectrum of human diversity (Mind Freedom International, 2019). Following in the footsteps of the Black Pride and LGBTQIA+ Pride movements, Mad Pride groups organize activities such as parades and rallies. Through these actions, they seek recognition of their identity and promote the de-pathologization of mental diversity, emphasizing the need for respect, appreciation, and validation within the community (Lewis, 2006) .
The Mad Pride movement underscores the strength, creativity, and significance of groups advocating for the right to madness today. Additionally, this movement has worked to increase its visibility without excluding the collaboration of critical professionals, considering them potential allies in building a collective proposal (Cea-Madrid & Castillo-Parada, 2018; McKeown et al., 2014) . In this way, the Mad Pride movement advances towards what Engler and Engler (2022) describe as the creation of an ecosystem that promotes change.
Participants in the Mad Pride movement can also contribute to advancing the field of public mental health by serving as a unique, valuable, and expert source. Through their experiences, they can speak about madness and psychiatric oppression within the mental health system (Hoffman, 2019) . The active formation of a group identity goes beyond individual well-being, as it also drives political critique and social change (Friedman & McAdam, 1992; Schrader et al., 2013; Simon et al., 2008) . In this regard, the movement adopts the slogan "nothing about us without us," emphasizing the essential commitment to involve the key stakeholders. As established in reports like "Towards Mad Justice and Reparation" (Vásquez et al., 2023) , it is crucial to identify and overcome the barriers that can hinder the exercise of rights for people with lived experiences of madness. Achieving this requires tools that gather information more accurately about the realities of madness. This not only involves conducting more research and studies but also actively involving those with lived experience in updating these instruments (Vásquez et al., 2023). In this way, their effective participation in the planning, implementation, and monitoring of mental health services, health services, and social services can be ensured (Hoffman, 2019). Finally, it is worth mentioning that the active recovery and redefinition of madness by those who self-identify as mad could be a politically powerful act (Rowland, 2015) .
Social networks as community and space related to Mad Pride
Firstly, based on the premise that "the personal is collective" (Guzmán-Martínez et al., 2021) , the necessary identification of political structures of oppression and collective resistance is emphasized. However, this assertion also refers to the essential reciprocity and continuous promotion of collective experience (Plaza, 2021) . Regarding Mad Pride, it considers that no issue, such as psychological distress, delusions, or abusive behaviors within the mental health system, should be experienced in isolation and disconnected from other similar experiences. In other words, it is desirable to start from communication and expert knowledge derived from personal experiences of madness (Guzmán-Martínez et al., 2021).
Given the aforementioned points, the potential of the spaces for encounter and empowerment provided by Mad Pride should not be overlooked. To understand the value of these spaces, one must consider the capacity of social capital, which Bourdieu (1986) defined as the sum of current or potential resources linked to social networks and interpersonal relationships generated by an individual or group. This conception of social capital is based on the premise that individuals possess not only economic or cultural capital but also social resources that originate from their social ties and interactions within various communities and collectives.
This social capital can be divided into "bridging" and "bonding" social capital. Bridging social capital refers to connections between diverse groups, whereas bonding social capital relates to cohesion within close-knit communities. Bridging social capital allows access to a greater diversity of information, exposure to new ideas, and a willingness to try new things. Meanwhile, "bonding" social capital fosters the flow of information and new ideas within groups of people who share similar beliefs and opinions, as seen in the case of mad pride (Castillo-de-Mesa and Gómez-Jacinto, 2022; Putnam, 2000) .
Currently, digital social networks are also considered spaces for social interaction and can be part of social capital. Therefore, digital social networks can serve as either bridging or bonding social capital. Additionally, these digital tools can enable individuals to participate in their own processes of change in a practical and direct manner, leading to constructive actions regarding their own social rights. Consequently, the information generated from digital spaces of encounter could be used to design preventive social policies at all levels, contributing to a critical debate aimed at improving the system, particularly the mental health system (García-Castilla et al., 2019; Hidalgo-Lavié and Lima-Fernandez, 2018; Ruiz-Mora et al., 2021) .
