Description
Book SynopsisThis book is an incisive and compelling portrait of the functioning—and failings—of California’s conservatorship system, drawing on hundreds of interviews with professionals, policy makers, families, and conservatees.
Trade ReviewA heartbreakingly insightful ethnographic deep dive into the failure of mental health care in the United States that everyone refuses to pay for—and for which no public authority takes responsibility. Barnard strategically takes us through each dysfunctional interstice of California’s iconically mismanaged mental health system that manages to maximize costs, minimizes benefits, and tortures everyone involved—especially people with psychosis spectrum disorders whose lives are cut short by the public/private bureaucratic quagmire that has been waging war on itself for the past half century. -- Philippe Bourgois, author of
In Search of Respect: Selling Crack in El Barrio and co-author of
Righteous DopefiendVivid case studies and probing interviews humanize this journey through the fraught terrain of involuntary care. Barnard pulls few punches in describing the more offensive stretches of the roadmap but avoids veering into unalloyed condemnation or praise. His thoughtful exploration yields reasons for hope that our better angels might prevail. -- Roderick Shaner, MD, former medical director of the Los Angeles County Department of Mental Health
The subject and title of
Conservatorship is perhaps the most important yet least studied power of domestic governance. As Alex Barnard's meticulous study of California’s system for protecting those most disabled by mental illness shows, this power is left to a largely unaccountable and invisible system of local and market actors. At a time of much interest in new legal solutions to our severe crisis of unhoused, untreated, and mentally ill citizens, Barnard’s findings suggest the priority of addressing our even deeper crisis of authority. -- Jonathan Simon, author of
Governing Through Crime: How the War on Crime Transformed American Democracy and Created a Culture of FearIn California, the state has abdicated its authority over the conservatorship process by delegating state functions to a fragmented field of actors. Cutting through overly simplistic accounts of conservatorship, Barnard uses rich data and sharp theory to delve into the pitfalls of this abdication of authority. -- Josh Seim, author of
Bandage, Sort, and Hustle: Ambulance Crews on the Front Lines of Urban SufferingConservatorship delivers the kind of critical analysis that...would require California politicians, more comfortable with increasing budgets than investigating outcomes, to expose themselves to more blame. * City Journal *
I recommend this very comprehensive book to anyone who is interested and ultimately frustrated by how our state has failed so many it purports a desire to help. * Southern California Psychiatrist *
Table of ContentsPreface
Introduction: The Other Magna Carta
Part I. The Conservatorship Continuum1. Outpatient
2. Crisis
3. Emergency Room
4. Inpatient
5. Public Guardian
6. Court
Part II. Care and Coercion Under Conservatorship7. Locked In
8. Stepped Down
9. Neglect and Abuse
10. Stabilization and Recovery
Part III. Reform11. Paving a New Pathway
12. Asylum for the Dying
13. Sharing Authority, Restoring Autonomy
Conclusion: Beyond Miracles
Methodological Appendix
Chronology of “Abdicated Authority”
Glossary of Terms, Procedures, and Facilities
Acknowledgments
Notes
Index
