The Prescribed-Only Clinic: Mental Health Care and the Logic of Control in Taiwanese Prisons

• In Event: Sociology of Mental Health Section Open Call Paper Session

Abstract

This paper examines the transformation of clinical practice within the Taiwanese prison system, an institution where the concept of "humanity" is routinely tested by overcrowded carceral settings and punitive drug policies. Based on twenty months of ethnographic fieldwork across multiple prisons and forty-two in-depth interviews with correctional officers, medical staff, and formerly incarcerated individuals, I argue that the prison’s logic as a "total institution" co-opts clinical practice, repurposing mental health care as a strategic tool for institutional management.

Findings reveal that the primary objective of psychiatric intervention has shifted from therapeutic healing to the maintenance of "inmate stability." This "order-first" mandate compels clinicians to navigate a landscape where psychiatric evaluations are redirected toward assessing institutional risk through "crime histories," and where they must manage "prison-made" illnesses—such as chronic insomnia—stemming from environmental deprivation and the loss of autonomy. Crucially, I show that clinicians do not necessarily neglect the suffering of the incarcerated by choice; rather, they face an "effect-less" reality in which they are powerless to intervene in the structural environment of the prison. Driven by high-volume demands and limited visit durations, the system side-lines social prescriptions and holistic care in favor of a purely pharmacological approach.

In summary, mental health care in Taiwanese prisons operates under a structural paradox where the duty to care is subsumed by the duty to control. By defining success as the absence of disruption, the institution effectively silences individual suffering in favor of bureaucratic equilibrium. This system manifests as the "Prescribed-Only Clinic"—a space where the complexities of the human psyche are reduced to a chemical management strategy, and where the prescription pad serves as the primary instrument for maintaining carceral order and silence.

Author

• Ting-She Chang, National Taiwan University