[*** WARNING for detailed domestic violence description from the fourth paragraph on. ***]

My local paper has been abuzz with righteous taxpayer outrage over the State paying for a tattoo removal for a woman, who I’ll call JMN.

The story of JMN disrupts a number of neat stereotypical societal narratives about domestic violence, about victimhood, about killers, about the meaning of ‘healthcare’.

To go back to the beginning, at least to the beginning of the public part of the tale, JMN is a convicted murderer. She was found guilty nine years ago of murdering her “Internet lover”, MW.

According to published accounts of the trial, JMN’s husband MH, an abusive, violent gang member, found out about her relationship with MW, and “punished” her repeatedly. He violently cut off her hair, leaving her needing skin grafts to her scalp and hand. He beat her repeatedly, with fists, with pool cues, with a belt. He poured boiling water over her. He forced her to have a tattoo reading “Property of [MH’s full name]”. He punched her and choked her, leaving her needing hospital treatment.

And after all of this abuse and intimidation which left her in fear for her life, he visited and threatened the lover, then ordered JMN to kill him.

JMN shot MW under her abusive husband’s orders, backed by this violent intimidation, and she was convicted of wilful murder. She has been in custody ever since, with a minimum sentence of fifteen years.

Unsurprisingly, perhaps, JMN now has mental health issues. (These are not described in detail in the press, nor should they be.) She was a victim of unspeakable violence (as well as being a perpetrator under duress), and is currently seeking criminal injuries compensation – which is what has triggered off the righteous-taxpayer-indignation. Her criminal injuries compensation was initially refused, and the case is now under appeal.

But the Righteous Indignant Taxpayers haven’t stopped there. The papers are now pawing over the rather insigificant detail that the State may partly fund tattoo removal for JMN. The Department of Corrective Services has committed to paying for half the cost of the procedure, which is expected to cost only $2000.

$2000.

The shadow attorney-general is outraged, he says, outraged! How dare the Precious Indignant Taxpayer be asked to fund “cosmetic surgery”! The Corrective Services Commissioner has responded in sensible and general terms, saying that he “was acutely aware he had to take into account many factors when making difficult and sensitive decisions in cases that involved complex social, psychological, cultural and physical health considerations”, and that he made a judgement call, as he does on a daily basis.

JMN is statistically at very high risk for mental health problems, self-harm, and suicide. She is incarcerated, and suicide is the leading cause of death in Australian prisoners. She has been the victim of horrific domestic violence, and victims of domestic violence are five times more likely to commit suicide than average. The Commissioner took into account psychological reports and his personal interview with JMN when making the determination that the State would fork out a grand or two to take off the tattoo she was violently forced to get, the tattoo that is reminding her constantly of her abuse and contributing to her mental health difficulties.

Let’s get a little perspective. One acute psychiatric bed-day in Western Australia costs just over $1000. The cost of this tattoo removal equates to around one weekend stay in hospital for a relatively minor psychiatric crisis. We’re not talking huge pots of cash here. We’re talking about a sum that is absolutely tiny in the scale of costs involved with healthcare and with the justice and corrections system.

We expect, as a society, to provide healthcare for prisoners. Western Australia is committed, on paper at least, to providing prisoners with the healthcare they need, including mental healthcare. The general level of care we as taxpayers have committed to equates to the level of care that people should be provided in the public healthcare system. Tattoo removal is on the proscribed “cosmetic surgery” list for State hospitals, but that list comes with one very important caveat – that the procedure should be denied State funding if there is no “clinically significant” indication.

I can’t think of any more “clinically significant” indication than a tattoo someone was forced to get at the hands of her abuser, a tattoo that is making her sick. A tattoo that reminds her around the clock of his attempts at intimidation and dehumanisation. A tattoo that states outright that she is the “property” of this violent man. A tattoo that contributes to her greatly increased risk of self-harm and suicide.

Cannot we, as fellow humans, can find enough shreds of compassion to be comfortable with spending this trivial sum on what is likely to be a cost-effective contributor to the health of someone we are, as a group, responsible for?

This case is a touchstone for a whole pile of prejudices. It makes people particular uncomfortable, I believe, because it disrupts the nice little myths that nice little Indignant Taxpayers like to indulge in. The neat little “innocent-victim” narrative of domestic violence is disrupted by the fact that this women is also a perpetrator. The neat little “evil-murderer” narrative is disrupted by the fact that she was the victim of horrendous abuse, and that she committed the killing under fear for her own life. The neat little “nasty slut” tattooed-woman narrative is disrupted by the fact that she was forced to get this tattoo in the course of her husband’s abuse. The neat little “adequate healthcare” narrative is disrupted by the fact that tattoo removal usually lies outside of what some of us might usually consider to be “healthcare”.

All of this is adding up to a situation where the Righteous Indignant Taxpayers want to wash their hands of it altogether, though it’s clear they’d rather have a set of public stocks and rotten tomatoes to throw. They shout in comments “Give her nothing but bread and water”, “Why am I responsible?”, and “This woman knew what she was marrying into – hard cheese, I’d say”. Revolting.

Australia’s National Mental Health Policy states that as a nation, our key aims in mental healthcare include the prevention of the development of mental health problems and mental illness, the reduction of impact of mental health problems, and the promotion of recovery from mental health problems. These aims apply no less to people in custody, who are at extremely high risk and have particular mental healthcare needs that are all too frequently dismissed or actively resisted by people in a society that wants nothing more than to inflict as much suffering as possible on prisoners.

There’s an interesting wider question here, which is about our definitions of healthcare, and about the fact that the determinants of health often lie outside the very narrow systems and procedures that we label “necessary healthcare”. For example, we know damn well, on a macro scale, that poverty and inequality is a more important determinant of health than doctors and nurses and public education programmes aimed toward “behavioural modification”. Could not a piece of marked skin be a more important determinant of health in a single person than all the psychologists and pills in the world?