Liberation Medicine in Authoritarian Contexts: The Brutality of U.S. Mass Incarceration

This article engages Führer and Vorhölter's (2025) reinvigoration of Nancy Scheper-Hughes's utopian call for liberation medicine in their special issue of Culture, Medicine, and Psychiatry. They offer a practical reconceptualization of liberation medicine as "concrete utopias" in the "medical undercommons". Inspired by Scheper-Hughes's humble call for "good-enough" ethnographic engagement in her documentation of a successful solidarity movement of single-mother agricultural laborers in Northeastern Brazil, I highlight ethnographically a (fragile) concrete utopian initiative: a peer-support program for inmates with psychosis spectrum conditions who are swept into the Los Angeles County Jail system's overcrowded mental health units on a daily basis by routinized law enforcement sweeps of homeless individuals. Developed by former gang members (without mental illness) facing capital punishment charges, this remarkable initiative of solidarity, redemption, and anti-racism through radical caregiving in a claustrophobic carceral environment is carving out a temporarily safe space free from abuse and violence. The larger facility remains gang-controlled and is overwhelmed by what colleagues and I have been calling "predatory accumulation" and "necrogovernance" processes (Hart et al., 2024, 2025). The inmates are powerless, caught within the "carceral mesh" of U.S. political-economic corporate and opportunistic special interests. Furthermore, the discretionary power of "hyperpunitive" U.S. judges allows them to routinely impose Life Without Parole (LWOP) sentences on redeemed inmates incarcerated as adolescents. Inspired by Scheper-Hughes's practical political optimism coupled with her love for ethnography and political activism, I end with eight practical suggestions for specific state bureaucratic reforms to foment public transparency about the useless cruelty of mass incarceration and the global rise of authoritarianisms in our perilous moment in global history.