Jessica Cooper, “At Wit’s End”

“At Wit’s End: The Ethics of Losing One’s Mind in San Francisco’s Public Mental Health Clinics”

This paper examines the ethical relation between the ways in which we imagine people to be in need of care and how we conceptualize domains available for political action. I draw on two years of ethnographic field work in San Francisco’s mental health court – a criminal court that aspires to turn the tides of mass incarceration by sentencing individuals whom the state considers to be mentally ill to court-monitored mental health care rather than a full prison term. Here, I focus on group therapy sessions for court clients at a local public mental health clinic during which clients and clinicians articulated different theories of personhood, care, and, consequently, justice. Generally, clinicians understood themselves to be helping clients to achieve mental health by teaching them to control their emotions in light of the everyday realities of extreme poverty and racism, while clients rejected a theory of mind in which emotions could be controlled in the midst of injustice. Yet, in the course of their months-long group therapy sessions, both clinicians and clients were forced to confront, in the course of care, interactions that exposed the limits of their expectations for personhood. Neither clinicians nor clients could sustain their orientations toward the ethics of care in light of homeless clients’ material needs. I argue that moments where expectations for minds and care bottom out and break down illuminate the ethical and political posturing of an analytical intersection care and theories of mind.