This year, on Access Awareness Day, Pivot is picking up the theme of “Inclusion Starts Here” to highlight how accessible and inclusive communities don’t rely on police violence or carceral interventions disguised as benevolent care. I’ve interviewed Vesper Moore, who is working in the US and internationally to advance the perspectives of Mad, disabled, and psychiatric survivors.
Vesper Moore is an Indigenous political activist of Kiskeia and Borikén Taíno descent. They are a leader, organizer, public speaker, and educator in the psychiatric survivor and disability rights movements. They are based in so-called Massachusetts, Nipmuc territory and homelands. Vesper is currently a board member at the Bazelon Center for Mental Health Law, the National Association for Rights Protection and Advocacy, and MindFreedom International. They are also a member of the Massachusetts Special Commission on State Institutions and the Chief Operating Officer of Kiva Centers.
Headshot of Vesper Moore via vespermoore.com
Last month, after the public execution of Jordan Neely on an NYC subway, Vesper co-authored a piece for TruthOut, entitled “Psychiatric Incarceration Isn’t Treatment — It’s Violence, Survivors Say.” Excerpt from the TruthOut Op-Ed:
“In a setback for the already precarious rights of these marginalized and oppressed vulnerable groups, cities and states across the U.S. are making it easier for cops and medical authorities to disappear Mad, disabled and unhoused people from the streets.”
In this interview, we talk about their systemic analyses that relate to psychiatry, disability justice, capitalism, and liberatory frameworks that keep people safe.
Deinstitutionalization didn’t cause the crisis of houseless people we see today. And re-institutionalization won’t fix that issue. Disappearing mad disabled people is a sanism issue we need to name and fight against as a society.— Vesper Moore (@MooreVesper) January 19, 2023
Note: This interview with Vesper has been edited and condensed.
Meenakshi (MM): Vesper, how would you define sanism for people unfamiliar with that term?
Vesper (VM): Often people operate under the guise of mental health stigma; but people don't think about historical discrimination on the basis of identity and being perceived as both “dangerous” and “incapable,” which Mad people face in our society.
I think that that's very critical. When we talk about the intersection, for Mad people in terms of disability rights, it's different because we're perceived as dangerous. And that danger has an impact on how people understand us in terms of defining sanism.
I like to kind of work from the definition of ableism which defines sanism as a system of assigning value to people's minds, based on societally constructed ideas of normality, productivity, desirability intelligence, excellence, and fitness. These ideas are, are deeply rooted in eugenics, anti-Blackness, misogyny, colonialism, imperialism, and capitalism.
Systemic oppression leads to people and society determining people's value based on their culture, age, appearance, religion, birth or living place, and through the guise of health and wellness or their ability. It's that idea of “Can they excel, can they behave in this way?” It also can lead to like criminalizing and incarcerating Mad, neurodivergent, and disabled survivors. That's how I would define sanism: a system that assigns value to people's minds as a societally constructed idea of normalcy.
MM: How does this specifically impact Black, Indigenous & other racialized folks?
VM: When we think about Mad people in our society, it's at the intersection of Mad people being dangerous and unable. When you think about how Black, brown, and Indigenous people are perceived and understood to be dangerous - because of systemic racism, white supremacy, and colonization - you can hink about what is considered conventional or normal is often a euphemism for what is considered white, cis, or acceptable in our society.
When you think about Madness in this way, anything that goes against that convention is Mad. It is subverting and defying the paradigm of how we understand acceptable behavior in our society, including acceptable dress, acceptable way of carrying ourselves and behaving in a space. This means true and authentic connections where anger, sadness, emotions, and altered states - understood as ways of processing trauma that's deep in the bodymind – are suddenly understood as unacceptable.
There is an extra layer, when you are Black, Brown, or Indigenous – about whether you can authentically express yourself without the fear of being murdered in public or in institutions.
MM: Right now, across so-called canada, there is intense politicization about unhoused people, also labeled as “mentally ill.” Can you speak to how poverty intersects with sanism? As we both know, there are people who experience mental distress, altered states, or psychosis across class lines; what is unique to how people who are living in poverty?
VM: Well, if we think about sanism as a system that puts a valuation on our productivity we see that unhoused people, poor people, and people with many different life experiences that relate to poverty, you see that our society will only provide and allow resources to be available to someone who can effectively produce and who can effectively move towards that end, to be able to produce and behave a certain way, within a certain timeframe, right.
What is the intersection there? I mean, we don't talk about stuff like this enough, but the impact of water pollution, and its impact on Black and Brown neighbourhoods. If the only water that is available to you is polluted water, that leads to different struggles in the body, and in physical health. Of course, you're going to feel emotional distress as a result.
Or food - having access to food is often governed by an institution, like a food bank. You have to fill out these forms, instead of just having food readily available in a way that is governed by the community, like community fridges, for example.
