What is “healthcare”? A tale of a murderer, a victim, and a tattoo.

[*** 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?

14 Comments

  1. Sad and disgusting. And unfortunately not a bit surprising not any of it. Women are often very heavily punished for violent crimes despite the popular narrative that says they get off lighter than men. The narrative that people (women particularly) can and should just leave abusive relationships is hard at work here also. Mental health care is pharmacological and nothing else. Insurance companies and national health systems should never pay for cosmetic procedures. (Except when they do. Like when people with prominent breasts have mastectomies and get implant mammoplasties or when people with testicles get prosthetics after orchiectomies.) People in prison are there to be punished and deserve nothing; if they are suffering then all is as it should be.

    I want to cry.

    The similarities to tattoo-removal programmes here in the US are striking. Few things help a young person get out of gangs and into the legitimate economy better than having gang-related tattoos removed — especially those on the face neck and/or hands. These tattoos similarly mark their bearers as property and consent is questionable at best. More than a few people have reported sexual assault as part of gang initiation and life.

    Righteously Indignant Taxpayers get pissed about these programmes. Of course.

  2. This story had not come to my attention. Thanks so much for highlighting it.

    It’s absolutely incomprehensible to me that people would balk at a relatively tiny sum of money being spent in a way that could seriously improve this woman’s life. I say ‘could’, because I am not her and therefore obviously don’t know if it ‘will’. But I find it hard to see how being forced to carry around the mark of your abuser could be anything but extraordinarily detrimental to one’s wellbeing. And when removing it is such a straightforward process…

    Opposing it just seems petty. It’s like, can we not be even slightly compassionate here?

  3. What a superb post. And I’m continually surprised by peoples’ failure to take into account the prospects for rehabilitation. Surely these irate letter writers/talkback callers would rather this woman had her own home and job when she gets out of prison? Yes? Then surely it would repay the cost of tattoo removal for her not to be unemployable due to prospective employers seeing it? Same goes for her psychological rehabilitation. If cost is all they care about, surely they don’t want to render her unemployable and a patient in the psychiatric system for life?

  4. This is simply ridiculous. The taxpayer is complaining about treating an injury she received at the hands of her abusive partner. Lovely. I pay tax in Australia, and while I’m not in WA (and I suspect it is probably a state-based tax that is involved) I’d cheerfully pay for this over many, many things those taxes are used for (not to mention I recognise that it shouldn’t be up to me–it should be up to the woman and her care providers to decide–NOT, as in this case, the prison system). The fact that the vocal commenters in Western Australia aren’t happy to pay reeks of sexism, classism and prejudice with respect to the “invisibility” of mental illness.

  5. How horrifying. And you just know that the same people who don’t want to pay for anything remotely therapeutic for prisoners will be complaining about recidivism in released offenders. Please note: I am not suggesting that this prisoner will re-offend; I do not believe or assume that and I’m not conflating her with recidivist offenders.

    What I am saying is that people would rather buy into the idea of a punitive prison system, no matter how ineffective it is, than into a system that actually engages with offenders’ problems and the complex social factors that help to cause crime. Righteously indignant taxpayers don’t want to hear that we might need to help people who are in prison, or that it might cost money. Above all, they don’t want EVER to hear that someone might simultaneously be a criminal and a victim.

  6. People’s attitudes towards people who have committed a crime, any crime, shocks me. I remember a conservative MP in my area was sending out a mailout decrying “perks” for prisoners, namely, tattoo programs. Apparently, if you’ve committed a crime, you deserve to get hepatitis C or HIV. Disgusting.

  7. After I read this post I couldn’t put into words my reaction. I still can’t. It’s just so heartbreaking and stomach-churning.

  8. Sparks – you’re so right.

    And all those “jokes” about prisoners “dropping the soap” are horrible – they’re still human beings, prison rape is not a joke.

    It’s hard to summon up sympathy for some criminals (that guy in Germany who kept his daughter locked up and had grandkids with her… the guy in CA who kidnapped the girl for years…) but they’re still human beings.

    In the US, we guarantee that most (those without money and/or influence) will end up homeless/back in prison – they can’t vote, few places will hire them, and rightly or wrongly, there aren’t many places for some to live – a bunch of released sex offenders had to live under a bridge in Miami because it was the only place far enough away from places they weren’t allowed to go.

    So this? Not surprising.

    On the face – she killed her boyfriend? And we’re paying for her tattoo removal? Yeah, whatever. But I never thought about the importance of tattoo removal until k0’s comment – it should be offered as part of the release to help them with a normal life.

  9. what an awful awful story. and of COURSE she should get assistance recovering from abuse, including tattoo removal.

    i’m a little surprised at what a controversial issue it seems to be there. here in california, tattoo removal is a fairly standard part of prisoner re-entry programs and gang prevention programs, to remove tattoos that mark someone as part of a specific gang. there’s a lot of free and low-cost tattoo removal services that require someone to do community service, etc, that are primarily aimed at individuals leaving gangs. i wonder (musing off the top of my head with no research) if there’s a difference in prevalence of that kind of tattoo? or if this is related to the atmosphere around domestic violence? i guess i’m searching for some explanation because the reality described in the post is overwhelmingly disheartening. 🙁

  10. Once again, I need to say thank you. Thank you, thank you, thank you. I’m so tired of hearing how threats to mental health aren’t threats to ‘actual’ health.

  11. re: gang tattoo removal – this tattoo doesn’t mark her as part of gang, so maybe that’s why?

  12. i wonder (musing off the top of my head with no research) if there’s a difference in prevalence of that kind of tattoo? or if this is related to the atmosphere around domestic violence?

    Reading Andrew Bolt’s commenters may not be the best way of taking the population’s temperature – but then again maybe it might. They’re split between the “yes, this is an abuse injury, she should receive help to recover” and “she chose to marry him, so she should deal with the consequences” victim-blamers, including those who go for outright dehumanisation with remarks about lying down with dogs and refusing to pay for her flea collar.

  13. Kaitlyn, the “Property of [Abusive Shitbag]” tattoo removal saga from lauredhel’s original post is unfolding in Western Australia and has no direct relation to gang-related tattoo removal programmes in the US. I just found it interesting — and saddening — that the stories of the people needing tattoos removed were so similar. As were the “Not on my dime!” reactions of the Righteous Indignant Taxpayers.

  14. K0 – you’re right, but surely where there are prisons, there are gangs (for survival, if nothing else), and thus gang tattoos?

    So while some places in the US will remove the gang tattoos, what’s the situation like in Australia?

    “Not on my dime” people are so…. they’re just not thinking of the big picture or outside their own bubble. (“I have insurance now, so why should I care?”)

    Can you tell mid-term elections are getting to me? Maybe the deficit wouldn’t be so huge if we raised taxes you…. nincompoop!