Institutions Often Treat Disability and Mental Health Not With Care But Violence

Typically, one hears the term “carceral” used in discussions of prisons and jails. One significant aim of the prison abolition movement is to critique and eliminate carceral forms of state punishment that encage, degrade and dehumanize human beings while stripping them of agency. It is important, though, that we begin to extend our understanding of carceral spaces to what are commonly considered to be sites of “care,” such as disability “treatment” facilities, nursing homes and group homes.

To explore a broader understanding of the term carceral and its logics, I spoke with Liat Ben-Moshe, an abolitionist and disability/mad studies scholar-activist. Ben-Moshe is an associate professor of Criminology, Law and Justice at the University of Illinois at Chicago, author of Decarcerating Disability: Deinstitutionalization and Prison Abolition (University of Minnesota Press, 2020) and co-editor of Disability Incarcerated: Imprisonment and Disability in the United States and Canada (Palgrave, 2014). Ben-Moshe conceptualizes carceral logics within contexts where people “can’t make decisions about their lives and in which people describe their experience as incarceration.” This perspective centers the experience and narratives of those harmed by these systems and institutions, and criticizes notions of “medicalization, ‘special treatment,’ segregation.”

In this exclusive interview with Truthout, Ben-Moshe discusses how carcerality, disability and abolition intersect and how questioning our own knowledge can help advance our goal of abolition.

George Yancy: When I think about the root meaning of the word “carceral,” I think of a site of enclosure. The term enclosure suggests that which is corralled or caged — a sense of debilitating restriction. We can think here of prisons, cells, solitary confinement, colonized spaces, internment camps etc. Hence, carceral is a term that I take to be diametrically opposed to freedom, openness, a sense of self-determination, and self-flourishing. Your work critically engages the forces of institutionalization of disabled people. Within this context, define what you mean by “carceral ableism.”

Liat Ben-Moshe: Thanks for inviting me to be in conversation, George. I want to start with the first part of your question — that “enclosure” (prisons, internment camps, and, I would add, psych facilities, nursing homes and disability residential facilities) suggests “a sense of debilitating restriction.” A lot of my work (and that of others) has tried to show the entanglements between disability/madness and carcerality or sites of enclosure, especially in two ways. Firstly, imprisonment, confinement and carcerality are not only about prisons, jails, detention centers, and other sites and logics tethered to criminal justice pathways (and immigration). Enclosure also includes sites of disability confinement, including nursing homes, group homes etc., and their logics (medicalization, “special treatment,” segregation). I often use [Self Advocates Becoming Empowered] SABE’s definition of carceral entity/space/logic as any setting in which one cannot direct or make decisions about their life. I want to be perfectly clear, though, that psych confinement or institutionalization is not like prison — they are both carceral, closed institutional settings in which people can’t leave or can’t make decisions about their lives and in which people describe their experience as incarceration.

(Fun fact: My book, Decarcerating Disability, was originally going to be called Politics of (En)closure, in order to emphasize the importance of understanding these as sites of enclosure in tandem — prison abolition with deinstitutionalization of sites of disability confinement.)

Secondly, I want to address enclosure or carcerality as “a sense of debilitating restriction,” as you referred to it. One of the ways in which many understand sites and logics of carcerality is through their debilitating function or nature. The ways that prisons, jails and detention centers are full of disabled and mad (i.e., “crazy,” “mentally ill”) people is not coincidental but part of the debilitating nature of incarceration itself, as Jean Stewart and the late Marta Russell warned over 20 years ago; disability and trauma are not a side effect but part and parcel of what carcerality does.

Carcerality has various manifestations: from toxic conditions, environments and materials such as closed wards with poor air quality, contaminated water and sanitation; the prevalence of transmitted illnesses like COVID-19; lack of medical equipment, assistive technology, access to interpreters and communication; no affirming health care, gender-responsive, reproductive or otherwise; or conversely, overmedication and sterilization; no sanctioned access to sexuality, family; and the pervasiveness of trauma which is only exacerbated by practices like strip searches (state-sanctioned sexual violence) and solitary confinement (which is even more prevalent for queer, gender nonconforming, trans, disabled and mad people who are imprisoned, supposedly for their own protection).