Through the digital interactions of individuals belonging to Mad Pride, they can empower themselves individually, in groups, and within virtual communities. Social networks also provide the opportunity to propose strategies, file complaints, or raise awareness about their conditions to entities that also use these digital platforms. This can foster empowerment dynamics within the context of social networks (García-Castilla et al., 2019; Johansson et al., 2021) . Although this work will analyze interactions occurring on the social network X, known as Twitter until July 2023, it must be considered that technological and digital realities are reinterpreted daily. This context causes the use of various social networks to be ever-changing, potentially leading to the rapid obsolescence of information. This frenetic pace in social network usage trends can create issues, resulting in social disparities and generating a digital divide either generationally or due to limited economic resources (García-Castilla et al., 2019; Reamer, 2013) . Therefore, these rapid changes can also exclude individuals who cannot access digital means, as well as those who consume less rigorous or more superficial content (García-Castilla et al., 2019; López-Peláez and Segado, 2015) .
Following the theoretical framework, the research objective of the study is presented. This work aims to delve into the use of X by the Mad Pride movement. Specifically, it aspires to analyze Mad Pride as a social movement of visibility and empowerment on the social network X. To achieve this, a descriptive study is conducted based on structured and systematic observation of Mad Pride on the social network X.
Methodology
The study focuses on the analysis of opinions and posts on platform X. Specifically, this social network revolves around microblogging, where users create and share short messages known as tweets. It is worth noting that each tweet typically does not exceed 280 characters and may contain text, photos, GIFs, or videos.
Procedure
For data analysis, the study has focused on analyzing hashtags from social network X, as these serve as a tool that encourages dual communication. When digital communities generate a tweet with a specific hashtag, it can be easily found by individuals interested in the topic associated with that hashtag. Simultaneously, when a certain level of dissemination is achieved, hashtags have the ability to incorporate a particular topic into the digital discussion agenda. In this case, the analyzed hashtags were #orgulloloco in Spanish and #madpride in English. Through the search process in these two widely used languages on the platform, efforts were made to access a substantial number of international posts.
The extraction of tweets was performed using the statistical software R, specifically through the utilization of the twitteR package. The use of this software enabled the research team to aggregate the content of tweets generated over the course of one year. The twelve months corresponding to the data collection procedure spanned from February 2022 to February 2023, aiming to gather a comprehensive narrative that encompassed Mad Pride events in various locations around the world. The extraction of tweets was completed between March 1st and 3rd, 2023.
Data Analysis
Following the previously described procedure, the subsequent dumping and content analysis of tweets were executed using the software program Atlas.ti v.22. The empirical approach undertaken adhered to the criteria of objectivity in qualitative research. Transcriptions were examined through an inductive thematic analysis. This process involved recognizing, examining, and extracting patterns or themes present in a dataset (Braun & Clarke, 2021) . Thus, thematic analysis provided a versatile and valuable research perspective, enabling the creation of "semantic" themes based on the meticulous description of information provided from the analyzed hashtags (Braun & Clarke, 2021; Javadi & Zarea, 2016; Verd-Pericás, 2005) . The coding team consisted of two researchers with scientific publications in the field of mental health. The team conducted a thematic coding of the tweets, utilizing pre-existing categories and also generating emergent categories.
At the beginning of the data analysis, duplicate tweets resulting from "retweets" and reproducing exactly the same content were removed. Following this process, the number of tweets reached was 403. This sample size is consistent with thematic qualitative analyses conducted previously in studies analyzing data from Twitter hashtags, as observed in the work of Bogen et al. (2022) .
It is worth mentioning that hashtag data could only be gathered from profiles set to public on the social network. To safeguard anonymity, any potentially identifying information was scrubbed from the dataset. Furthermore, given the sensitive nature of some narratives, the research team opted for additional precautions to maintain confidentiality. In the event of potential reverse searches based on tweet content, it was decided to paraphrase or summarize the tweets rather than directly reproduce their content.
