Disability Justice Demands Abolition

Everyone needs care, though some care is more socially acceptable to need than others. Disabled people take issue with the term “special needs,” because everyone has needs. For example, we all need to be taught things and we all have different ways of learning—but in public school, whether or not your “needs” are considered normative depends on the standards set by the schools. All of these standards are arbitrary and/or come from the long history of colonization, ableism, and white supremacy that has formed our current understandings of who deserves care and in what ways they deserve it.

Many carceral systems exist under the guise of “caring” for disabled people, and care is often at least part of the rationale for their continued existence. However, these places do not provide care in any kind of real or humane way—in large part because their purpose was never actually to care for disabled people.

One of the common questions I am asked about abolishing the police is what will happen to people who are in crisis—usually they mean mental health crisis—if there are no police. I can’t help but notice that often the question is framed in a way that makes clear that the questioner is not asking, “What will happen to me if I am in crisis?” but instead, “Who will keep the crazy people away from me?”

In a way, this is understandable. We have been taught that there is some “other” inherently dangerous group of “mentally ill” people that we need to keep ourselves and our communities safe from. (This is usually racialized too, of course.) But the disabled people whom the police are using these violent tactics on are not “them,” but “us”: your mom with depression, your child with schizophrenia, you after a future crisis.

One thing that makes disability unique is that any of us can become disabled at any time. We need to make sure we are thinking about these policies from the perspective of the safety of the most vulnerable person in the situation.

This isn’t a judgment on the knee-jerk reaction that has been culturally embedded in us. It’s a call to interrogate those reactions and to not make decisions based on feelings but instead on the actual impacts. To borrow from Mariame Kaba: I don’t care about your fucking feelings. I care what you are fighting for.

It’s important to understand that people with disabilities—including psychiatric disabilities—aren’t any more dangerous than nondisabled people. In fact, disabled people are three times more likely than nondisabled people to experience serious violence. Even if someone is having a severe mental health crisis, the major concern in the situation is much more likely to be suicide than homicide. You don’t need to be protected from disabled people; disabled people are the ones who need protection.

Also, not everyone with visible mental health disabilities is in crisis. Ableism tells us that to have any kind of disability is to suffer a horrible fate, when the vast majority of the negative consequences of being disabled come from society rather than from the disability itself. It is true that sometimes people are in crisis and need support, but police and other carceral interventions are not the answer, and they tend to make things worse. We need to build noncarceral services that are actually safe for people in crisis, whether from mental health issues or another emergency.

Finally, if we are in crisis, you should treat us like everyone else and help us if you have the capacity and ability to do so—like you would anyone else. Disabled people aren’t some separate species. We need housing and food and health care just like everyone else. If we are lacking necessary care, then the solution should be to get us care, not involve people who greatly increase the risk of violence.

The Police Make Things Worse

People with mental health and psychiatric disabilities are in special danger from police and are consistently targeted for arrest because the disabilities themselves are criminalized. Exhibiting symptoms of mental illness in public is enough to get someone arrested. One of the many reasons that people without homes are especially at risk of being arrested is because of the inability to have their symptoms in private. In most places, the police are the entity designated to respond to mental health emergencies, and we have been conditioned to think that they will help the situation. However, the police can only make things worse.

The police don’t defuse situations, they escalate them. The only thing they are capable of doing—aside from committing overt violence—is arresting someone or bringing them to the emergency room. That’s literally it. Well-meaning people sometimes call the police because they want to get someone “help,” but often the reason the person is in crisis in the first place is because of the lack of health care, and calling the police just puts them in a position where it’s even harder to get care. In other words, the problem is not solved with police, it’s solved with resources.