What some people propose as a reaction or solution to these realities — like creating special units for imprisoned people who are mentally ill, or specialty courts like the new CARE Court in California — is what I call carceral ableism or sanism. Carceral ableism or sanism is the practice and belief that disabled/mad people need special protections in ways that often increase their proximity to carcerality and vulnerability to premature death (Ruth Gilmore’s definition of racism).

By ableism, I mean the oppression faced due to disability/impairment (perceived or lived), which not only signals disability as a form of difference but constructs it as inferior. Sanism is oppression faced due to the imperative to be sane, rational and non-mad/crazy/mentally ill/psychiatrically disabled. (Alerting readers to a great discussion of anti-Black sanism in a previous interview.)

Ableism and racism are interconnected, as others point out, and can be seen clearly in the ways disabled people of color (but not only) are captured by carceral systems, including policing, through pathways I refer to as racial criminal pathologization. As Talila A. Lewis emphasizes in one of your earlier interviews, ableism is also the core and connected to all other sites of oppression, whether it is acknowledged as such or not; a trunk in the eugenics tree, as Talila refers to it.

There has been a great deal of discussion at the grassroots level of activism and within the academy (and for those who engage in political praxis within both spaces) of the meaning of abolitionism vis-à-vis the prison-industrial complex. This raises all sorts of questions that overlap with the abolition of racial capitalism, forms of military policing, surveillance etc. Define how you understand abolitionism specifically within the context of the abolition of carceral ableism. Given your intersectional analysis, I’m sure that this raises so many other incredibly important overlapping issues.

It’s about the abolition of ableism and sanism, in intersectional ways. This means focusing on the abolition of the prison-industrial complex as a structure but also abolition of all that upholds able-white supremacy and its lineages of harm, including what some have termed the medical-industrial complex.

It is also an important moment to think about these intersections of carcerality, disability and abolition now. The anthology I co-edited, Disability Incarcerated, was published almost a decade ago and conceived of years earlier. It came out of a desire of some of us scholars of disability to see more work that expands what carcerality means both contemporarily and historically to squarely infuse disability/madness and critical disability analysis. Meaning, to insist that disability (broadly defined, including Deafness, neurodiversity, madness) is essential to understanding how carcerality works; and also that carcerality is a major factor and not an aberration in disabled people’s lives. This is what I’ve called elsewhere “the institution yet to come,” even if incarceration is not present in our (disabled people’s) lives, it is a constantly looming presence. You are always just a move away from the asylum, the nursing home, the group home. Always there, to make you act, be or perform “normality,” breathing in your shadow if not already materialized.

Disability and trauma are not a side effect but part and parcel of what carcerality does.

The book, Disability Incarcerated, opened up a subfield of carceral studies. Today this intersection and intervention might seem to be common sense, but it is important to highlight the paucity of scholarship on these topics 15 years ago. My hope is that contemporaneous interventions outside of academia related to what would come to be called disability justice would now be combined with the intensified curiosity towards carceral abolition, something that was in its infancy (at best) when abolitionist theorizing, gatherings and praxis came (back) on the scene in the 1990s in terms of prison-industrial complex abolition.

Abolition is a framework, and as Mariame Kaba aptly says, is a political vision, a structural analysis of oppression, a practical organizing strategy (and an ethical stance I would add), and disability justice and critical disability/mad studies analysis is essential to this. For example, current calls to replace the police with social workers and the seeming common sense of (bio)psychiatry are contested stances in critical disability/mad movements. Psychiatrization (and social workers who have the right to remove children from their families, for example) is seen as trauma and violence, not an alternative to it.

In most of my philosophy courses, I try to engage the pedagogical assumptions embodied in the work of Paulo Freire. I’m thinking of his revolutionary text, Pedagogy of the Oppressed. In that text, Freire critiques what he calls the banking system of education, which is a top-down process where students are relegated to those who simply listen, and do so, as he says, “meekly.” For Freire, education ought to be liberatory. To be so, it is indispensable that the educational process is dialogical, where people are treated as equal partners in their agency and capacity to name reality together. I would argue that Freire is providing us with an epistemology that recognizes the invaluable voices and lived experiences of those who are systematically marginalized. Talk about the meaning of what I would call counter-epistemologies or alternative epistemologies when it comes to disabled people. More specifically, speak to the contours (and even urgency) of what many call “crip and mad knowledge.”