Results
From the data, four overarching thematic categories emerged, encompassing: 1) Visibility and activism; 2) Resources and support; 3) Reporting; and 4) Professional perspective. Out of these primary categories, 11 emergent sub-themes were identified. As depicted in Table 1,2 the highest percentage of identified sub-themes pertained to publications regarding demonstrations and visibility of activities in public spaces (31.8%); followed by the category of catharsis and support (18.6%); with the sub-theme of promoting artistic and creative activities trailing closely behind, at 11.2%.
Visibility and activism
Content analysis within this primary category, focusing on visibility and activism, has enabled the identification of three secondary categories: demonstrations and visibility of activities in public spaces, reconceptualization of the concept of madness, and promotion of artistic and creative activities.
Demonstrations and visibility of activities in public spaces
Publications referencing demonstrations and activities within the mad pride space represent the highest percentage of dissemination through the use of hashtags. It is noteworthy that tweets not only focus on announcing upcoming demonstrations but also promote activities with informative impact on society at large. As depicted below, additional campaigns and actions are carried out that go beyond the visibility of madness. In this manner, the movement aims to have a cross-cutting impact, for instance, on the environment through actions such as waste collection.
This 2022, on #MadPrideDay in Asturias, we took to the woods for a festive campaign of collecting #SaneTrash and exploring, from the #MadPride and #MentalHealthDignity perspectives, recycling solutions for the environmental pollution (1:100).
Additionally, as a means of visibility, advocacy actions are proposed to visually display various medications that are prescribed and consumed daily by psychiatrically labeled individuals.
CRAZY DEMONSTRATION [...] Bring your medication boxes, blister packs, leaflets, etc... (1:114)
Similarly, the tweets encourage potential allies to join the movement through statements such as: "At the mad pride march, don't let privilege cloud your empathy" (1:107).
Reconceptualization of the concept of madness
The Mad Pride movement strives to reclaim terms such as "crazy" from their negative connotations and transform them into expressions with positive connotations. This aspect, which constitutes a fundamental facet of the movement, has been clearly manifested in the analysis conducted.
I love this because it reminds me of the reclamation of the term "crazy" in mental health spaces […] especially #MadPride, which, in my opinion, is about reclaiming concepts like madness… (1:12).
In relation to the secondary category that focuses on the redefinition of concepts associated with madness, there is a reflection on the use of concepts other than "recovery." In this regard, considerations such as those outlined below have been formulated.
I find the term "recovery" distasteful, even though I use it frequently myself. It feels like the universal way of forcing us mad people into neatly defined productive roles. It's as if we're not considered good enough until we can thrive and contribute to the economy (1:25).
Promotion of artistic and creative activities
The organization of parades and demonstrations in public spaces constitutes an act that can catalyze the generation and promotion of creative initiatives on a global scale. In the context of Mad Pride, activities in public spaces often incorporate public displays, as observed in the analysis of the results, leading to events that include the portrayal of individuals subjected to mechanical restraints or strapped to stretchers. Additionally, other actions are intrinsically related to artistic expression in its various forms, such as music, poetry, storytelling, or visual arts. In this regard, both organizations and individuals involved define Mad Pride as a space that stimulates creativity.
#MadPride is a free, youth-led event that celebrates wisdom, capability, and creative achievements, and works to dismantle the stigma and barriers associated with mental health (1:40).
In the realm of creative production, it is notable to mention activities such as the conception and execution of a music video named "Universal Madhouse." Additionally, another initiative within the movement involves fostering and issuing a call for artistic creation from a standpoint that integrates elements associated with madness, aiming to later showcase the resulting pieces.
We have composed, created, and birthed this tribute to all the eccentrics... for the #MadPrideDay #UniversalAsylum, premiering on May 20th... (1:116).
