Welcome to this ‘surveillance’ special issue of Asylum Magazine, put together by the survivor-led campaign group Stop Oxevision.
For the past 18-months they have campaigned against the use of Oxevision, a video-based surveillance technology which is increasingly being used in psychiatric hospitals in England, Sweden and, more recently, the US. The device consists of a camera and infrared sensor, affixed above a patient’s bed. Staff can use the camera to watch a patient in their bedroom as well as taking readings of their pulse and breathing rates. In the event of an ‘incident’, and purely at the discretion of staff, video footage of patients can be saved for use in subsequent investigations, including criminal proceedings.
Oxevision is primarily used within patient’s bedrooms in psychiatric hospitals, however it is also used in prisons, police custody cells, care homes and seclusion rooms on mental health wards – all settings with inherent power imbalances amongst staff and detainees. As a campaign group, we have also raised concerns about video surveillance devices used in psychiatric hospitals more generally, including CCTV cameras and body worn cameras used in mental health wards, and even in community settings, in the UK.
Since our inception, Stop Oxevision have highlighted a number of concerns about the use of Oxevision, including that the technology has been, and continues to be, used against the wishes of patients. The technology also risks worsening the quality of care that patients receive by reducing opportunities for human interaction and creating an overreliance on technology which in some tragic incidents has been associated with patient deaths.
In this issue of Asylum, Alexis Quinn, in her article (De)humanising people in psychiatric inpatient settings, describes some of the harms posed by Oxevision and similar video-monitoring technologies. Drawing on her experiences, and emphasising how surveillance breaches Human Rights law, Alexis discusses the objectification of staff surveillance and the use of CCTV in a mental health ward, which was ultimately used to criminalise her. Other experiences of Oxevision are shared through poetry, such as Marcus Ten Low’s ‘Oxevision eyes’ and ‘A constant hum’, as well as Sophina Mariette’s ‘The octopus has no blind spot’ – poignant pieces that remind us of the chilling presence of Oxevision in everyday life on the ward.
The use of surveillance in psychiatric services often mimics and exacerbates experiences of mental illness. For example, in Just in Case: Schrödinger’s cat, OCD and self-surveillance, Hat Porter outlines their experience of ‘magical thinking’, and describes their resulting compulsions as a form of self-surveillance. This dynamic is further illustrated in various pieces across this issue, including artworks and poetry.
The (mis)use of surveillance technology in mental health is not an issue restricted to the Global North. This is demonstrated by Neha Jain in ‘Being Watched in a Halfway Home: Reflections of a Researcher’, as she reflects on her fieldwork in two mental health halfway homes in India. We hear how both institutions used CCTV to closely scrutinise and enact control over residents’ behaviour. Patient resistance to surveillance is often evident, as Jain highlights through her description of how she and the residents learned to resist the technology with radical acts of solidarity and friendship.
Throughout our campaign, we have frequently encountered the retort that having video cameras will protect patients against abuse. However, the power imbalances and functionality of these technologies can actually enable them to be weaponised against patients. For example, although sections of footage from Oxevision can be saved, this has to be done by staff and we have heard that cameras have miraculously ceased working, or footage has been lost, when patients make complaints. Similarly, body worn cameras let staff choose when they want to record and or whether to use video or audio, making it possible for staff to get away with abuse off-camera.
Ultimately, whether surveillance devices can be used as a tool of ‘safety’, depends which side of the camera you are on. This is illustrated with painful clarity in ‘Staff controlled surveillance is not safety’ where an anonymous author recounts her experiences of abuse at the hands of a male staff member, despite the presence of Oxevision and its promises of patient protection. Again, these concerns transcend borders and contexts, as Sonia Soans explains in her piece on CCTV in India. Drawing together our concerns about cameras in mental health wards with feminist perspectives on violence against women, she emphasises that ‘more surveillance’ is not the answer to complex social issues.
Surveillance is not unique to video-based monitoring devices, but is inherent in many aspects of psychiatric treatment – both in hospital and even in our own homes. This might include staff regularly checking patients or observing us 24 hours a day, but is also inherent to the scrutiny placed on patients where our every movement is watched, judged, documented and ultimately controlled. In ‘reflections on my experience of postpartum psychosis’, Adeline describes her experiences of treatment on a mother and baby unit where both herself and her baby were closely monitored. Yet again, such surveillance was weaponised and punitive, worsening her paranoia. As the ever-expanding mechanisms through which such surveillance is being enacted, and the harms it causes, become increasingly stark, age-old debates about the delineation between ‘care’ and ‘control’ seem somewhat trivial.
More widely, this surveilling logic operates as part of a network of oppressive institutions including the police, the Department of Work and Pensions DWP and social services, controlling and restricting the rights of Mad and disabled people. In Surveillance under the DWP: a retraumatisation machine, Danny Taggart and Nicky describe the violence of the welfare benefits system. In a system that rewards assessors for rejecting applications, Nicky and Danny describe how claimants are constantly treated with suspicion, (re)creating psychologically abusive dynamics. Similar themes are reflected in ‘They’re behind you’ (but they haven’t got your back) by Alex Dunedin, who describes how the expansion of technologically-mediated surveillance throughout society functions contradictorily to its purported aims of efficiency and ‘improvement’, particularly in neglectful and harsh welfare services.
In Prevent and the surveillance state, Hil Aked describes how the UK government’s counterterrorism strategy, Prevent, functions as a form of racialised surveillance. Disproportionately targeting Muslims, especially those experiencing mental distress, the strategy relied on fraught ‘scientific’ claims that there is a connection between mental ill health, autism and terrorism; legitimising intrusive surveillance in healthcare spaces, and causing significant harm for those targeted.
Therefore, it is impossible to separate the logics of psychiatric surveillance from the political contexts in which they are deployed; structurally violent institutions enable the proliferation of surveilling and punitive practices that are exacerbated along intersections of race, class, disability, and gender. This is further highlighted in Chronicle of a death foretold – and denounced – in the capital of Brazil, in which Pedro Henrique Antunes da Costa details the horrific torture experienced by a young black woman in an asylum in Brazil. His article ends with a call to close illegal asylums, observing that those who accept abusive practices remain accomplices to the violence of the institution.
This notion, that those who tolerate harmful practices actively enable them, also rings true in the context of our own campaign; as we continue to see people in positions of power choose not to speak out, to protect their own interests.
Surveillance is not safety.
In solidarity,
Hat Porter
Nell Head
Sophina Mariette
Beth Harby
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