Street Psychiatrics and New Configurations of Madness

This chapter discusses how the women in the daily-rent hotels found themselves enmeshed in a complex web of addiction, mental health diagnoses, and housing instability in which specific forms of social recognition were in operation. In 1997, the disallowance of substance use dependence as a qualifying disabling health condition for SSI benefits spawned the development of a new disability economy. Despite widely accepted scientific evidence demonstrating the high frequency of mental illness and substance use disorder comorbidity, a new social actor, the “neurocrat,” was constructed to document mental health disorders in exception of substance use disorder for SSI applicants. As is well understood, accessing SSI welfare benefits enables the safety-net health care system while also ensuring access to subsidized housing, case management, and other social benefits. In this way, neurocrats made the madness of poverty socially legible.