Alex Vosick Barnard

Analyzes, based on interviews with government actors, public defenders, and clinicians in over twenty counties in California, the use of legal guardianship ("conservatorship") to obligate gravely disabled individuals into care. Reveals the way that the conservatorship process excludes individuals with co-morbid substance abuse, criminal justice contact, or histories of violence, exacerbating the problem of homelessness in the state.

Notes despite the closure of the majority of public psychiatric beds since the 1960s, involuntary hospitalization remains a key moment in the trajectory of many people with severe psychiatric illnesses through the public mental health system. Draws on observations of hundreds of judicial hearings to decide on the continuation of involuntary care to show why hearings contribute to deepening a patient's embeddedness within the public mental health system in Paris while exacerbating their chaotic trajectory between hospitals, jails, and the street in New York.

A 2005 reform to France's disability system sought to provide new services and supports to help people living with severe mental illness live independently in the community. Based on months of observations and interviews in a French disability office, the paper shows how the decision-making tools and heuristics used by disability bureaucrats nonetheless excluded this population from many of the benefits to which it was entitled.