# From Disciplinary Societies to Societies of Control: Foucault, Deleuze and the Care of People Under the Mental Health Review Board in Psychiatric Settings

## TL;DR

This paper explores ethical challenges faced by psychiatric nurses managing individuals declared not criminally responsible due to mental disorder in Canada.

## Contribution

The study introduces a novel analysis of the Mental Health Review Board's role through Deleuze's 'societies of control' framework.

## Key findings

- Involuntary readmission processes create ethical tensions for psychiatric nurses.
- Coercive practices and power imbalances affect therapeutic relationships in psychiatric settings.
- Nurses face conflicts between public safety and care philosophies under MHRB supervision.

## Abstract

The number of individuals declared not criminally responsible on account of mental disorder is increasing in Canada. The supervision of these individuals—balancing the imperatives of public safety with philosophies of care—can create significant ethical dilemmas for psychiatric nurses. This article examines the intersection of mental health and the justice system, drawing on the accounts of nurses and service users admitted to psychiatric units. Using grounded theory, the study seeks to deepen understanding of the impact of judiciarization, particularly its influence on therapeutic relationships and the perceived quality of care. Special attention is given to the role of the Mental Health Review Board (MHRB) in monitoring individuals found NCRMD. Grounded in the theoretical framework of Deleuze's notion of societies of control, the analysis of interview data reveals three central categories: (1) the process of involuntary (re)admission; (2) the complexities of the care partnership; and (3) ethical tensions and prejudice. The experiences of users are explored through the lenses of coercive practices, disciplinary structures, and varied forms of social control in the context of MHRB supervision. Psychiatric nurses' narratives point to challenges related to power imbalances, conflicts of professional allegiance, and ambivalence in care perspectives—highlighting the need for ongoing ethical reflection and systemic change in the management of NCR patients.