Analysis: gendered and raced psychiatrization of self-harm

In 2005, former Village Voice reporter Jennifer Gonnerman (2005) published a feature article titled “Tanisha’s Scars,” about Tanisha Jackson’s practices of self-harm — most prominently cutting. The article highlights how Jackson’s familial history, her incarceration at Bedford Hills Correctional Facility', her placement in solitary confinement, and time at the CNYPC have all been integral factors informing Jackson’s self-harm in particular and mental health challenges more broadly. Jackson, who spent 11 years at Bedford Hills at the time of publication and was institutionalized in psychiatric facilities and ‘group homes’ as an adolescent, is written about through the medicalized and naturalized category of ‘mental illness’ in ways that recognize the social and environmental factors that may exacerbate mental distress, but still emphasize a biological deterministic understanding of mental unwellness as inherent biological proclivities that preceded Jackson’s expressions of mental distress, such as self-harm. In this way, Jackson’s presence at Bedford Hills and CNYPC and her other aforementioned experiences of institutionalization are constructed as simply creating additive stress as opposed to those spaces producing mental unwellness themselves. While solitary confinement is expressly showcased as detrimental to the mental wellness of incarcerated peoples, it is discursively constructed as an aberrant, torturous practice exogenous of the otherwise necessary carceral space. This discursive construction exemplifies the liberal reformist ideology of carceral humanism that positions carceral spaces as somehow able to rehabilitate incarcerated peoples who are mentally unwell.

Conversely, Jackson published her experience of solitary confinement in an online blog “Stories From the SHU”, operated by Mental Health Alternatives to Solitary Confinement (MHASC), an organization working towards the expulsion of solitary confinement for incarcerated peoples with psycho-social disabilities in New York State. In “The Sorrow of Isolation”, Jackson writes about the ways in which her engagement with self-harm is punished through solitary confinement, a practice she states has resulted in the deaths by suicide of her close friends and other peers at Bedford Hills. Jackson states: “several of my peers have and will kill themselves in this place designated for punishment and isolation to make one ‘think’ about what we’ve done” (p. 1). In so doing, Jackson illustrates the often fatal contradiction of punishing people for experiencing mental distress. Moreover, she writes about the provocative role that prison employees play in making solitary confinement both a punitive option and a fatal practice. As such, and in opposition to Gonnermans account of Jackson’s experiences of incarceration and self-harm, Jackson’s first-person account highlights the ways in which incarceration itself— including the mistreatment and neglect by prison guards — is a constitutive element of mental distress while incarcerated. Jackson’s first-person account thus troubles both the carceral humanistic tendency to make “kinder” spaces of punishment and containment as well as the tortuous and maddening qualities of and imperatives to solitary confinement. Jackson makes evident the explicit role that incarceration has played in the production and exacerbation of mental unwellness that does not rely on psychiatrization that marks mental distress as solely biological and divorced from punitive incarceration in penal and psychiatric institutions.