Dealing with Violence Without Police

Even though it’s a myth that disabled people are more violent than nondisabled people, sometimes there are situations that are potentially violent even in the absence of police. Gisela Sartori, who started Second Opinion Society (SOS), a Canadian house for people in mental health crisis founded on noncoercive principles, has on-the-ground experience. In Call Me Crazy: Stories from the Mad Movement, she says:

People ask, what if someone comes in who’s really angry and wants to hit people? Our answer is that we will give them lots of things they can hit. We’ll tell them they can hit things and throw things against the walls in this room, but that they can’t hit people.

In four years of existence, no one has ever been violent at SOS. Once, someone came after me with a butcher knife. And I said, very clearly and calmly, ‘Put that knife down.’ And that was it.

Situations like this sound (and can be!) very scary, especially if you don’t have experience with this stuff. However, most of the people I know who have spent time either on the streets or in direct service would be able to handle a situation like this in a way that deescalates the situation and leads to greater safety for everyone.

Not so the police.

When the police are called, the absolute best-case scenario is that they act as a taxi to take someone to get “help” without arrest or injury (but inevitably with trauma). In the United States, this almost always means the emergency room (ER), which has itself become criminalized.

Like a terrible lottery, each trip to the ER increases someone’s chances for law enforcement contact. Many hospitals have their own police or employ local police or security. As legal scholar Ji Seon Song has detailed, it is a terrible combination that the place where people go when symptoms may be flaring is also somewhere that is under constant police surveillance.

Since disabled people will disproportionately require medical care, we are also disproportionately affected by the criminalization of the ER. Poor disabled people of color are especially at risk of being arrested, which is not only unjust but also adds yet another barrier to accessing healing. Accessing care in the ER necessarily means being surveilled during the notoriously long time that you usually have to spend in the waiting room. Since people with private health insurance can usually get care outside of the ER—including preventative care that reduces the need for the ER—as usual the surveillance burden and therefore risk of arrest is on the most marginalized. Disabled people are not more “criminal” than other people, they are just surveilled more.

Suicide Prevention

A huge part of emergency mental health is suicide prevention, but suicide prevention cannot be relegated to only emergencies. It needs to be part of the fabric of everything we do. In other words, part of suicide prevention is making sure that people have enough money to live comfortably, have housing, and have access to any medical or therapeutic services that someone wants. Suicide prevention goes beyond keeping people from literally killing themselves, but also means giving people what they need to live and thrive.

Suicide is the leading cause of death in jail, so abolition itself is suicide prevention. Prison and jail are created to deteriorate mental health, and corrections officers often make this worse. Our system not only puts people in situations that create and exacerbate suicidality, it dehumanizes (overwhelmingly) multiply marginalized disabled people to such a point that their lives are seen as having no value at all.

The central suicide resource in the United States is what is now called the Suicide and Crisis Lifeline. Whenever someone is struggling with suicidality, the main (and usually only) resource or advice given is to call or text the lifeline. It’s become so widely relied on that recently the government made it easier to access by allowing callers and texters to connect by dialing just three numbers: 988. While this may sound like a positive development, policies often do not do what they claim to do. You need to look closer.

One huge problem with this arrangement, which the lifeline doesn’t publicize much, is that it sometimes calls the police on people. I worked at my local branch of the suicide hotline for a short time about six years ago, when it was called the National Suicide Prevention Lifeline. We were instructed that if we thought someone was in imminent danger of killing themselves, then we should try to get their address or use their cell phone information to call their local police and send them to the person.

During training at the hotline, I brought up the fact that the police do not respond equally to different people and was immediately dismissed. I cannot speak to now, but at least at that time the well-known biases of the police against both people of color and disabled people were not discussed. Neither was the fact that people involved in the criminal legal system are much more likely to kill themselves. Calling the police on suicidal people just puts those people in situations that are proven to increase the likelihood of suicide.

