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Ethnographic analysis highlights disparities in treatment and outcomes for mental illness between poor and elite populations.
What do freedom and humane treatment mean for those with serious mental illness in a strikingly unequal, two‐tiered healthcare system? America’s poor experience a frayed social safety net, whereas promises of full recovery, specialised treatment and boutique beachside facilities characterise private treatment for the wealthy. Neil Gong’s 2024 monograph, Sons, Daughters, and Sidewalk Psychotics: Mental Illness and Homelessness in Los Angeles , explores this question by examining care and control at the ends of the socioeconomic spectrum: in the public social safety net ecology experienced by the poor and the rarely glimpsed private care ecology of the elite. Rooted in structural analysis, his ambitious multisite ethnography compares the social prognoses, or possible social outcomes, of formerly unhoused persons with serious mental illness in downtown Los Angeles accessing housing‐first programmes and wealthy patients using private rehabilitative programmes just a few physical (but hundreds of metaphorical) miles away. Though scholars may anticipate coercive behavioural control of the poor and relative freedom for the wealthy, Gong’s findings complicate our understanding of how socioeconomic status shapes mental illness governance.
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Meghann Lucy (2025) studied this question.
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