All of you, artists, activists, change-makers, dreamers, and cat hunters. The deadline for this is Thursday, and the application process is very simple. Apply now. #Madlove #Madpride #CAMHS (1:81).
Resources and Support
In this second main category, an analysis of the responses of relief and support generated on platform X is conducted. Additionally, the advocacy and promotion of rights driven by the Mad Pride movement itself are also presented.
Relief and Support
A significant percentage, specifically 18.6%, of the analyzed hashtags focuses on the role of support and relief provided by the use of social media. The accessibility and anonymity facilitated by social networks create a friendly environment in which self-identified "mad" individuals can find relief by sharing common experiences. Below are some examples of this secondary category.
I know what it's like to live on the margins. From third to sixth grade was hell for me (1:4).
Mad people are often seen as weak and fragile. This is a fallacy. We are the strongest people I know. We have to fight every day to present an appearance of normal life (1:23).
Additionally, emphasis is placed on the importance and value of being able to have peer support or support from individuals who share similar experiences.
Remember, we are here to provide peer support! (1:9).
I cannot express the love I have for the #madpride #madtwt #bipolarclub and #neisvoid communities. It is so nice not to feel alone (1:84).
Becoming more aware of issues related to psychiatric survival can save lives and improve the mad community (1:42).
Advocacy and promotion of rights
As part of the resources provided by dialogue and posts through social media, there is the promotion and defense of the rights of mad individuals. Promoting narratives like those presented helps to raise awareness of the violations of rights that mad individuals face on a daily basis.
It is not illness; it is structural violence. It is not depression, it is exploitation. There is not enough water for so many pills. It is not anxiety, it is precarity. (1:111).
Human dignity is threatened by an idealistic pursuit of perfect performance. A new direction is needed where significance must also accommodate the fallible, the vulnerable... (1:35).
Complaints
The third main category focuses on complaints of discrimination on the grounds of madness. Specifically, this category is divided into four subcategories: anti-sanism; economic exclusion, capitalism, and madness; complaints about professional care; and other forms of experienced discrimination.
Anti-sanism
From this secondary category, there is an opposition to sanism defined as "a form of structural oppression consisting of a set of practices and ideology that presupposes the superiority of the thoughts, practices, and experiences of neurotypical people over those of mad individuals" (Antropóloga Trastornada, 2020).
Neurodiversity is not an illness (1:10).
Psychiatry does nothing but perpetuate a system that serves the interests of a few, nullifying those who deviate from its norms. #MadPride (1:120).
Economic exclusion, capitalism, and madness
Introducing this subcategory, it is important to acknowledge that the inequality stemming from madness often results in severe economic exclusion for individuals considered mad. Those involved in the movement also critically reflect on their entrapment within a capitalist system, which ultimately marginalizes and expels them from mainstream society.
People who are considered mad have an issue with money. Or is it money that is "mad"?
It seems like a way to force us "crazies" into productive boxes. It is as if we are not deemed good enough until we can thrive and financially contribute to the economy (1:26).
Professional care complaints
With regard to complaints about professional care, the most recurrent complaints have focused on aspects such as involuntary hospitalizations, overmedication, the use of electroconvulsive therapies, and mechanical restraints.
In Mexico, psychiatric hospitals are concentration camps. No to involuntary confinement of homeless people (1:105).
Electroshock has alternatives: community health and collective madness (1:109).
Professional perspective
Lastly, a category has emerged that focuses on Mad Pride from a professional and allied perspective of the Mad Pride movement. Specifically, two subcategories have been identified: one that reflects on professional practice, and another that focuses on the professional dissemination and research of the Mad Pride movement.
Professional practice
Regarding professional practice, some individuals contemplate the necessity of incorporating movement from a paradigm that acknowledges and appreciates the attributes, experiences, particularities, ideas, states, and emotions of those perceived as mentally ill. Some reflections that capture and synthesize this idea are presented below.
