Silences, tactics and refusals: the management of psychotropic drugs within a judicial asylum

Abstract

A woman, confined for nearly a decade in a forensic psychiatric hospital, watches, numbed, the slow and progressive withering of her body and mind; a man decides to “pretend to be insane” to escape his sentence, but once inside the institution, he finds himself gradually going mad due to the intensive and prolonged use of psychotropic drugs; a defiant butch lesbian is sent to the Hospital for Custody and Psychiatric Treatment as a form of administrative punishment and, upon arrival, is forced to choose between a neurochemical gag or the controlled vomiting of medications in an attempt to rid herself of their effects. Based on these three ethnographic cases, I discuss the everyday practices of compulsory medication and the responses of inmates in a forensic psychiatric hospital. At a time when efforts are being made to shut down these institutions—following the recommendations of Resolution No. 487 of the National Council of Justice, issued on February 18, 2023—I examine the role of psychotropic drugs in the strategies of care and containment in one of the three Hospitals for Custody and Psychiatric Treatment in the state of São Paulo, where I conducted my doctoral fieldwork. I conclude that, even within an institution in which psychopharmaceuticals predominantly operate as a technology of control and submission, inmate-patients and members of the technical staff also mobilize silences and deviations as tactics of negotiation and refusal.