Book Review: Knowles, Bedlam on the Streets

Caroline Knowles
Bedlam on the Streets
Routledge, 2000, 180 pp.
$Cdn. 34.99 paper (0-415-23299-6), $Cdn. 113.00 cloth (0-415-23298-8)

Bedlam on the Streets is an ethnographic study of public “madness” in Montreal. The book offers vivid accounts of the daily existence of the individuals who utilize the city’s homeless shelters, rooming houses, shopping malls and fast food joints. Here we encounter the trepidation in which those who are deemed mad exist within the broader social landscape. The book captures the vitality, dynamics and meaning of the lives of this vulnerable and marginalized group. The essence of their being is seen through photography and heard in the narrating voices that detail their journey into madness and how madness and homelessness shape their existence in their social world.

The book is set within the framework of postmodernist theory that is intended to "situate this social geography of madness within the broader parameters of systems of social welfare, globalization and race, arguing that the ‘community mental health care’ system is a system of neglect" (back cover). The book most certainly does use postmodernist rhetoric, and as a result the reader must be highly versed in postmodernist terminology and theory to comprehend the first few chapters. This is a serious problem, because other readers will be tempted to put the book aside before getting to the chapters that report the findings of Knowles' research team. This is a shame, since the research serves as an indictment of social policies, which are having tragic consequences and, as such, the work should be read by policy makers, agency workers and scholars who may not be comfortable with postmodern discourse.

As mentioned above, the author's intention is to examine systems of social welfare and the community mental health care system. The social welfare system is briefly discussed in the introduction, but from then on the term is used loosely and only in its relationship to the lives of individual participants in the research. Since it was the very system that deinstitutionalized the "mad" and, as the author stated, is a system of "neglect," why is there no critical analysis or discussion of it? The author’s failure to operationalize this key variable of the study renders several of her conclusions suspect.

A serious discussion of globalization is promised, but it is not delivered. The author implies that this concept is “within the broader parameters of systems,” but analysis of it is so broad as to be just about non-existent. This failure to fully address the “global” aspect of homelessness abandons any possibility of drawing realistic conclusions beyond the scope of the group studied. While there is great merit in the detailed observations of the homeless, the overall analysis is stranded between “micro” subject matter and an incomplete “macro” analysis.

Before commenting on the elements of race and ethnicity in this text, it is worth noting that the author states, “this is not the book I intended to write. It grew monstrously and insistently from research material collected … I had assumed there was, as the rhetoric insisted, a community system of mental health provision in which the outreach of psychiatry could be described, documented and taken to task for its forms of racial marginalization. There wasn’t. … As the research re-focused on the task of excavating the system’s social and spatial relationships, so its forms of racialization and ethnicization took a back seat …To have persisted with the original plan and foregrounded race and ethnicity, rather than the system in which they are articulated and given meaning, would not have done justice to the research findings and the voices heard”. Here the author has acknowledged that race, ethnicity and to some degree gender are undercurrents of this book. They are realistic sub-themes that add a worthy dimension to an analysis of the homeless case studies (ix).

Race, ethnicity and gender were present in the narratives of the individuals and have contributed to the meaning of their social lives. In agreement with the author, these issues are not the crux of the narratives collected here. In the context of this book, they are but contingent factors contributing to the homeless population’s overall marginalization. Why then include such a detailed discussion in the conclusion regarding racial implications?

Knowles utilizes personal narratives as a complement to observational analysis. This proved to be a sound technique for realizing the real “meaning” of the lived experiences of the people who participated in this research. Indeed, the personal accounts of individuals' experiences of madness provide a rare and valuable contribution to Psychiatric Sociology.

The author acknowledges that the relationship between homelessness and “madness” is an intimate one. Indeed, these issues exist in a cyclical relationship. While Knowles well succeeds in expressing the plight of the homeless mentally ill, she fails on several levels to address and investigate further the nature of this relationship. The “mad” stigma is too easily applied, or assumed, without appreciating what qualifies as “mad”. As such, the author’s exposé serves only to perpetuate long-held myths about homeless people. Just as not all the mad are homeless, not all the homeless are mad, despite being caught up in a system of neglect which is a challenge to the sanity of everyone involved in it, including agency workers.

There is merit in re-affirming the author’s excellent use of narrative techniques in this book. In an attempt to give meaning to the lived experiences of the people studied, Knowles succeeds in “capturing” the reader, almost entrancing her/him into the lives of the homeless. Regrettably, this technique is also the author’s greatest challenge.

Arguably the narratives offer insight into the “madness” experienced by some of those who participated in the research. However, nowhere does the author acknowledge the level of “madness” assumed or ascribed to them. She simply accepts their confessions verbatim and fails to comment on the idea that some of her self-identified “schizophrenics” may not have been so given this diagnosis in other circumstances. In sum, her narratives exist in isolation, not being qualified by the author in terms of their authenticity or commenting on the intimate relationship between “being mad” and “being homeless”.

To close on an editorial criticism, there is nothing in the title of this book or on the back cover to indicate that the research was conducted in Montreal, or even in Canada. A subtitle would have been helpful for someone contemplating buying or borrowing this book.

