Protecting the human rights of the mentally ill in China by using indigenous idiom: an example of the application of the receptor approach
July 25,2017   By:chinahumanrights.org

Protecting the human rights of the mentally ill in China by using indigenous idiom: an example of the application of the receptor approach 

Tom Zwart

1. Introduction

- In view of our time limitations and considering the fact that I already spoke this morning, I will only highlight one aspect of my paper, namely the opportunity to avoid stigma for the mentally ill in China by using lay terms to describe the illness.
- Many of those suffering from mental illness are leading a tough life because of the stigma attached to psychiatric diseases. They face social exclusion because they are shunned by the community.
- Consequently, they tend to avoid diagnosis and treatment, which makes their plight even greater. As a result, the human rights of the mentally ill in China are under great pressure.

2. A cultural remedy for a cultural problem

2.1 Culture as cause

- The stigmatisation of the mentally-ill does not flow from ignorance or lack of sympathy, but roots in traditional Chinese culture. According to Confucianism, upon birth everyone become as member of the human race. But this biological min status does not confer any rights or social standing upon the individual.
- These are the prerogatives of the person or ren. Such personhood can only be acquired through self-cultivation and taking part in society. To become ren one is therefore supposed to leave behind the animal-like instincts and desires of the min stage by joining others in creating a better society.
- In order to be able to be treated as a person with rights, one reciprocally has to act as a person by engaging in social relationships and building social networks.
- People who are incapable of fulfilling such social obligations, such as the mentally ill, are therefore regarded as non-persons who belong nowhere. This lack of personhood invites humiliation, discrimination and stigma. Therefore, losing personhood is not the consequence of stigmatisation, but paves the way for it.

2.2 Culture as solution: the use of indigenous idiom

- Stigma is the result of the process of 'labelling', whereby people attach a particular label to a phenomenon.
- As soon as a psychiatrist in China diagnoses a person as suffering from schizophrenia, this not only paves the way for effective treatment, but also sets into motion a process of stigmatisation. The sufferer becomes a social outcast, whom from then onwards will be kept hidden in the family homestead.
- The negative consequences of stigmatisation can be prevented or remedied by using alternative labels to describe mental illness.
- For example, schizophrenia is referred to in lay terms as 'excessive thinking' (xiang tai duo). The belief that the disorder which psychiatrists call schizophrenia is caused by 'excessive thinking' is widely held by the Chinese people.
- When a person is diagnosed as suffering from excessive thinking, she or he will not be seen as the moral 'other' who merits stigma and discrimination, but as 'one of us'. Application of these idioms thus mitigates the strangeness of the patients' behaviour and diminishes their social rejection.
- Therefore, by using the socially acceptable label of 'excessive thinking' instead of the biomedical diagnosis of schizophrenia, mental illness stigma may be mitigated.
- By using the indigenous idiom of 'excessive thinking' the group members make the diagnosis of this mental illness culturally manageable.
- As part of this vernacularisation process, an extraordinary disease, which normally makes the patient stand out and leads to her or his exclusion, is put within the framework of common behaviour in which all group members occasionally engage.
- Empirical research conducted by Yang and others has demonstrated that such an inclusive labelling strategy is effective. If this labelling strategy would be applied at a larger scale, this would restore the human rights of tens of millions of people.

From:The Third Session of China-Europe Seminar on Human Rights , July 2-3