Drawing on the critical feedback that these social movements provide for mental health professions can assist counselors in repairing ruptures and strengthening therapeutic work (1:89).
Being a psychoanalyst should also entail defending the right to madness (1:6).
Dissemination and Research
Finally, it is worth mentioning the interest in the dissemination and research of the Mad Pride movement. Despite this, it is important to note that academic interest in Mad Pride has been a recent and gradual process. Additionally, on the social media platform X, posts have been identified with the purpose of recruiting participants for studies or initiatives related to this movement.
Are you currently taking antipsychotic medication and experiencing side effects such as fatigue, sedation, or excessive sleepiness? Would you be interested in discussing this with me in a research interview? (1:44).
We are seeking individuals with clinical experience working with individuals who are diagnosed with mental illness and who support a #MadPride perspective. This is for a chapter in an upcoming book on sexuality and disability. (1:31).
Discussion
This study has provided first-person accounts from individuals involved in the Mad Pride movement. Concerning the aim of the research, it has been established that Mad Pride is a social movement aimed at visibility and empowerment, evidenced by a frequent stream of posts on social network X. Over a total period of 12 months, utilizing hashtags such as #madpride and #orgulloloco, a total of 403 posts related to the movement were identified.
In terms of visibility and activism within the Mad Pride movement, it has been observed that social network X plays a prominent role as a dissemination platform for various events, parades, and demonstrations. It is noteworthy that this type of publication constituted the highest percentage, representing 31.8% of the total publications. Through the use of hashtags related to Mad Pride, it is easy to locate calls for gatherings and protest actions, which can turn platform X into a supportive and disseminating tool for individuals experiencing madness. These findings are in line with the study conducted by Correa-Urquiza et al. (2020) , which analyzed messages on Twitter during Mad Pride Day and concluded that social networks serve as a space to disseminate and amplify messages that are later projected onto the streets through banners, signs, and megaphones.
Regarding the secondary category focusing on the re-signification of the term "mad," which has been addressed in 3% of the analysis hashtags, it is worth noting that this category has been a matter addressed since the inception of the movement. Presently, it continues to hold a space for discussion on social media platforms. Furthermore, these findings have underscored the necessity of debating not only the term "mad" but also the usage of concepts such as "recovery." In this regard, Beresford (2020) emphasizes the significance of acknowledging that the mad pride movement has utilized language since its inception as a tool to challenge psychiatric vocabulary.
Another opportunity highlighted by the results identified on network X has been the category of promoting and disseminating artistic and creative activities. These activities were found to be deeply rooted and interconnected with the mad pride movement. Results focused on artistic activities, such as the aforementioned music video "Universal Madhouse," and the promotion of creation from a perspective of madness, exemplify a space that can be mobilizing and stimulating. In this context, Netchitailova's study (2022) emphasizes that madness should allow for the expression of diverse perspectives, which includes the exploration of the unknown through art and humor surrounding madness, as well as the presentation of diverse narratives on this subject. The artistic realm has the potential to bring us closer to various psychological conditions, which Medicine often attempts to categorize and explain in a simplified manner.
Regarding the primary category of support resources that may emerge on social media, anonymous venting is one of the key advantages offered by communication through specific hashtags, representing 22.6% of the total. In relation to this topic, the seminal work by Chamberlin (2023) , titled "On Our Own: Self-Help Alternatives to the Mental Health System," emphasizes the importance of considering the possibilities and limitations of self-management in mental health as opposed to the discipline imposed by multinational corporations, administrations, as well as by individuals considered "experts" linked to health, psychology, or social services. Self-management is founded on respect, autonomy, and mutual support.
In terms of the category focusing on support spaces, the promotion of rights has been identified as an important component. However, from the analysis conducted, a lack of intersectionality in this regard has been observed. Specifically, there is a noticeable absence of direct results addressing sexual rights, as well as a lack of a feminist perspective focusing on the promotion of women's rights within the mad pride movement, or a racialized perspective of mad pride. This deficiency has been recognized by authors such as Beresford (2020) , who questions how concerns of Black and minority ethnic communities are overlooked. Primarily, Mad Pride has been contemplated from a perspective of the global North or from a Eurocentric approach, without adequately including or involving the global South (Guzmán-Martínez, 2021) .