Terry-Lynn Dean
Canadian Mental Health Association
terrylynndean@cogeco.ca

Judith Blackwell
Brock University
jblackwell21@cogeco.ca



		Canadian Journal of Sociology Online November - December 2001 Caroline Knowles Bedlam on the Streets Routledge, 2000, 180 pp. $Cdn. 34.99 paper (0-415-23299-6), $Cdn. 113.00 cloth (0-415-23298-8) Bedlam on the Streets is an ethnographic study of public “madness” in Montreal. The book offers vivid accounts of the daily existence of the individuals who utilize the city’s homeless shelters, rooming houses, shopping malls and fast food joints. Here we encounter the trepidation in which those who are deemed mad exist within the broader social landscape. The book captures the vitality, dynamics and meaning of the lives of this vulnerable and marginalized group. The essence of their being is seen through photography and heard in the narrating voices that detail their journey into madness and how madness and homelessness shape their existence in their social world. The book is set within the framework of postmodernist theory that is intended to "situate this social geography of madness within the broader parameters of systems of social welfare, globalization and race, arguing that the ‘community mental health care’ system is a system of neglect" (back cover). The book most certainly does use postmodernist rhetoric, and as a result the reader must be highly versed in postmodernist terminology and theory to comprehend the first few chapters. This is a serious problem, because other readers will be tempted to put the book aside before getting to the chapters that report the findings of Knowles' research team. This is a shame, since the research serves as an indictment of social policies, which are having tragic consequences and, as such, the work should be read by policy makers, agency workers and scholars who may not be comfortable with postmodern discourse. As mentioned above, the author's intention is to examine systems of social welfare and the community mental health care system. The social welfare system is briefly discussed in the introduction, but from then on the term is used loosely and only in its relationship to the lives of individual participants in the research. Since it was the very system that deinstitutionalized the "mad" and, as the author stated, is a system of "neglect," why is there no critical analysis or discussion of it? The author’s failure to operationalize this key variable of the study renders several of her conclusions suspect. A serious discussion of globalization is promised, but it is not delivered. The author implies that this concept is “within the broader parameters of systems,” but analysis of it is so broad as to be just about non-existent. This failure to fully address the “global” aspect of homelessness abandons any possibility of drawing realistic conclusions beyond the scope of the group studied. While there is great merit in the detailed observations of the homeless, the overall analysis is stranded between “micro” subject matter and an incomplete “macro” analysis. Before commenting on the elements of race and ethnicity in this text, it is worth noting that the author states, “this is not the book I intended to write. It grew monstrously and insistently from research material collected … I had assumed there was, as the rhetoric insisted, a community system of mental health provision in which the outreach of psychiatry could be described, documented and taken to task for its forms of racial marginalization. There wasn’t. … As the research re-focused on the task of excavating the system’s social and spatial relationships, so its forms of racialization and ethnicization took a back seat …To have persisted with the original plan and foregrounded race and ethnicity, rather than the system in which they are articulated and given meaning, would not have done justice to the research findings and the voices heard”. Here the author has acknowledged that race, ethnicity and to some degree gender are undercurrents of this book. They are realistic sub-themes that add a worthy dimension to an analysis of the homeless case studies (ix). Race, ethnicity and gender were present in the narratives of the individuals and have contributed to the meaning of their social lives. In agreement with the author, these issues are not the crux of the narratives collected here. In the context of this book, they are but contingent factors contributing to the homeless population’s overall marginalization. Why then include such a detailed discussion in the conclusion regarding racial implications? Knowles utilizes personal narratives as a complement to observational analysis. This proved to be a sound technique for realizing the real “meaning” of the lived experiences of the people who participated in this research. Indeed, the personal accounts of individuals' experiences of madness provide a rare and valuable contribution to Psychiatric Sociology. The author acknowledges that the relationship between homelessness and “madness” is an intimate one. Indeed, these issues exist in a cyclical relationship. While Knowles well succeeds in expressing the plight of the homeless mentally ill, she fails on several levels to address and investigate further the nature of this relationship. The “mad” stigma is too easily applied, or assumed, without appreciating what qualifies as “mad”. As such, the author’s exposé serves only to perpetuate long-held myths about homeless people. Just as not all the mad are homeless, not all the homeless are mad, despite being caught up in a system of neglect which is a challenge to the sanity of everyone involved in it, including agency workers. There is merit in re-affirming the author’s excellent use of narrative techniques in this book. In an attempt to give meaning to the lived experiences of the people studied, Knowles succeeds in “capturing” the reader, almost entrancing her/him into the lives of the homeless. Regrettably, this technique is also the author’s greatest challenge. Arguably the narratives offer insight into the “madness” experienced by some of those who participated in the research. However, nowhere does the author acknowledge the level of “madness” assumed or ascribed to them. She simply accepts their confessions verbatim and fails to comment on the idea that some of her self-identified “schizophrenics” may not have been so given this diagnosis in other circumstances. In sum, her narratives exist in isolation, not being qualified by the author in terms of their authenticity or commenting on the intimate relationship between “being mad” and “being homeless”. To close on an editorial criticism, there is nothing in the title of this book or on the back cover to indicate that the research was conducted in Montreal, or even in Canada. A subtitle would have been helpful for someone contemplating buying or borrowing this book. Terry-Lynn Dean Canadian Mental Health Association terrylynndean@cogeco.ca Judith Blackwell Brock University jblackwell21@cogeco.ca http://www.arts.ualberta.ca/cjscopy/reviews/bedlam.html November 2001 © CJS Online