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Vulnerable to the State? The Indefinite Imprisonment of People with Intellectual Disability Under Forensic Mental Health Law as Structural Violence
Abstract
Violence against people with intellectual disability is commonly understood to occur as a result of an individual’s heightened ‘vulnerability’, based on their disability status. Critical disability studies scholars have problematised ‘vulnerability’, critiquing this term as being socially produced and based in a negative ontology of disability. In this article, we critically reflect on the ways in which people with intellectual disability labels are subjected to structural violence via criminalisation and indefinite detention in prison through the operation of interlocking and multi-layered systems, such as police systems, prison systems, guardianship systems, and the operation of forensic mental health systems. We argue that vulnerability framings used by these systems serve to obscure the structural violence that they ultimately perpetuate. To conduct this analysis, we engage with a testimony: Sue’s story. Sue is an intellectually disabled woman, whose entry into the criminal legal system in Victoria begins with police contact and summary offence charges and ends in indefinite detention after an assessment of unfitness is made under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 (Vic) (CMIA). Through an examination of Sue’s case and treatment under the CMIA, we argue that one of the key limitations of vulnerability theories is that notions of ‘vulnerability’ imply a need for protection that can both obscure and animate the use of carceral responses which reproduce harm and embed the ongoing debilitation of criminalised disabled people in society.
... Various studies have demonstrated that structural violence can manifest in several ways, including: internal displacement and development; food and politics; water and sanitation; social services [36]; and food insecurity [37]. Additionally, the indefinite detention of individuals with intellectual disabilities under forensic mental health law constitutes a manifestation of SV [38]. SV also affects other vulnerable groups such as immigrants [39] and individuals living with HIV in these communities [40]. ...
Background
There are many dimensions regarding autism that are closely connected to social structures, policies, and power dynamics, silently impacting the well-being of individuals within the autism spectrum. This research aims to explore these overlooked aspects using a theoretical framework called "structural violence."
Methods
The study was conducted in Kurdistan, Iran, and a qualitative longitudinal approach was chosen. A purposive sampling method was employed to select the participants, with 11 parents taking part. The study data comprised 29 interviews using a topic guide conducted over a span of 2 years. Thematic analysis and a matrix-based approach were utilized for data analysis. To enhance the scientific rigor of this research, four criteria, including Guba and Lincoln’s principles, were implemented to ensure methodological accuracy.
Results
The research findings highlight four primary forms through which structural violence impacts children on the autism spectrum and their families: access to healthcare, geographic disparities, awareness and stigma, and poverty and financial burden. Additionally, the study identified 11 subthemes related to structural violence in the context of autism and families.
Conclusions
We illustrated how structural forces create barriers to accessing adequate healthcare services, exacerbate discrimination based on ethnicity and geography, perpetuate stigma, and contribute to poverty and the inability to meet basic needs. These factors not only worsen health issues but also deepen existing disparities in healthcare access and outcomes for children on the autism spectrum and families. We emphasize the urgent need for systemic changes to address these issues. It is essential to promote public awareness, provide better access to health and support services, and address economic and political factors that contribute to these inequalities.
This chapter provides an overview of dominant mental health paradigms in contemporary Western contexts, with a focus on critically analysing two foundational assumptions of psychiatry: ‘benevolence’ and ‘expertise’. Mainstream mental health campaigns implore people to seek help when distressed, leading to widely accepted claims that mental health services are the only appropriate form of support in times of distress, suffering, or crisis. Strongly held beliefs that coercion is in the best interests of psychiatrised people reinforce the status of mental health services and marginalise the perspectives and knowledges of people with experiences of psychiatric harm, and yet the evidence-base for biomedical psychiatry is highly contested. It is argued that robust critiques of the claims of psychiatry are urgently required, given the harms caused by psychiatric practices, including the routine use of involuntary interventions by acute mental health services. We also argue that a gendered and socio-political analysis of psychiatrised women’s experiences is needed. Given the scale of change that is required, it is essential to move beyond tokenistic reform gestures. This chapter introduces a participatory action research study, exploring women’s experiences of and resistances to involuntary mental health treatment. Key definitions and an overview of the book as a whole are also included.
Building on conceptions of policing as a colonial project, this article contributes to spatial and sensory understandings of policing by examining everyday practices of gender and racial criminalization. I argue that criminalization results from ‘seeing like a cop’ (Guenther 2019), and reordering and securing spaces accordingly. I explore the logics, practices and effects of this regime of visuality and spatial governance, drawing upon research on the criminalization of women who experience interpersonal, state and structural violence in Melbourne, Australia. For these women, police visions of danger, disorder and disposability pre-empt their displacement and punishment. The perceptual practices of police forge carceral continuums that connect the gentrifying streetscape and the home, producing both as sites of racial surveillance and gender entrapment. The article highlights the capacity for sensory analysis to deepen understandings of the violence work of policing.
