Cassandra Evans

Type

Text

Type

Dissertation

Advisor

Ray, Sharon | Friedner, Michele I | Block, Pamela | Burch, Susan

Date

2017-12-01

Keywords

Medical sciences | containment | disabilities | Social sciences | housing | institutionalization | mental health | psychiatry

Department

Department of Basic Health Sciences

Language

en_US

Source

This work is sponsored by the Stony Brook University Graduate School in compliance with the requirements for completion of degree.

Identifier

http://hdl.handle.net/11401/78293

Publisher

The Graduate School, Stony Brook University: Stony Brook, NY.

Format

application/pdf

Abstract

This is an ethnographic research project examining the lives of individuals with psychiatric disabilities in Suffolk County, Long Island, New York during September 2015 to July 2017. This research considers key aspects of deinstitutionalization, community-based mental health care, and the transition processes that resulted from people leaving long-term psychiatric care. I argue that spaces such as designated mental health housing and occupations, like mental health “Program,” limit choices and perpetuate a sense of control and containment, or what I term “chosen for” spaces—living sites and vocations that are chosen for people on their behalf, diminishing their agency and autonomy. Alternatively, some individuals resist, thereby affecting “chosen by” activities and vocations, or pastimes and occupations of their own choosing. Thus, there are cases where an individual’s chosen by occupation or living situation promotes more autonomy and well-being than others that have been forced upon them. This research interprets how individuals in Suffolk County, New York, navigate the movement from large institutions to smaller, community-based interventions—whether that embodies living independently or living in community-based mental health housing with services—as they negotiate occupations. An analysis of the goals of emerging peer mental health recovery programs in the area is included as well because this is an occupation that many people are tracked into. I contend that the occupation of peer mental health worker remains ambivalent for people. Finally, an overarching aim in this project is to provide an ethical counter-narrative that allows for the uncommon, atypical life path or trajectory of many who have been institutionalized once or numerous times, who may be considered mentally disabled or different, living in a world that has more dominant expectations for typical mental functions, productivity, and rehabilitation. In effect, however, while asylums might be gone, total institutions remain. This study contributes to disability studies, mental health, bioethics, mad studies, and public housing and policy literature. | 252 pages

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