The utilization of social media as an accessible and anti-sanism space for denunciation must be emphasized. The findings reveal that social network X also serves as a platform for custodial criticism, denunciation of economic exclusion, and complaints regarding discrimination and professional attention, which collectively represented 22.5% of the analyzed hashtags. However, it is important to consider that the digital divide among populations accessing social services, for instance, remains a prevalent issue, as highlighted by the study conducted by Múñoz-Moreno et al. (2023) .
In this regard, the digital divide may also be linked to economic exclusion and capitalism within the context of the Mad Pride movement. On this matter, scholars such as Spandler and Poursanidou (2019) argue that maintaining focus on diverse forms of exclusion beyond psychiatric perspectives is crucial. Concerning this issue, it is important to highlight that many of these actions consider intersectionality with other movements and dissidences from various fields, such as anticapitalism, as outlined in Castillo's work (2021) . This underscores the importance of addressing madness from a multidisciplinary and intersectional perspective that considers a variety of social, economic, and political factors.
Drawing from the results obtained, it is deemed essential for professional practice, particularly in the field of mental health, to adopt a critical reflection. Professionals should thus question their own practices, including actions related to involuntary hospitalizations, overmedication, therapies such as electroconvulsive treatment, and mechanical restraints, among others. It is therefore necessary to adopt an intersectional and anti-oppressive approach that values and is grounded in the everyday knowledge of individuals involved in the mad pride movement. Furthermore, it is important to promote actions that transform diversity into an opportunity for coexistence, mutual support, and group interaction, as suggested by Wilson and Beresford (2000) .
Lastly, if attention is focused on the dissemination and scientific research of mad pride, it is essential to debate from which perspectives these studies are developed. In this regard, Beresford and Carr (2018) question that most studies on mad pride can become elitist, as they are often conducted by academics or doctoral students. On the other hand, it is important to value the specialized experiences and initiatives that drive the study of Mad Pride.
Concerning the secondary category of dissemination and research, it is important to value approaches that respect and appreciate the diversity of experiences and perspectives of mad people and non-normative psychic experiences. Mad studies, as defined by Ingram (2021) , focus on amplifying the voices of those who have been stigmatized or marginalized due to their madness and on challenging the power structures within mental health care (Ingram, 2021). Additionally, it is crucial to highlight and value initiatives such as the Center for Mad Studies in Chile, a research group conducting militant research in the field of madness, adopting an alternative approach to the biological paradigm. These initiatives contribute to enriching the field of study and promoting a broader understanding of madness.
Conclusion
This study has facilitated an approach to mad pride narratives through the social network X. Mad pride, as a movement for visibility and collective empowerment, plays a fundamental role in political action and in criticizing the biological perspective of mental health and psychiatry. The relevance of this collective movement must be acknowledged in the professional realm, given that mad studies and the mad pride movement constitute a highly enriching, diverse, and challenging project. It is unsurprising that tensions and difficulties arise between the field of psychiatry and the Mad Pride movement.
Despite the main categories of analysis focusing on aspects such as visibility, activism, support resources, and reports of rights violations, it must be recognized that this movement is inherently dynamic. Therefore, there are no simple answers for understanding the shifting dynamics of dissemination and socialization occurring through social networks like X. However, it is suggested that it is more appropriate to acknowledge these tensions and maintain an open space for them rather than attempting to resolve them prematurely and definitively. Ultimately, regardless of what mad studies are or may become, and regardless of who they include or exclude, we agree on the importance of fostering alternative countercultures of critical research, support, and solidarity. The voice of madness deserves attention, as does the study of madness and psychiatrization.
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Received: October 14, 2023; Accepted: April 02, 2023