Palliative states: migrant advocacy and necrocapitalist care in Canadian mental health services
Creators: name: Tam, Louise
Publisher: name: No Publisher Supplied
Year: 2023

description: The following exploratory project problematizes mental health support as a site of equitable social change through mapping the organizational relations of migrant mental health interventions in Canadian immigration law and social services. Increasing numbers of advocates and activists enter the mental health professions to support precarious migrants in “frontline work.” Frontline service provision is romanticized by the political left without questioning for whom and from what agenda mental health policies, programs, and services operate. In Palliative States, I answer the following questions: What are the frameworks, tools, and outcomes of progressive psychiatry, psychology, and social work? How are professional advocates’ social justice and anti-oppression politics institutionalized and redirected by Canadian state-funded mental health care? Drawing on institutional ethnographic interviews with psychiatrists, legal professionals, and community mental health workers, this dissertation claims mental health interventions are palliative, providing necrocapitalist care that ultimately consigns migrants to exploitation, disablement, incarceration, and premature death. “Palliation” describes a form of reasoning, mode of intervention, and experience of subjectivation, which together form the ideological state apparatus I call the palliative state. Palliation is a capitalist ideology towards mental health care that delivers austere social support masquerading as welfare. Palliative techniques include mitigation, comfort, and distraction, which temporarily suspend suffering and death. Finally, palliation is a type of consciousness. Foremost of these is “salvage mentality,” or the traumatic response to resuscitate life through system navigation and emotional adaptation, optimizing capitalist systems. Chapter One theorizes salvage mentality as leftists’ workaholism, defeatism, and deferral of social change. It also historically situates salvage mentality within Black, Indigenous, and racialized professionals’ calls for reparations from the settler capitalist state. Contemporary state-funded Indigenous and multicultural mental health initiatives promote individual capitalist survival under the guise of social security and well-being. Through a historical materialist analysis of qualitative interviews, organizational literature, legislation, and case law, the remaining chapters investigate the outcomes of salvage work. In attempts to mitigate inaccessible immigration procedures, psychiatrists supply mental health evidence to help secure status, a strategy stymied by the government’s ongoing interdiction of specific refugees. Chapter Two examines psychiatrists’ self-perceptions of their usefulness to argue that the power of mental health report writing has been overstated. Psychiatrists’ sensitive assessments and hyperproductive report writing mediate migrants’ encounters with the state, restoring faith in Canada’s immigration system. Chapter Three demonstrates how mental health reports are palliative distractions undercut by race-specific policies. These include the Canada–U.S. Safe Third Country Agreement (since 2004), Designated Country of Origin system (2012–2019), and Nigeria Jurisprudential Guide (2018–2020). Finally, in efforts to ease the anxiety and depression of newcomers, social workers comfort and shield landed immigrants from distress, helping them accept or overlook employment discrimination, unfair working conditions, and racism. Chapter Four argues that social workers adopt a mental health recovery model towards oppression that builds migrants’ resilience to psychologically overcome oppression, thereby acculturating migrants to poverty. As forms of palliative maternalism, validation, hope, and ignorance work as psychological breakwaters that can inadvertently decapacitate and debilitate migrants.