Presented by Alex V. Barnard, Assistant Professor of Sociology at New York University (NYU)

Is there an underlying order to how societies classify, treat, and control madness? Both popular and scholarly portrayals of contemporary mental health systems emphasize service fragmentation and inter-professional competition. In this talk, I draw on a year of in-depth fieldwork in France, including observations in a public mental health clinic, social service office, and courts, supplemented with nearly two-hundred interviews with administrators and clinicians, to show the underlying logic to the trajectories of people with serious mental illness through the welfare state. As I show, decision-making across these sites is linked by a shared conception, both embedded in formal policy and informal practices, of what makes someone a malade—a real mentally-ill person. This strong medical and bureaucratic identity ties this population to a paternalist, protective psychiatric system, in sharp contrast to the U.S., where the absence of a clear administrative category for this population leads to a chaotic mix of coercion and care from jails, shelters, and hospitals. While these results reveal the power of the French state to construct a particular definition of what it means to have a serious mental illness, I show how defining the population in this way constrains attempts to reform the system. This talk suggests how the dynamic interplay between categories adopted in official policy, used in professional practice, and adopted by populations themselves can reproduce national differences, even in an era where psychiatric knowledge and medical treatment are converging across national borders.

Speaker

Alex V. Barnard is an assistant professor of sociology at New York University and holds a PhD in sociology from the University of California, Berkeley. His work examines medical and bureaucratic decision-making, welfare policy, and social control comparatively. His previous book, Conservatorship: Inside California's System of Coercion and Care for Mental Illness (Columbia University Press), examines California's involuntary treatment system, showing how a failure of government oversight and inter-agency coordination leads to the extensive use of coercive interventions that provide neither care nor control. Ongoing projects include examining trends in national legislation around involuntary psychiatric treatment, analyzing variation in the policing of protests and university responses to the 2024 student protest encampments, and the governance of emerging addictions to online gambling and AI.

Co-hosted by the Department of Sociology Colloquium Series