Such an important question! I want to urge us to understand the connections between disability and carcerality/enclosure/imprisonment beyond the nexus of disability=disabling=bad, or even of ableism, debilitation and carcerality. If we stay only here (disability as deficit, pathology, something to remedy or avoid) we do not get to abolition and liberation for all. Or at all.

I suggest that there is liberatory potential in the activism and wisdom of disabled and mad people, including about how to close down, contest and move beyond sites of enclosure and carceral logics. I refer to this as a crip/mad of color critique of incarceration and decarceration. For example, if we do not center the knowledge and analysis of disabled/mad people, we would not understand that abolition is not a fickle impossible dream for the future, but something that has already happened, here in the U.S., in our lifetime, in the form of the closure of disability carceral facilities (psych hospitals and residential institutions for people with intellectual disabilities). Deinstitutionalization is the largest decarceration movement in U.S. history. In my book, I try to show what we can learn from deinstitutionalization towards carceral abolition and anti-prison activism.

I want to explain why I call this crip/mad of color critique. “Of color critique” is referring to queer of color critiques which is a framework to connect racial capitalism, neoliberalism (with its diversity and inclusion nods), sexuality/difference and the state. It attempts to destabilize the status quo instead of including oppressed groups within it (gays in the military, disabled in a more accessible prison etc.). These ideologies and practices end up further marginalizing said oppressed communities, especially those of color.

Crip and mad are reclaimed terms, similar to the term queer. They are turned on their heads and become ways to flaunt defiant and critical stances from terms that were used as a slur (mad/crazy, crip comes from “cripple”). They can be used critically as verbs (cripping, maddening). These knowledges are sometimes referred to as cripistemologies.

These terms are also contested, sometimes by disabled people or people with mental health difference or that have been psychiatrized. In my work, I focus on people with intellectual and developmental disability (I/DD) labels and anti-psychiatry activists, communities that have embraced terms like neurodiversity more than “crip,” which is perceived as a term more representative to those who are politicized with physical or sensory disabilities. The term “mad” is also not universally embraced by people with mental health differences (some use “mental illness,” others use “consumers,” “survivors” or “ex-patients”).

Not everyone that is disabled or has mental health differences is politicized, so not everyone wants or can (especially because of racism in the form of state violence and also within these cultures and movements) to claim disability or can identify as mad.

I wasn’t politically disabled until I found communities of disabled people who brought me into disability culture. I didn’t know I (and disabled/mad/Deaf/neurodiverse people) had a culture or shared history, disabled ancestors and teachers, art, humor. This is what disability studies, wisdom of disabled elders and critical analysis from mad and anti-psychiatry people had brought me and made possible.

In my own work on whiteness, I have critiqued its epistemological arrogance. Whiteness, on this score, functions as a site that is alleged to possess “absolute knowledge” about those who are deemed “other.” This “knowledge” functions as a site of what Charles Mills coined as epistemology of ignorance. According to this concept, white people are willfully ignorant. In other words, they decide to avoid information that shows that their beliefs are in fact false. It is as if they collectively sign a social contract to avoid knowledge, especially when it comes to matters having to do with race. I have argued that white people need to practice greater forms of epistemic humility and indeed become disoriented in relationship to their whiteness, where they lose their way as a condition for a more insightfully resistant way of being-in-the-world. Provide a sense of how you think about epistemic humility and processes of disorientation that might prove instructive in terms disrupting what it is that an ableist epistemology claims to know about disability.

I want to emphasize that we all live in the legacy of eugenics and therefore not even we (disabled/mad people) are immune to ableist epistemology. But your focus on disorientation and epistemic humility (being honest about what we do not know) is a very important lesson I learned from feminist philosophers and from abolitionists.