Vancouver Community Fridge – 4040 Victoria Drive Alley| April 8, 2021
MM: This is so basic. I’m struck, as someone trained in social work, by how people fixate on this idea of “clinical practice" or other interventions that suggest medical superiority when people’s needs are so universal - food on their own terms or eliminating exposure to environmental racism.
VM: There's this consistent idea of layered policing. It's important to emphasize here that when we're talking about clinicians, we're talking about social workers, we're talking about militarized law enforcement, and the court system. These are institutions that have been designed to keep the colonizers and their institutions intact. From the very beginning, by design, these systems do not incorporate Indigenous people who have ancestral ties to these lands, or the folks who may consider these lands home to them, having immigrated to these lands or brought to these lands because their ancestors were enslaved.
When we're talking about clinicians – whether white, brown, or Black - we're talking about systems of oppression that are designed by colonizers in these lands, including the power struggle of determining "effective” practice. This is rooted in what is acceptable and “evidence-based,” but I have heard critique of that term - evidence-based as a euphemism for being properly vetted by white supremacist institutions. That includes clinical practice and social work.
When we talk about mutual aid, community-run initiatives, peer support, or when we talk about social movements, and communities supporting each other from their own perspective for journeys of healing, we're talking about communities governing that process. Historically, this happened in communities for hundreds and hundreds of years. We're talking about human beings, in a very mutual way, supporting the sustainability of each other without the oversight of an institution
MM: Even within neoliberalism and austerity, governments constantly choose violent, resource-intensive interventions. They're just doing this out of cruelty. Cruelty is the point. Which brings me to policing - can you talk about how policing reinforces sanism?
VM: In terms of cops, and law enforcement, we have a system of militarized law enforcement. I want to emphasize that they are being militarized, in a reactionary position, to respond.
And again, the roots of these institutions are to maintain the authority of white people, primarily white men in our society. So, by design, when you have unhoused, people who are who are just existing and living in a way that is deemed unsightly by our society or people at the intersection of Madness, unsightly, and “unacceptable” behavior, there's an immediate instinct to send the cops to remove them.
There are long histories of this – like the Ugly Laws. I think Ugly Laws stopped being in effect formally in the 1970s, but there are current manifestations that target poor and unhoused people, disabled people, and Mad people deemed unsightly. They are removed from the public or ordered off the street. The cops have historically physically and mentally enforced that removal. You have that forceful physical removal, and then you have social workers convincing parents that it's in their best interest to take their children away, particularly Black, and brown children. You have clinicians who do the same. Then they incorporate the aspect of maybe you need to not live in the community, and you need the constant 24/7 care in an institution, right? Where they're billing for each bed that is full.
Going back to layered policing, you have different roles here, right? You have cops who, historically, have always been in that role of physically removing someone and often killing, and harming unhoused and Mad people and disabled people.
MM: This is getting into important intersections - the physical force of policing also undergirds the interventions of other layered policing agents, like social workers, nurses, and psychiatrists. Do you think that is apparent to the general public?
VM: I don't think so. Most people can recognize physical force, a lot more than they recognize other forms of policing. People generally are like, “Oh, well, you know you physically harmed that person; that person is bleeding, their arm is broken, this has happened to them...” It's very striking and apparent when it's a white cop harming a brown or Black person.
When we are talking about the medical industrial complex and the mental health industrial complex, we are also looking at forms of policing that have been designed for social control, specifically of people who have been deemed socially deviant and socially unacceptable. The key difference here is you have convinced a society, built on a system and institutions of sanism. These institutions enforce the idea that the right thing to do is to put a person away because they are “dangerous.”
The public lynching of Jordan Neely on that subway was deemed acceptable because people thought, we needed to defend people from this dangerous, autistic person. Those were the headlines - news platforms calling him “unhinged,” “mentally ill,” and “dangerous.” Then you have an apology-non-apology from Daniel Penney, and he claims he acted to protect himself and other subway passengers. All these actions were deemed acceptable because Jordan Neely is a Mad person, Jordan Neely is an unhoused person. They're not producing something of value that is considered valuable by capitalism, even though their value is inherent for simply being alive, being a human being. Jordan Neely was a brilliant performer.
We have reached this point, when you are labeled unstable, your value is removed in the eyes of society.
Noise Demo outside CSC Pacific Institution / Regional Treatment Centre | May 24, 2020
MM: It’s hard to accept that carceral approaches to psychiatry are still misunderstood as compassionate, despite numerous studies, Inquiries, and state redress. There is ample evidence about the harms of involuntary treatment or police-based wellness checks.
VM: We have this misconception in our society, where carceral psychiatric interventions are viewed as failsafe. There’s a turn towards these institutions – even in social movements we see prison abolitionists, movements for Black Liberation, and LGBT rights turning to carceral psychiatric interventions. Because we have come to understand this packaging: you are vulnerable, seek mental health treatment.
