1/No legal rights of people with mental illness and guarantees access to treatment
Sociopolitically, China’s delay in passing a national mental health law that clearly delineates the legal rights of people with mental illness and guarantees access to treatment contributes to negative stereotyping, anticipated devaluation, and discrimination reported by people with schizophrenia across multiple life domains
2/The traditional viewpoint that cultivation of restraint is integral to moral character further shapes how mental illness stigma is felt
In Confucian thought, one must learn to control oneself before exerting social influence (Lau, 1984). Partly due to public beliefs in China that people with mental illness act dangerously and unpredictably (Phillips & Gao, 1999), we propose that such persons are viewed as not fully cultivated and thus incompetent to participate in social life.
According to Confucian humanism, “people are born to be virtuous”, with ren (仁) and li (禮) being the twin pillars of society which is about people treating each other with courtesy, and respecting each other’s roles and statuses within a family/social system. Given the symptoms of mental disorders are often disruptive to social and behavioral norms, the subject of mental illness or bipolar disorder is seen as moral weaknesses and shame to an individual or the entire family. Thus, it might be fine to talk about mild emotional concern such as “feeling sad, worrying” but not the acting out the high mood (e.g., excessive spending, sexually active, acting on the grandiose plan) or hearing of voices. In other words, there may be a value system attached to various emotions in Chinese culture; for instance, “feeling sad, worrying” is acceptable but not in extreme forms of emotions.
3/Face
The interpersonal level of stigma includes all individual-to-individual forms of discrimination, including social distancing and rejection. Our analysis highlights physician and family member stigma as particularly salient in China. In addition, loss of guanxi or social capital – i.e., loss of social opportunities to achieve desired social statuses such as marriage, and diminished access to material resources (via social-exchange networks) – also constitutes a crucial aspect of interpersonal stigma. Because loss of face compromises one’s moral standing in a local community and access to social resources, stigma is further seen to directly threaten the interpersonal engagements that define what is most at stake for ordinary Chinese in everyday life
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