Recovery, Mental Health and Inequality: Chinese Ethnic Minorities as Mental Health Service Users

195 Pages·2017·1.586 MB·English

by  Lynn Tang

Recovery, Mental Health and Inequality
Mental health has long been perceived as a taboo subject in the UK, so much so
that mental health services have been marginalised within health and social care.
There is even more serious neglect of the specific issues faced by different ethnic
minorities.
This book uses the rich narratives of the recovery journeys of Chinese mental
health service users in the UK – a perceived ‘hard-to-reach group’ and largely
invisible in mental health literature – to illustrate the myriad ways that social
inequalities such as class, ethnicity and gender contribute to service users’ distress
and mental ill-health, as well as shape their subsequent recovery journeys.
Recovery, Mental Health and Inequality contributes to the debate about the
implementation of ‘recovery approach’ in mental health services and demon-
strates the importance of tackling structural inequalities in facilitating meaningful
recovery. This timely book would benefit practitioners and students in various
fields, such as nurses, social workers and mental health postgraduate trainees.
Lynn Tang is Assistant Professor in the School of Arts and Humanities, Tung
Wah College, Hong Kong.
Routledge Studies in the Sociology of Health and Illness
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Recovery, Mental Health and Inequality
Chinese Ethnic Minorities as Mental Health Service Users
Lynn Tang
Forthcoming titles:
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Recovery, Mental Health
and Inequality
Chinese Ethnic Minorities as
Mental Health Service Users
Lynn Tang
First published 2017
by Routledge
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and by Routledge
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Routledge is an imprint of the Taylor & Francis Group, an informa business
 2017 L. Tang
The right of Lynn Tang to be identified as author of this work has been
asserted by her in accordance with sections 77 and 78 of the Copyright,
Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Names: Tang, Lynn, author.
Title: Recovery, mental health and inequality : Chinese ethnic minorities as
mental health service users / Lynn Tang.
Other titles: Routledge studies in the sociology of health and illness.
Description: Abingdon, Oxon ; New York, NY : Routledge, 2017. |
Series: Routledge studies in the sociology of health and illness |
Includes bibliographical references and index.
Identifiers: LCCN 2017002012| ISBN 9781138849976 (hardback) |
ISBN 9781315725086 (ebook)
Subjects: | MESH: Mental Disorders—therapy | Asian Continental
Ancestry Group—psychology | Mental Health Services—organization
& administration | Ethnic Groups—psychology | Minority Groups—
psychology | United Kingdom—ethnology | China—ethnology
Classification: LCC RC455.4.E8 | NLM WA 305 FA1 | DDC 362.2089—dc23
LC record available at https://lccn.loc.gov/2017002012
ISBN: 978-1-138-84997-6 (hbk)
ISBN: 978-1-315-72508-6 (ebk)
Typeset in Times New Roman
by Swales & Willis Ltd, Exeter, Devon, UK
Contents
List of tables vi
Acknowledgements vii
1 What recovery? Whose recovery? Recovery as a
disputed approach 1
2 Exploring social inequalities with the Capabilities
Approach and Intersectionality Analysis 24
3 When things start to fall apart: social conditions and
the loss of capabilities 36
4 Becoming a psychiatric patient 60
5 Life after shipwreck: social conditions for capabilities
(re)development 91
6 Stubbornly strive to be human: meanings of recovery,
hope and adaptive preferences 115
7 Social conditions for recovery: towards a social justice agenda 134
Methodological epilogue: developing the service user
knowledge of Chinese communities 148
Appendix: participants’ biographical data 163
References 164
Index 179
Tables
3.1 Age and gender of the participants at the time of interview 37
3.2 Birthplace of participants 37
3.3 Occupations of participants in the UK 40
3.4 Educational levels of participants 41
3.5 Types of housing of participants at the time of interview 41
3.6 Languages spoken fluently by participants 41
4.1 Diagnosis received as reported by participants 67
Acknowledgements
This book is an outcome of my academic, as well as personal, journey to date. It
also constitutes the journeys of my research participants. For this journey to be
realised, I have the Overseas Research Students Awards Scheme and the Warwick
Postgraduate Research Studentship to thank for the full scholarship to pursue
the PhD research that this book is based on, as well as the British Sociological
Association for the Phil Strong Memorial Prize, which enabled the participants
to share their recovery journeys with me. Thanks also go to Amy Cui from the
