The Ethics and Politics of Involuntary Psychiatric Commitment: Beyond the Total Institution
- Mack, Abigail
- Advisor(s): Throop, Christopher J;
- Ochs, Elinor R
“The Ethics and Politics of Involuntary Psychiatric Commitment: Beyond the Total Institution” examines the lived experience of medical and legal professionals who work at the intersections of the pubic mental health care and justice systems in Los Angeles. The dissertation draws on nineteen months of ethnographic fieldwork that traces the practice of involuntary psychiatric commitment from initial emergency triage to inpatient unit to courthouse where patients may contest the circumstances of their holds. Through this fieldwork, the dissertation demonstrates how public health and justice systems—framed as both “silos” and “revolving doors”—operate as distinct institutions while medical and legal professionals and their patient/clients circulate in and between them. In the midst of these cycles of people and institutional ideologies competing articulations about appropriate care emerge that frame the ethics and politics of enacting involuntary commitment, excluding some people from care and often reproducing structures of systemic racism and poverty. The study mobilizes a critical phenomenological approach to elaborate lived experience of working in and living through systems of inequality particularly as it is disclosed and mediated by language and mood. In the process, it elaborates how everyday encounters within medical and legal institutions may unsettle the political status quo and provide an opening for alternative forms of caring for people in mental health crisis.