The Mariel Crucible: Stigma and Psychiatric Dehospitalization between the U.S. and Cuba

In October 1980, one hundred Cubans who had arrived in the Mariel boatlift were transferred to a separate building at St. Elizabeth’s Hospital in Washington, D.C. The migration had precipitated a crisis of psychiatric infrastructure in the U.S., as officials struggled to find a place for those requiring long-term care. The stigma that had attached itself to the boatlift, plagued by allegations of the forced removal of criminals and mental patients from Cuba, did little to help their cause. Mentally ill migrants were left particularly vulnerable in the web of ad hoc care that had emerged out of psychiatric deinstitutionalization. At St. Elizabeth’s, an early riot set the terms for engagement, with INS officials thereafter treating the building as a carceral facility in many respects. The fate of its inmates would not be settled for over a decade.

Yet the unfolding of the crisis must be understood in light of broader anxieties regarding the racial and sexual difference of the refugees. Journalists, officials, and physicians alike contributed to a depiction of the migrants as manifesting a poorly controlled, undisciplined, and even pathological masculinity. Indeed, as a result of the migration, homosexuality – and its alleged link to psychological disturbance – became a contested political object on both sides of the Florida Straits. At the same time, the conflation of racial, sexual, and psychological difference become closely linked to presumptions of delinquency. The creeping process of criminalization inhibited the reach of popular sympathy, including at St. Elizabeth’s itself.