Chinese Community Centre Birmingham, Louise Wong from the Wai Yin Chinese
Women Society, as well as Perry Fung and Khim Wong from the Chinese Mental
Health Association for their generous help in introducing me to the participants.
My deepest gratitude goes to the research participants. I feel honoured to listen
to their stories and am touched by their sorrows and strengths in their recovery
journeys. I hope this book does justice to their stories.
I must thank my supervisors, Mick Carpenter and Peter Ratcliffe, for persis-
tently raising the bar and widening my academic horizons. Gratitude is extended
to David Pilgrim and Hilary Marland for their critical comments on the PhD the-
sis, and to Bob Carter for his encouragement during the Prato Writing Workshop.
I am also thankful to Simon Clarke, Phil Mizen, Joy Fillingham and Mandy
Lugsdin for their generous hospitality when I travelled between Hong Kong and
the UK; as well as Miu Chan and Kender Wu for their assistance in the research.
Having worked in ‘Mental Health in Higher Education’, a multidisciplinary
teaching and learning project, this broadened my understanding of the contested
nature of mental health (problems) as well as the vital role of the service user
movement in advancing our knowledge about mental health. I learnt a lot from
my wonderful and supportive colleagues Jill Anderson and Hilary Burgess, and
would like to thank the Centre of Excellence in Interdisciplinary Mental Health at
the University of Birmingham for appointing me as an honorary fellow and offering
continuous support during my PhD years.
I am blessed with friendships that provide a solid foundation for me to take on
this project. Thanks are due to Charlene Clempson, Anne Barrett, Sarra Facey,
Jill Anderson, Jan Wallcraft, Elisabeth Simbürger, Rosario Undurraga, Milena
Kremacova, Kirsty Liddiard, Kirsty Warren, Ruth Pearce, Mark Carrigan,
Elizabeth Matka, Amalia Schnier, Wai-Ha Lam, Anita Liu, Yubin Chiu, Huamei
viii Acknowledgements
Chiu, Debora Poon, Garyin Tsang, Lai Ching Leung, Florence Hui and Mei Tse.
Special love goes to Ann Davis and Alex Davis for their enormous faith in me and
generous support in myriad forms. I wish Wai-Ling could read this book as she
has always been a key part of this journey. I must also thank my dear parents for
having always shown unreserved support in my academic pursuit. My profound
love is dedicated to Chris King-Chi Chan, my partner, for always being there to
share the adventures of life, through better or worse.
1 What recovery? Whose recovery?
Recovery as a disputed approach
Introduction
This book critically interrogates the concept of recovery and the elements of the
recovery approach, through exploring the way social inequalities shape the jour-
neys of Chinese mental health service users in the UK. Recovery as a movement
originating in the US has gained impetus internationally and has been adopted as
a mental health policy paradigm in many different countries (Ramon et al., 2009;
Slade et al., 2012). In the UK it has been a frequent discursive feature of policy
documents and has been adopted by governments as their ‘vision’ of mental
health services (DoH, 2001, 2009, 2011).
The recovery movement has its roots in new social movements and has
concerned itself with asserting the rights of mental health service users
to control their own lives in the face of the dominance of psychiatric
power. However, criticism had been made of the way recovery has been
mainstreamed and appropriated by mental health policies. Such criticism
questions the extent that social-structural inequalities leading to, and result-
ing from, distress and mental ill health, can be addressed in a neo-liberal
political economy and policy context (Pilgrim, 2008; Spandler and Calton,
2009; Edgley et al., 2012; Morrow, 2013).
It is against this background that this book aims to problematise the con-
cept of recovery and argue for the central role of social justice at the heart of
a recovery paradigm – one that addresses and tackles multilevel inequalities.
It aims to achieve this empirically by exploring the lived experiences of a
marginalised group of mental health service users. Incepted from my experi-
ences as a Hong Kong Chinese woman who has used mental health services
in both the Hong Kong and UK, this book is based on my doctoral research
on Chinese service users living in the UK, which illuminates how structural
inequalities contribute to their ill health and shape the social conditions in
which they recover. This study privileges service user knowledge and illus-
trates their agency throughout the recovery journeys. Through understanding
their struggles of recovery, this book will shed light on the cultural as well as
structural factors that facilitates or hinders recovery in a multicultural society
for this ethnic minority community.