TY - JOUR
T1 - Bureaucratically split personalities
T2 - (re)ordering the mentally disordered in the French state
AU - Barnard, Alex V.
N1 - Funding Information:
The author gratefully acknowledges the assistance of Martin Eiermann, Gil Eyal, Neil Fligstein, Marion Fourcade, Matty Lichtenstein, Michael Long, Mara Loveman, Marie Mourad, Isabel Perera, Gisele Sapiro, Tonya Tartour, two anonymous reviewers, and the Theory and Society Editors, as well as the Culture Organizations and Politics Workshop, Berkeley Medical Sociology Working Group, the Berkeley-SciencesPo Collaboration Conference, the Columbia Science Knowledge and Technology Working Group, and the Center for European Sociology. A version of this article was presented at the 2017 ASA Annual Meeting in the Regular Session on Health Policy. Research was made possible with the generous support of the Chateaubriand and Georges Lurcy Fellowships and the Institute for International Studies and Center for European Studies at Berkeley.
Publisher Copyright:
© 2019, Springer Nature B.V.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - The ability to (re)classify populations is a key component of state power, but not all new state classifications actually succeed in changing how people are categorized and governed. This article examines the French state’s partly unsuccessful project in 2005 to use a new classification—“psychic handicap”—to ensure that people with severe mental disorders received services and benefits from separate agencies based on a designation of being both “mentally ill” and “disabled.” Previous research has identified how new classifications can be impeded by cultural and cognitive barriers to their adoption and struggles between professionals or administrators over their implementation. Drawing on 186 interviews, archival sources, and 13 months of observations across different French bureaucracies, I expand on this literature in two ways. First, I use the case of psychic handicap to argue that a new classification can also fail to achieve its intended effect when it constitutes a bureaucratically split personality—a combination of classifications that imply that individuals belong to two, mutually exclusive kinds of people. I show how psychic handicap embodied contradictory expectations about the behavior, characteristics, and institutional trajectory of people with mental disorders. Second, I identify how bureaucrats resolved these contradictions through mechanisms of refractory looping, outsourcing expertise, and classification by default, which in this case led to the reclassification of this population as simply “mentally ill.” This framework calls attention to how practical inconsistencies can limit the impact of new classifications, even absent overt resistance to their elaboration or implementation.
AB - The ability to (re)classify populations is a key component of state power, but not all new state classifications actually succeed in changing how people are categorized and governed. This article examines the French state’s partly unsuccessful project in 2005 to use a new classification—“psychic handicap”—to ensure that people with severe mental disorders received services and benefits from separate agencies based on a designation of being both “mentally ill” and “disabled.” Previous research has identified how new classifications can be impeded by cultural and cognitive barriers to their adoption and struggles between professionals or administrators over their implementation. Drawing on 186 interviews, archival sources, and 13 months of observations across different French bureaucracies, I expand on this literature in two ways. First, I use the case of psychic handicap to argue that a new classification can also fail to achieve its intended effect when it constitutes a bureaucratically split personality—a combination of classifications that imply that individuals belong to two, mutually exclusive kinds of people. I show how psychic handicap embodied contradictory expectations about the behavior, characteristics, and institutional trajectory of people with mental disorders. Second, I identify how bureaucrats resolved these contradictions through mechanisms of refractory looping, outsourcing expertise, and classification by default, which in this case led to the reclassification of this population as simply “mentally ill.” This framework calls attention to how practical inconsistencies can limit the impact of new classifications, even absent overt resistance to their elaboration or implementation.
KW - Boundary objects
KW - Bureaucratically split personalities
KW - Classification struggles
KW - Psychiatric diagnosis
KW - Psychic handicap
KW - The French state
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U2 - 10.1007/s11186-019-09364-2
DO - 10.1007/s11186-019-09364-2
M3 - Article
AN - SCOPUS:85074335697
VL - 48
SP - 753
EP - 784
JO - Theory and Society
JF - Theory and Society
SN - 0304-2421
IS - 5
ER -