The more severe the illness, the better you're off in the public system: economic wealth and mental health care in Hong Kong
Hanna Mantila (University of Edinburgh)
Paper short abstract:
Drawing on recently completed fieldwork in Hong Kong, this paper examines the role of psychiatrists in both dismantling and re-enforcing the paradoxes of the mental health/economic wealth relation.
Paper long abstract:
Modern psychiatry has moved towards an understanding of mental health and illness as inherently multifactorial, a conceptualization that also brought forth an urgent need to establish causalities that could be swiftly and cost-effectively addressed. Although the incentive behind such processes is well-intended and apparently rational, this paper suggest that the empirical data collected by anthropologists through interviews and observation highlights discrepancies between expected causalities and mental health as it is perceived and treated in clinical realities. As mediators between psychiatric knowledge, systems of health care, patients and society, psychiatrists as subjects of study provide a novel angle through which the paradoxes of the mental health/wealth relation can be explored. Hong Kong, a developed region with a comprehensive and extensive public and private health care system, provides evident examples to discuss. Here, it seems on the surface that the public system caters to the more severe mentally ill and the private consoles those ''with so much money they get depressed''. Although in theory this pushes the relations further by linking economic wealth with emotional distress and depravity with more organic disorders, deeper inquiry belies such simplification. Different stakeholders, such as the WHO, local health governments, and the pharmaceutical industry, construct their own frameworks of causalities, all traversed and negotiated through by patients and doctors alike. Drawing on fieldwork in Hong Kong, this paper looks at how the clinical experiences and perspectives of psychiatrists address and contribute to the understanding of economic wealth as a potential core factor of mental health issues.
Economic wealth and mental health: questioning the paradoxes