Background
The terminology and definition of "Autism Spectrum Disorder" can inadvertently shift focus away from exploring the disregarded dimensions associated with autism that are both subtle and impactful. These dimensions are closely connected to social structures, policies, and power dynamics and they silently impact the well-being of individuals within the autism spectrum. This research aims to explore these overlooked aspects using a theoretical framework called "structural violence."
Methods
A qualitative longitudinal approach was chosen to capture the intricacy and depth of participants' experiences in this research. The study was conducted in Kurdistan, Iran. A purposive sampling method was employed to select the participants, with eleven parents (four fathers and seven mothers) taking part. The study data comprised 29 interviews conducted with these 11 parents over a span of 30 months. Thematic analysis was utilized for data analysis. To enhance the scientific rigor of this research, four criteria, including Guba and Lincoln's principles, were implemented to ensure methodological accuracy.
Results
The research findings highlight four primary forms through which structural violence impacts children with ASD and their families: access to healthcare, geographic disparities, awareness and stigma, and poverty and financial burden. Additionally, the study identified 11 subthemes related to structural violence in the context of autism and families.
Conclusions
We illustrated how structural forces create barriers to accessing adequate healthcare services, exacerbate discrimination based on ethnicity and geography, perpetuate stigma, and contribute to poverty and the inability to meet basic needs. These factors not only worsen health issues but also deepen existing disparities in healthcare access and outcomes for children with ASD and families. we emphasizes the urgent need for systemic changes to address these issues. It is essential to promote public awareness, provide better access to health and support services, and address economic and political factors that contribute to these inequalities.
Disabled people are subject to disability laws – such as guardianship, mental health and mental capacity legislation – which only apply to them, and which enable legal violence on the basis of disability (‘disability-specific lawful violence’). While public health laws during the COVID-19 pandemic enabled coercive interventions in the general population, disabled people have additionally been subject to the continued, and at times intensified, operation of disability laws and their lawful violence. In this article we engage with scholarship on law, temporality and disability to explore the amplification of disability-specific lawful violence during the pandemic. We show how this amplification has been made possible through the folding of longstanding assumptions about disabled people – as at risk of police contact; as vulnerable, unhealthy and contaminating – into the immediate crisis of the pandemic; ignoring structural drivers of oppression, and responsibilising disabled people for their circumstances and the violence they experience.
In this article, we adopt a Critical Disability Studies orientation to interrogate ‘acquiescent’ behavior of one adult diagnosed with developmental disabilities – Suzanne – in interaction with her caregiving parents. We conduct conversation analysis of interactions and offer themes of Speaking over/capping it off, Speaking for/giving it over and Correcting/redirecting as evidence of Suzanne acquiescing as part of ‘orchestrating’ input from her parents to get what she wants. We discuss adults diagnosed with developmental disabilities navigating daily life amidst shifting powerplay by strategically steering conversations in ways that serve them and we argue such navigations as vital to understanding ‘acquiescence.’
Since there is also no U.S. constitutional guarantee to basic social goods, such as housing, education, or health care, the anti-discrimination, sameness-of-treatment approach to equality prevalent in the United States is particularly problematic. The discourse of human rights that supports claims to such goods in European and other countries does not exist in America. We have not ratified many of the international agreements, including those associated with economic rights, as well as CEDAW and CRC. The courts are little help. In fact, attempts to apply human rights ideals internally - to American practices and laws - have been met with resistance, if not outright rejection. Several Justices of the Supreme Court decried references to human rights principles used to bolster arguments about constitutionality under American precedent to be the application of "foreign fads" when (superior) American constitutional provisions should prevail.My development of the concept of vulnerability and the idea of a vulnerable subject began as a stealthily disguised human rights discourse, fashioned for an American audience. The concept has evolved from those early articulations, and I now think it has some significant differences as an approach, particularly in that a focus on vulnerability is decidedly focused on exploring the nature of the human part, rather than the rights part, of the human rights trope. Importantly, consideration of vulnerability brings societal institutions, in addition to the state and individual, into the discussion and under scrutiny. Vulnerability is posited as the characteristic that positions us in relation to each other as human beings and also suggests a relationship of responsibility between state and individual. The nature of human vulnerability forms the basis for a claim that the state must be more responsive to that vulnerability and do better at ensuring the "All-American" promise of equality of opportunity.