A suicide hotline is a good idea theoretically, especially because suicide is often impulsive and a big part of acute prevention is distracting someone until the most destructive feelings pass. However, we can’t rely on these carceral options run by people who think they know better and are not accountable to the communities they are “serving.” Oftentimes, leadership refuses to engage in these conversations and just publicly minimizes their use of the police instead of talking to those of us concerned about why we think it is such a bad idea. (Some suicide lines don’t call the police, such as the Trans Lifeline.) I’m not saying you should never use these services if you are comfortable with the risk, but people should be fully informed about all consequences to their actions, whether they are in crisis or not.

Mandated Treatment

Another way that disabled people are targeted by carceral systems is that they can be incarcerated without even being charged with a crime. Though the specifics of each state’s laws differ slightly, every U.S. state has some kind of “mandated treatment” law. A common form of mandated inpatient treatment is colloquially known as a “5150,” after the section of the California Welfare and Institutions law that allows psychiatric hospitals to hold people with certain disabilities involuntarily up to seventy-two hours without a hearing if they are deemed a “danger to themselves or others.” Under the California law, “grave disability” alone is justification to hold someone. The seventy-two-hour hold can be extended an additional fourteen days if certified by the facility. Though patients are entitled to a hearing, it is an “informal” one, and they are represented by a “patient advocate,” not a lawyer. I focused on California because 5150 is so well known, but other states have similar laws.

Because these laws explicitly focus on people with mental health disabilities, certain diagnoses mean that someone is perpetually at risk of losing their freedom. While these laws are theoretically to help disabled people, they just lead to more harm. One problem is that the places where people are held are not healing and often lead to more issues long term. Being held somewhere against your will is inherently traumatic.

The purpose of these laws is not to protect or heal disabled people, but to give the state a way to incarcerate them. But incarceration doesn’t make anyone safer. This also gives doctors and other medical professionals a pseudo-state power, since they are the ones doing the diagnosing, making the decisions as to whether someone should be held, and writing the reports that the courts use to make their decisions.

Another problem with these laws is that while you are being held, you don’t get much say in the medications you are given and can be medicated against your will. In We’ve Been Too Patient: Voices from Radical Mental Health, Jeffrey Goines writes about being forcibly restrained and medicated in the hospital:

It was a horrifying situation—I was surrounded, restrained, and bracing myself for the inevitable. I didn’t hear the order, but I knew what was coming. They stuck me with a hypodermic needle attached to a syringe filled with Haldol. Haldol is a miserable first-generation neuroleptic (a.k.a. antipsychotic), whose short-term side effects include hallucinations, sedation, drooling, compulsive pacing, diarrhea, and muscle aches. I had pleaded with the doctor and nurses to take the medication orally, since that would have cushioned the anvil-like impact of the drug on my mind and body. I knew about the federal statute mandating that patients who are willing to take medication orally can’t be forcibly injected, but the law didn’t protect me that night. I was left on a stretcher writhing in restraints as the delusional psychosis of the antipsychotic set in.

Forty-seven states also have so-called “assisted outpatient treatment” laws that allow forcible medication of disabled people even in the absence of incarceration. However, studies have found that these laws don’t improve outcomes and are based on false assumptions.

No one should be forced into treatment. Just because someone is disabled does not mean that they should not have the same right to self-determination and bodily autonomy that nondisabled people have.

Peer Services

Along with getting rid of coercive policies, we also need to develop noncarceral ways to support each other. One option is to create and invest in true peer services. I hesitate to even use the word “peer” in this context because it has become so “professionalized,” but when I say “peer” I mean that no one necessarily has more formal education than another person. If one person is getting paid to be there and one person is not, they are not peers. In the landmark 1977 book On Our Own: Patient-Controlled Alternatives to the Mental Health System, Judi Chamberlin explains the importance of patient-led alternatives:

Patient-controlled alternatives can provide services to people without the demoralizing consequences of the authoritarian, hierarchical structure of traditional mental health services. When the emphasis is on people helping one another, the gulf between ‘patient’ and ‘staff’ disappears. Someone can seek help from others without being thought of as sick or helpless. The same person who seeks help can also offer it.

