Send message to Author

Paper short abstract

This paper examines how mild intellectual disability (MID) is enacted when access to care is at stake in the decentralized Dutch care system. Following "clients" and social workers, it shows how MID takes shape across care regimes with competing logics of eligibility and deservingness.

Paper long abstract

This paper explores how the category of mild intellectual disability (MID) is enacted in situations where access to care is at stake within the context of the decentralized Dutch care system. Drawing on ethnographic material that follows people labeled with MID and their social workers as they navigate pathways towards care and support, I analyze how MID is enacted across distinct care regimes that rely on sharply demarcated logics of eligibility, responsibility, and deservingness.

Empirically, I show how MID operates as a relational category that takes on different meanings across care regimes and life worlds. For those labeled with it, MID is often experienced as an undesirable identity, while simultaneously functioning as a prerequisite for accessing certain forms of care. Yet this paradox of recognition does not guarantee access. MID is frequently deemed insufficient for long-term care, where more severe or clearly provable forms of disability are required.

At the same time, MID rarely appears in isolation. Mental health problems, poverty, and other forms of social vulnerability commonly co-occur, yet these overlapping categories often obstruct rather than facilitate access. While comorbidity is widely acknowledged in research and practice, care infrastructures continue to demand categorical and diagnostic purity.

Focusing on moments where biomedical and social categories of care overlap, I argue that MID reveals how classificatory systems that promise fair allocation of care resources produce exclusion, delay, and distributed responsibility while failing to do justice to the complexity of the real-life problems of those living with the category of MID.