Redistribution and its Discontents: On the Prospects of Committed Work in Public Mental Health and Like Settings

Refusal of services has long been treated as prima facie evidence of a disordered mind; this paper inquires instead into the tainted nature of the offer. I first sketch the conflicted nature of relief in the American welfare state—hedged so as to ensure only the truly needy will apply—and the way symbolic means are deployed to that end. I then go on to suggest that refusal to accept aid on those terms (even among the street-dwelling, psychiatrically disabled homeless) may be a last-resort exercise of self-respect. This dynamic has an ancient pedigree, whose mythic prototype is Philoctetes. Equally striking is the legacy of the outlaw hero of the story, apparent in the ways frontline workers today contrive to outwit the system’s structural constraints. These anomalous forms of “committed work”—acts of resistance delivering both effort and benefit that cannot be bought—are my real concern. I review ethnographic work suggesting that such acts of common ministry are well-documented exceptions to the broad commodification of care and take their toll on the workers themselves. The paper closes, ruefully, with an acknowledgment of the contradictory valence of system-sustaining resistance that is so easily co-opted and integrated as compensation for “institutional bad faith” (Bourdieu).