Care facilities are almost always hierarchical, with the providers having much more power than the patients. Some may argue that this is necessary because the health professionals have expertise that patients don’t. However, this ignores the knowledge that comes from living in a disabled body. It sets up a disempowering dynamic in which patients are not listened to because only the nurses and doctors are seen as having worthwhile knowledge.

Chamberlin helped to create the Mental Patients Association (MPA). The MPA was a group of ex-patients who came together to run an organization that later opened residences as well. Chamberlin explained the framework of the residence: “Decision making is in the hands of the residents. This includes not only trivial day-to-day decisions—what should be served for dinner, for example—but also major ones. Prospective new residents are accepted into the house by the vote of current residents.”

Chamberlin stresses the importance of real decision-making power and calls out organizations that allow participants to make only surface decisions, like what movie to watch, or allow participants to “interview” applicants but give them no actual decision-making power. The noncoercive aspect of the services is an important part of them, as is the disabled-led approach. This is a great example of one of the tenets of disability justice: leadership by the most impacted. Unfortunately, after a lot of great work, the MPA closed due to financial issues.

It’s important to note that it doesn’t matter what resources are possible if an organization can’t remain open. People talk about defunding the police and putting that money into services, and I agree, with the caveat that we need to look very closely at these services and consider them using the principles of abolition, disability justice, and the other liberatory theories we have available.

Caretaking is hard, but we are all already doing it every day in big and small ways for each other, disabled and not. It is also a skill, and you do need to have certain knowledge to do a good job, but this information can be taught to people who may not be able to jump through the artificial hoops of the education system.

I would go a step further and say that the opportunity to take care of someone can be a reward in itself. While caretaking is incredibly stressful, it can also be very rewarding and generative for people. No one is obligated to give more than they can, just as we are able.

Informal Community Support

Many of the people in my life (including myself) have intense struggles with mental health and fear that the only way to get the care we need is to go into the hospital, which always involves at least some trauma.

One of the things I do to help friends in mental health crises who are trying to stay out of the hospital is to help them figure out what they need that the hospital has and to see if we can create that in a noncarceral setting where they are in control. If it’s the monitoring they need, then we can set up a plan for that. If it’s a change of medication, we can help them get and attend an appointment. If it’s someone to be available to talk to, we can do that. If it’s a rest (which is common under capitalism!), then maybe we can crowdfund a short vacation.

Of course, this does require having a community of people who are able and willing to assist you in these ways, which a lot of us don’t have. My disabilities make me feel so isolated, and I don’t necessarily have people I can count on to do these things for me. It’s OK if you don’t either. This is just one of the infinite tools we have or can create.

I’m not saying that people should never go to the hospital, especially if that is what they think is best and they are making that decision on their own. Likewise, everyone should have access to culturally appropriate therapists educated in our modalities of choice. We should also have access to therapists who look like us and have had life experiences similar to ours. I like therapy and get a ton out of it. Other people choose not to use it or will engage at certain times and not others. Similar to medical care, just because it is based on the medical model doesn’t mean we shouldn’t engage with it when it can be helpful (as we define it) for us. Further, people need to be able to talk openly about suicide without fear of being locked up.

Police and prisons soak up so many resources that it’s hard to even imagine how different the world could look if those resources were devoted to keeping us all actually safe, instead of creating the illusion of security for some at the expense of the safety of others. We always need to remember that we don’t need to settle for the systems that currently exist. We can make our own.

Excerpted from A People’s Guide to Abolition and Disability Justice by Katie Tastrom. It appears here with permission from PM Press.

_{Image: Matheus Ferrero/Unsplash/Inquest}

Contributors

Katie Tastrom Katie Tastrom is a disability justice activist and writer who has worked as a lawyer, social worker, and sex worker.

Topics

• Decarceral Pathways

Tags

• abolition
• bookshelf
• disability justice
• disability rights
• mental health
• police violence