The Co-Production of Confinement and the Psychiatric Government of Suicidality – Ethnographic Insides in the Practical Accomplishment of Involuntary Hospitalizations in Germany

On the empirical basis of a six-month ethnographic research (including participant observation, ethnographic interviews and document analysis, especially of patient files) on acute psychiatric wards in three different psychiatric hospitals in Germany, with a focus on the making, decoding and handling of suicidality, this talk will examine the co-production of psychiatric confinements through various agents.

In theory, regarding the German laws for the 24-hours or the long-term involuntary commitment, the authority over the decision lies alone in the hands of psychiatrists for short-term, and in the hands of local district judges for long-term hospitalization. In practice, there are many living and non-living agents from inside and outside the institution involved in the decision-making process. What is more, there are a lot of claims about the use, misuse and abuse of those laws through different parties (patients who are said “to pull the suicide-ticket”; doctors or judges who are interpreting the law from their conservative, “paternalistic” or liberal, “irresponsible” stance; families, police and retirement homes who are said to “deport” uncomfortable members; etc.). At the core of this talk are the socio-material entities (architecture of the ward; laboratory tests; psychopharmacological medicines; bodily signs; dangerous materials such as pills, ropes, broken glasses), which might configure, mediate or disrupt the production of involuntary hospitalizations as well as the question, how do they co-produce psychiatric confinements?

The co-production of confinement (with all the possible mis-usages of mental health law) might be analyzed as part of a medicine-political technology of prevention and intervention, which serves the regulation and government of risky, deviant and, in this case, suicidal bodies. It produces and structures a field of possibilities through which suicidality becomes an individual, psychiatric and manageable problem.