Gonnermans article also largely draws on accounts by prison employees and officials, whose experiences of controlling and surveilling mentally unwell incarcerated peoples are centered as the primary concern of this carceral space. Incarcerated women’s experiences of mental distress and self-harm told through the voices of prison officials mark these women as having ‘manipulative’ tendencies who express unbridled violence towards officials, behaviours seemingly constitutive of mental ‘illness’. In so doing, people incarcerated at Bedford Hills, which the article follows, are constructed as monstrous, violent, and threatening in ways consistent with much discourse about ‘mental illness.’ The distressful experiences of individuals, often in response to their incarceration, is framed as a tertiary concern at best. This is evidenced through Gonner- man’s citation of a text co-written by former Bedford Hills warden Elaine Lord titled Acting Out: Maladaptive Behaviour in Confinement. This book, published by the American Psychological Association in 2002, is a quantitative and qualitative study of “maladaptive” and “pathological ”s “misbehaviours” of incarcerated people in the New York State prison system. Such language already positions incarcerated peoples who are mentally unwell as unwilling to properly ‘adapt’ to carceral spaces in which their individualized unwellness undermines their ability to rehabilitate in an otherwise corrective prison system. Lord’s contribution to the text, a chapter titled “The Prison Careers of Mentally 111 Women” outlines the ways that incarcerated people at Bedford Hills experiencing mental distress, particularly those who self-harm, are ‘disturbed,’are a ‘drain of medical resources’, and produce large expenses for the penal system. Additionally, gendered notions of how ‘women’ more prominently engage in self-harm construct incarcerated peoples in women’s prisons as, on the one hand, in need of patriarchal supervision of these irrational gendered (and misgendered) subjects (Spade, 2011) and, on the other hand, as a burden to both the economic structure of the prison system as well as individual prison employees whose experiences are written as more valid in the chapter. In so doing, incarcerated peoples are rendered fiscally problematic and pathologically inept in ways that suggest carceral expansion as a solution. For example, Lord (2002) writes: “it is clear that prisons must adapt [to the increase of mentally unwell inmates] by creating more appropriate environments for these inmates — as long as society believes that is where mentally ill inmates should be maintained” (p. 368). Legal scholar Dean Spade (2011), argues that

When working to address conditions ot imprisonment, then, we must avoid proposals that include constructing buildings or facilities to house trans prisoners, to hire new staff, or make any other changes that would expand the budget and/or imprisoning capacities of the punishment system.

(p. 147)

As such, the liberal reformist ideals of creating spaces better suited to ‘treat’ people in mental distress (such as the CNYPC) participates in expanding carceral spaces under the auspices of benevolent psychiatric care. Given the publisher of the text, the American Psychological Association, we can see how institutionalized psychology and psychiatry work in confluence with carceral systems to reify penal and psychiatric incarceration as necessary and — when done ‘right’ — benign by reifying the medicalization ot mental distress that undergirds the naturalization of mental ‘illness’ as individualized, biological, and pharmaceutically fixable.

The confluence ot penal and psychiatric systems of punishment, especially at Bedford Hills, has been outlined and analyzed by organic intellectuals whose lived experiences of incarceration make evident how both systems rely on the naturalization of each other in order to maintain systems that incapacitate and contain BIPOC. In No More Cages, contributors in an August 1979 issue highlight the creation ot a hushed-up ‘Satellite Programme’ for the ‘mentally disturbed’ that was created on the grounds of Bedford Hills (Women Free Women in Prison Collective, 1979, p. 12). Ten women who were incarcerated at Bedford Hills in the preceding decade were sent to the Matteawan State Hospital for the Criminally Insane, a men’s psychiatric prison. Public uproar about the transfer — uproar outlining the physical and sexual violence these women inevitably experienced — ensued leading up to a judicial banning of such transfers. The ruling, however, resulted in prison expansion. CNYPC subsequently opened in 1977 on the same grounds as the closed Matteawan State Hospital (Yanni, 2007). CNYPC is the psychiatric institution to which women at Bedford Hills are contemporarily and punitively sent, such as Tanisha Jackson, for expressing mental distress penalised as ‘internal infractions’.

In a 1981 volume of No More Cages dedicated to “Lesbian Pride Week”, contributors write about psychiatric prisons — euphemistically referred to as forensic hospitals — as examples of aggresive prison expansion as well as spaces where the pathologization and criminalization of non-heterosexual expressions materialize (Women Free Women in Prison Collective, 1981). For instance, the volume outlines the presence of queer folks in psychiatric institutions as a means for them to be “forcibly ‘cured’ from the ‘sickness’ of homosexuality” (p. 2). The newsletter troubles the naturalization of institutionalized psychiatry as it pertains to the regulation ot gender and sexuality. Non-heterosexual people are outlined to be “locked up without even the pretense of a trial, on the basis of a judgement of a psychiatrist about what their future behaviour might (sic) be” (p. 2). As such, the centrality of institutionalized psychiatry in pathologizing, criminalizing, and punishing deviations from heteronormativity is illustrated.

