'I'm Not a Vet, but I Know a Dog When I See One': Sociology of Detection

• In Event: Medical Sociology Section Open Call Paper Session

Abstract

Municipal and community stakeholders, such as housing inspectors, protective service workers, and landlords, invest extensive resources attempting to detect mental illness and deviance, particularly when it can affect public health and safety. While mental illness is theoretically under the jurisdiction of the healthcare system, in the context of deinstitutionalization, inaccessible mental healthcare, high housing costs, and social welfare retrenchment, the identification and management of the social consequences of mental illness are increasingly falling under the jurisdiction of street-level bureaucrats and other nonmedical stakeholders. Research in the medicalized governance of urban poverty highlights the role of these nonmedical stakeholders in managing community mental illness. However, this work is demographically focused on low-income persons who live in cities and mostly limited to visible behaviors that constitute public nuisance and self-referrals. Yet, how do community stakeholders detect the consequences of mental illness when they are less visible and spatially dispersed, though still potentially harmful to public health and safety? And what guides their decision-making? This paper explores a critical case—the identification and management of hoarding in Boston—to argue for the need for a sociology of detection. Based on 61 in-depth interviews with persons with professional and/or personal experience of hoarding; 19 months of ethnographic fieldwork; and administrative data analysis, I identify two typical paths to detection. Despite believing the many cluttered dwellings as indicative of mental illness, community stakeholders do not use diagnostic symptoms, such as the Diagnostic and Statistical Manual of Mental Disorders, in their assessments, nor does detection typically result in therapeutic treatment. Instead, stakeholders categorize individuals based on sensory data and underlying socioculturally derived criteria about what is acceptable, safe, and “normal” and use the punitive tools at their disposal to minimize the social consequences of the mental disorder: clutter.

Author

• Meghann Lucy, Montana State University