We don’t often think about these interventions as part of an industry that is trying to keep rooms in institutions full. It is an industry that is trying to sell a lot of these substances - psychiatric medication. As an industry, it must keep people's attention and keep people within it, just like any other industry within capitalism. People are still stuck in that thinking about vulnerability and seeking mental health treatment, searching for empowerment and mental wellness. People don't think about the human rights of the people who are trapped in that industry, or who are profited off of in that industry.
There are layers of oppression for people who have been impacted by psychiatric intervention. A multi-layered expansion of involuntary commitment is sweeping unhoused Mad, disabled people off the streets.
This industry was not built with keeping people alive in mind. Or keeping them in the community. When we talk about involuntary commitment or Ugly Laws, we are talking about people who are deemed unsightly. These institutions have always been used to put us away. There’s a long and very open disability history of how these institutions have treated people terribly.
When we talk about the mental health industry and people being Mad, the conversation changes. It's like, “Whoa, wait a second. We need these facilities to force people to stay alive. We need these facilities to make sure that they're not disrupting our street festival...” It comes down to an intensive class issue.
Detail from a Smokey D x Grow Up Mural at 312 Main Street | August 1, 2022
MM: The last thing I wanted to chat about was inspiring work you have come across – in the US or globally. What are some liberatory frameworks or inspiring models that you have seen?
If we operate with the current financial systems and institutions that we have, within capitalism, we're always going to have harm. But there are community-run initiatives that inspire formalized approaches to really intervene in police situations and a lot of other situations. There are projects that bring forth community care, in a way that is governed by disabled people, psychiatric survivors, and Mad people alike.
Our nonprofit Kiva Centers does it, through peer-run respites, Karaya and Juniper. We have one in Worcester and one in Bellingham. These are places people can go instead of a psychiatric hospital or institution, and they are often utilized as a resource to get people out of acute mental health units. We've supported 762 people since 2021. That's a lot of people. Over the last three years, people have been trapped in institutions due to COVID. We used to have an understanding with state hospitals in Massachusetts, that people could come to our centres during the day and then go back to the institution in the evening. Then, the day-passes stopped. And they were trapped on their units. They were isolated. We said you can't just keep people trapped in there, they need air, space, and community outside of this place. So, it was instrumental to have peer-run respites. We’re also doing mobile peer respite, where it's not just at the houses, but we're going to people we are supporting when they are in crisis. Another inspiring model is Soteria House. These aren’t always peer-run but operate on a similar model. They are an alternative to hospitalization as well. Some other models that are mobile on the street, like Mental Health First from the Anti-Police Terror Project, and CAHOOTS In Oregon.
The commonality of these models is that they are designed by the community based on a need and a transparent recognition of the systems of oppression that are already in place. They don’t centre profit; they centre what the community needs. It's people living in that community who are coming together to design their approach. They try to partner with the existing initiatives and projects that have been built right, and then lean on each other to support the blossoming of an initiative that is truly community-run and community-created. That's an important piece, it’s not an agency or corporation coming in, telling folk exactly how to support each other, even though we don't know anything about you. That's the contrast: it must be designed and specialized within that community.
Vesper’s work and organizing have brought the perspectives of Mad, labeled "mentally ill", neurodivergent, disabled people, and survivors to national and international spaces. They have shaped strategies around trauma, intersectionality, and disability rights.
Inspired to take action?
Earlier this year, Pivot released our position paper, Involuntary Treatment: Criminalization by another name. In response to existing involuntary or carceral treatment, as well as the calls for expansion from politicians and lobbyists, we endorse supports and services that directly meet people’s material needs, built on a framework of consent, capacity, cultural safety, and peer leadership.
Join us and click below to support our position paper!
Involuntary treatment is a euphemism for coercive and forced medicalization.
Say NO to criminalization!
Forcing Drug Users into Treatment Is Wrong, Dangerous and Ineffective (May 25, 2023)
Tyson Singh Kelsall, Alya Govorchin & Lyana Patrick
BC and Alberta are contemplating forced treatment despite the lack of positive evidence.
Psychiatric Incarceration Isn’t Treatment — It’s Violence, Survivors Say (May 6, 2023)
Leah Harris, Liat Ben-Moshe & Vesper Moore
After the murder of Jordan Neely, NYC’s mayor doubled down on his plan to disappear those who “appear mentally ill.”
Care and Carceralism (April 18, 2023)
Ji Seon Song
Disentangling medical care from policing, prisons, and other punitive institutions remains an imperative – now more than ever
‘Layered policing’ expands police amid calls to defund (March 13, 2021)
Resource Guide (Primarily US-resources)
Curated by Vesper Moore
Using the law as a catalyst for positive social change, Pivot Legal Society works to improve the lives of marginalized communities.