Abolition is not a fickle impossible dream for the future, but something that has already happened, here in the U.S., in our lifetime.

I am reminded of Ami Harbin’s Disorientation and Moral Life. Harbin’s definition of disorientation is experiencing serious (prolonged and major) disruption to one’s life so that one does not know what to do. These experiences of disorientation, although often unpleasant and jarring, can also be productive. It is this connection between epistemology and disorientation (or knowing and not knowing how to go on) that offers a rich point of analysis that might aid in conceptualizing activism in our current unpredictable and disorienting times.

Disorientation can be productive in creating not just specific new knowledge but a different relationship with knowledge, and with the inability to know “how to go on.” This inability, this disorientation, this unfamiliarity, can be harnessed as a potential tool for liberation in the form of epistemic humility, the process of knowing what you don’t know, and of maintaining humbleness about the knowledge you do have.

Abolition, whether of carcerality or ableism, is not only a political movement but also a specific epistemology that produces an ethical position. As an epistemology that produces specific forms of knowledge, abolition facilitates other ways of knowing. I call this dis-epistemology, by which I mean letting go of attachment to certain ways of knowing. Dis-epistemology denotes letting go of the idea that anyone can have a definitive pathway for knowing how to rid ourselves of carceral logics. It is this attachment to the idea of knowing and needing to know everything that is part of knowledge and affective economies that maintain carceral logics. Abolition is about letting go of attachments to forms of knowledge that rely on certainty (what are the definitive consequences of doing or not doing) and expertise (tell us what should be done) as well as specific demands for futurity (clairvoyance — what would happen).

Some use simplistic arguments like, “If you can’t offer a specific solution, then you are part of the problem.” But I suggest that this epistemic humility can actually be conceptualized as a strength of abolition, especially as it is done collectively, in a series of prefigurations, together in action, on the ground.

Carceral abolition is also about ridding ourselves of carceral logics. It’s about building a society in which caging and segregating people for wrongdoings would be nonsensical, as Angela Davis, Ruth Gilmore, and many others have taught us. Abolition necessitates creating different ways of understanding and responding to harm and difference, and therefore is about both praxis and prefiguration, and the insistence of doing it now, without waiting for the world we want, but making it now with our actions.

As an example, COVID made it abundantly clear that the vast majority of people lack any disability competency or embodied experience with it. For a short time, it did lead to epistemic humility of some kind for some folks that just had to admit that they do not know how to live an enclosed life, sheltered in place, where most things are closed off or inaccessible to them and they often have to rely on others in getting their needs met. For many of us sick and disabled folks, this was a common experience prior to COVID. We could rely on our knowledge about podding, pod mapping, mutual aid networks, interdependency, but also consent (very common knowledge for those of us who have personal attendants, home care workers etc.). It did not equalize things, however. Just brought to the surface the deep level of inequality already there.

There are times when I’m uncertain (deeply skeptical) of how different oppressed communities might work together. Part of this has to do with how I think about the pervasive ways in which anti-Blackness continues to haunt even those communities that fight against sexism, classism, ableism and cisgenderism. Yet, there is the necessity for resisting forms of poisonous siloing. As you continue to engage in political praxis and theorize forms of oppression, while recognizing their interdependency, how do you think optimistically about the importance of community.

I am not sure I am the right person to ask because I am Jewish, so not sure I am capable of optimism. (I’m just joking.) But I do think historical lessons and wins are really important in activism (in this case, abolition or disability justice or both). This is why, although I am not a historian, I find it useful to do this genealogical work, to learn the roots not only of our oppression (carceral ableism) but our resistance (disability culture, disability justice, deinstitutionalization, self-advocacy, anti-psychiatry).

This does not mean no accountability, though. So, rooting out anti-Blackness should be part and parcel of everything we do.

Maybe that is the coalitional optimism? Because wherever there is oppression, there is resistance. So maybe not optimism, but I like Dean Spade’s insistence on joy and desire in activism. And, also hope. As Kelly Hayes and Mariame Kaba emphasize, hope is a practice, and something that is better practiced collectively.

This interview has been lightly edited for clarity.