The Mariel Crucible: Psychiatric Dehospitalization between the U.S. and Cuba

• In Event: Histories of Psychiatry in Latin America: New Trends

Abstract

In October 1980, roughly one hundred Cubans, recently arrived in the Mariel boatlift, were transferred from resettlement camps to a separate building at St. Elizabeth’s Hospital in Washington, D.C. They would remain there for nearly fifteen years in a state of legal limbo. That intermediacy was in turn an echo and even amplification of the ambiguous status of Marielitos more broadly. The 1980 Cuban migration had precipitated a crisis of psychiatric infrastructure in the U.S., as resettlement officials struggled to find a place for those requiring long-term care. The stigma that had attached itself to the boatlift, plagued by allegations of the forced removal of criminals and mental patients from Cuba, did little to help their cause. Mentally ill migrants were left particularly vulnerable in the web of ad hoc care that had emerged out of psychiatric deinstitutionalization in the United States.



Nowhere were the tragic effects of this process more visible than at St. Elizabeth’s itself. An early riot set the terms for engagement, with INS officials effectively reconceptualizing the building as a prison. Allegations of the forced administration of psychiatric drugs proliferated. The fate of the Marielitos at St. Elizabeth’s would not be settled for over a decade, when many of them were relocated to prisons and halfway homes around the country. The Mariel boatlift—and the special building dedicated to it at the iconic hospital—thus offer a paradigmatic test case in U.S. dehospitalization, but also a cautionary tale about the human victims of psychiatric politicization.

Author

• Jennifer L Lambe, Brown University