The punishing capacities of the psychiatric system and pathologizing mechanisms of the prison system work in tandem to incapacitate nonnormative practices and bodyminds. The authors go on to write: “increasingly, the State is combining the functions of psychiatric hospitals and prisons” (p. 2) where “more and more behaviour modification units are being built in prisons, and more and more prison wards are being built in psychiatric institutions” (p. 5). In so doing, these organic intellectuals showcase the ways in which psychiatric and penal institutions were increasingly in collusion in ways that expanded practices ot incarceration. Given the emergence of mass incarceration in the late 1970s and early 1980s, contributors of No More Cages were witnessing, in real time, patterns and trends that saw an exponential rise of prison construction and subsequent incarceration in women’s prisons. It is this historically specific analysis ot and foresight into prison expansion that elucidates why liberal reformist ideologies and practices are based on dangerous ideas ot carceral humanism. Writings in No More Cages thus inform and forewarn abolitionist thought and praxis about the ways in which institutionalized psychiatry in particular, and the psy-sciences more generally, have and do operate through carceral logics. Critical readings of historicized knowledge produced by the aforementioned organic intellectuals through a critical mad studies lens and crip-of-colour critique thus provide an abolitionist analysis germane to the disruption of current attempts to ‘reform’ (read: expand) carceral spaces to be better equipped to ‘treat’ (read: psychiatrize and often involuntarily medicate) people perceived to be experiencing mental unwellness.

No More Cages circulated in the northeast of the United States and southeast regions of Canada during its publication. Largely in conversation with the newsletter Phoenix Rising: The Voice of the Psychiatrized, published in Toronto, Canada, and running from 1980 to 1990, contributors and publishers of No More Cages engaged in transnational critical analysis ot prison and psychiatric systems in the Canadian carceral context as well. Phoenix Rising (1989) likened psychiatric hospitalization to penal incarceration whilst recognizing the particularities of psychiatric treatment in prisons as an additive state of criminalization ot which both required abolition. As No More Cages produced an analysis that criticized the role that institutionalized psychiatry played in penal systems, Phoenix Rising critiqued the authority of institutionalized psychiatry in labelling and criminalizing mental distress in ways that individualized expressions ot mental unwellness without attending to socio-cultural and political economic structures. It is this naturalized authority, evidenced in No More Cages as well, that buttressed both penal and psychatric incarceration. Moreover, the historicization of this confluence functions to provide an abolitionist analysis that pushes back against seemingly benevolent mental health reforms in contemporary Canadian carceral spaces as well. The liberal ideologies inherent to such reforms situate mental unwellness as an individualized predisposition to distress occurring outside ot the context ot incarceration. For example, a 2010 government report titled “A Comparative Review of Suicide and Self-Injury: Investigative Reports in a Canadian Federal Correctional Population”, written by state researchers employed by Correctional Services of Canada, concludes that the motivation tor self-injuries is “coping with negative emotions” where “the stress of incarceration was not found to be a common motivation tor engaging in SIB [self-injurious behaviour]” (n.p.). The individualistic imperatives to such a research finding highlights the pathologizing language ot the carceral state that absolves itself from producing mental distress in ways that help maintain the illusion that a liberally modified version of incarceration could somehow be an effective provider of mental health care.

It is thus the historical and contemporary experiences of incarcerated and formerly incarcerated people — particularly those marginalized by the intersectional structures of heteropatriarchy, settler colonialism, racial capitalism, and ableism/sanism — whose intellectual work reveals the incommensurability ot incarceration with any form of justice or care. As such, abolitionist thought and praxis that centralizes intersectional analyses — primarily those that critically engage with disability'justice and mad /disability studies — functions to elucidate the interconnected way's in which overlapping and compounding structures of discrimination undergird practices of incarceration whilst solidifying and reproducing those structures for the justified maintenance of White majority and White supremacist, racial capitalist, settler states such as what is known as the United States and Canada.

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