In contemporary China, people diagnosed with serious mental illnesses have long been placed under the guardianship of close relatives who decide on their hospitalization and treatment. Despite attempts at reforms to ensure patient rights, the 2013 Mental Health Law reinforced the family's rights and responsibilities. In Between Families and Institutions, Zhiying Ma examines how ideological, institutional, and technological processes shape families' complicated involvement in psychiatric care. Drawing on extensive ethnographic fieldwork in psychiatric hospitals, community mental health teams, social work centers, and family support groups as well as interviews with policymakers and activists, Ma maps the workings of what she calls "biopolitical paternalism"-a mode of governance that sees vulnerable individuals as sources of risk, frames risk management as the state's paternalistic intervention, and shifts responsibilities for care and management onto families. Ma outlines the ethical tensions, intimate vulnerabilities in households, and health disparities across the population that biopolitical paternalism produces. By exploring these implications, Ma demonstrates the myriad ways biopower enables, inhibits, and transforms medical care in China.
Zhiying Ma is Assistant Professor in the Crown Family School of Social Work, Policy, and Practice at the University of Chicago.
Acknowledgments ix Introduction 1 1. Constructing Families, Contesting Paternalisms 29 2. Hospitalization, Risks, and Familial Commitments 51 3. Kinship and Its Limits amid Serious Mental Illness 69 4. Biopolitical Paternalism and its Maternal Supplements in Community Mental Health 87 5. Determining Risks and Responsibilities Under the Mental Health Law 111 6. Suffering, Sociality, and Citizenship Among Family Caregivers 133 Conclusion 155 Notes 165 References 173 Index 193
"In this fascinating and moving ethnographic examination of the management of severe mental illness in contemporary China, Zhiying Ma shows not only how the lessons of psychiatric care can apply to other types of biopolitical management in China, but how these lessons apply elsewhere throughout the world. Between Families and Institutions is one of the best books I have read in a while." - Katherine A. Mason, author of (Infectious Change: Reinventing Chinese Public Health after an Epidemic) "Offering a highly sophisticated and multidimensional account of how mental illness is treated, managed, and lived, Zhiying Ma shows how the predominating logic of risk in postsocialist Chinese psychiatry and governance overrides any meaningful ethics of care, leaving family members to absorb and make up for deficiencies of institutional care and support. Within the anthropology of China, there is virtually no existing study of this kind. This outstanding book makes an important contribution to the anthropology of China as well as social science approaches to mental health." - Teresa Kuan, author of (Love's Uncertainty: The Politics and Ethics of Child Rearing in Contemporary China)
