In Process is a blog series that highlights the activities and experiences of current archival studies students in the Los Angeles area. Check in every two weeks, for grad students’ insights and fresh perspectives on new and emerging trends, issues, and events in the field.
By Noah Geraci
Before returning to school, I spent several years working in disability and mental health services– my last job before starting my MLIS program was as a counselor for a community mental health agency in San Francisco. Combined with a personal interest in mental illness and disability rights, as well as academic interests in trauma, memory and marginalized histories, these experiences have led me to researching and writing about records of mental illness and mental healthcare in archives. How do we think about them? How are they currently arranged and described and accessed (or not accessed)? How might we do those things differently if we prioritized the autonomy and dignity of the people represented by them? For those who have passed, how might we, to borrow a phrase from Verne Harris, begin to take responsibility before their ghosts? What might we learn from community archives, human rights archives, and trauma and affect theory?
As I’ve started to pursue this research this year, I’ve sometimes encountered trepidation. One archival staff member warned me that anything from the twentieth century was a “hot potato” due to potential legal complications, and even some of the primary researchers of historical mental health records regard these materials as especially problematic. While healthcare privacy law (HIPAA in the United States) is certainly something to be taken seriously– as well, of course, as ethical obligations around privacy– it sometimes seems that the fear of making mistakes in handling these records has led to completely disengaging from them, and neglecting important histories.
I think the anxiety around privacy legislation does a couple of things: first, it forecloses on the possibilities of what we might understand as a “mental health record” by centering the clinical record that is subject to these laws. What happens if we broaden our idea of the record, as community archives practitioners and scholars often urge us to do? Materials like patient artworks, manuscripts and diaries, musical compositions, graffiti on hospital walls, belongings left behind at closed hospitals, physical spaces and buildings, online communities, zines, and oral histories all hold potential to provide a more thorough and nuanced view of the many facets of mentally ill and/or institutionalized lives than what is reflected in the clinical record alone. And while work with these records should still be subject to rigorous ethical reflection, they are generally not subject to the legal stipulations of HIPAA.
Second, I think the assumption that HIPAA means clinical records are untouchable erases the possibility of individuals having a stake in the disposition of records created about them, perhaps even desiring to make them public or creatively speak back to the records and recontextualize them. Remember that bumper sticker that says that feminism is the radical idea that women are people? Well, working ethically with mental health records requires a strong investment in the sadly still-radical idea that the people represented in them are people. Unfortunately, even some of the most recent and relevant scholarship in this area refers to patients as not possessing agency. People with mental illnesses are records creators and co-creators, archivists, and archives users.
A few projects that I think are doing an especially good job are the California Memorial Project, which holds remembrance ceremonies at state hospital sites and hopes to expand into doing oral history work; the Psychiatric Survivor Archives of Toronto, an independent community-based archives; and the Asylum Projects wiki, an exhaustive collaborative site with information about the histories of institutions of all kinds, as well as message boards where people have been able to connect about their experiences and provide research support. Another interesting place to visit locally is CSU Channel Islands: in its former life, the campus was the grounds of Camarillo State Hospital. Some hospital administrative documents, as well as items left behind when the hospital closed, are housed in their University Archives.
Noah Geraci is an MLIS student at UCLA who works at UCLA’s Digital Library Program. Born and raised in San Diego, in other lives he has been a mental health counselor, home care worker, elementary educator, writer, and punk musician.
Published by: Los Angeles Archivist Collective in In Process