Hate crime is defined by the FBI as a criminal offense motivated by bias against the following protected categories: race, ethnicity, ancestry, religion, sexual orientation, disability, gender, and gender identity. There are three official sources of hate crime data in the United States: the Uniform Crime Report (UCR), the National Incident‐Based Reporting System (NIBRS, part of the UCR reporting program), and the NCVS (National Crime Victimization Survey). According to the FBI in 2018, of the 16,039 agencies that participated in the UCR reporting program, 2,026 agencies reported a total of 7,120 hate crime incidents. Both the UCR and NCVS reveal that victims were most commonly targeted due to their perceived race/ethnicity. Recommendations to reduce hate crime include condemnation of the hate incident by community leaders and proper identification and prosecution of criminal acts of hate.
“Disabling” forensic detention involves challenging the self-evidence of the meaning of disability in forensic mental health law, and in turn illuminating the significance of this meaning to the possibility and permissibility of forensic detention and other interventions in the bodies of people designated with cognitive impairments and psychosocial disabilities (“people designated as disabled”). I apply this approach to an examination of a case study of one individual subjected to forensic detention: an Indigenous Australian woman with Fetal Alcohol Spectrum Disorder, Roseanne Fulton. By examining Fulton’s forensic detention, in the context of her earlier life circumstances and her subsequent journey through various “alternatives” to this forensic detention I show the interrelationships of forensic detention with a range of legal options for punishing, regulating and intervening in designated as disabled bodies and situate these interrelationships in a broader range of issues of violence, institutional failure, social disadvantage, settler colonialism, and ableism. My central argument is that the ongoing subjection of Fulton to a range of forms of control across her life suggest that the possibility of forensic detention and other forms of punishment of people designated as disabled is not attached to a particular material architectural space or a particular court order, but instead attaches to these individuals’ bodies via medico-legal designations as disabled and travels with these individuals through time and space. I propose that more directly it is the disabled body that is the space of punishment and the disabled body makes material architectural spaces punitive. A “reform”, indeed even an “abolition”, approach focused on material architectural spaces of disabled punishment will not interrupt the ongoing processes of control of criminalized people designated as disabled if it does not also acknowledge and challenge the temporal and carnal logics underpinning the carcerality of the disabled body itself.
In the first sustained examination of disability through the lens of political theory, The Capacity Contract shows how the exclusion of disabled people has shaped democratic politics. Stacy Clifford Simplican demonstrates how disability buttresses systems of domination based on race, sex, and gender. She exposes how democratic theory and politics have long blocked from political citizenship anyone whose cognitive capacity falls below a threshold level?marginalization with real-world repercussions on the implementation of disability rights today. Simplican’s compelling ethnographic analysis of the self-advocacy movement describes the obstacles it faces. From the outside, the movement must confront stiff budget cuts and dwindling memberships; internally, self-advocates must find ways to demand political standing without reinforcing entrenched stigma against people with profound cognitive disabilities. And yet Simplican’s investigation also offers democratic theorists and disability activists a more emancipatory vision of democracy as it relates to disability? one that focuses on enabling people to engage in public and spontaneous action to disrupt exclusion and stigma. Taking seriously democratic promises of equality and inclusion, The Capacity Contract rejects conceptions of political citizenship that privilege cognitive capacity and, instead, centers such citizenship on action that is accessible to all people. © 2015 by the Regents of the University of Minnesota. All rights reserved.
Purpose
The support given to prisoners when they leave prison has a bearing on their success in starting a new life and on community safety. This paper aims to examine the community re‐entry experiences of ten people with an intellectual disability in Queensland, Australia.
Design/methodology/approach
The findings in this paper are part of a wider study on the life stories of ex‐prisoners with an intellectual disability. Seven male and three female participants with intellectual disability were interviewed using a semi‐structured life story method. Interviews were respectful of the communication styles of participants and involved multiple interview sessions, ranging from two to nine interviews per person. Data were analysed using narrative and thematic analysis with the assistance of NVivo 8 software.
Findings
Participants found the process of leaving prison an emotional event, often clouded with both confusion about when release was to occur, and uncertainly as to what they could expect on the outside. The need for concrete information and coordinated hands‐on assistance in negotiating supports in the community have significant implications for correctional and community services.
Originality/value
This study captures the perspectives of people with intellectual disability on community re‐entry. These perspectives are often overlooked in policy and practice developments in the field of corrections. Yet without understanding this group, the field is unable to address their particular needs.