Making the subjects of mental health care: a cross‐cultural comparison of mental health policy in Hong Kong, China and New South Wales, Australia

• Published in: Sociology of health & illness Vol. 41; no. 4; pp. 740 - 754
• Main Authors: Cui, Jialiang, Lancaster, Kari, Newman, Christy E.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.05.2019
• Subjects: comparative methods; Constructionism; Cross cultural studies; Cross-Cultural Comparison; Health care policy; Health Policy; Health problems; Hong Kong; Humans; Mental Disorders - psychology; Mental health; Mental health care; Mental health policy; Mental health services; Multiculturalism & pluralism; New South Wales; policy analysis; Policy Making; Poststructuralism; Reforms; Social problems; Hong Kong; New South Wales; Hong Kong China; Australia; New South Wales Australia; policy analysis; comparative methods; mental health services
• ISSN: 0141-9889; 1467-9566; 1467-9566
• DOI: 10.1111/1467-9566.12851

Constituting ‘social problems’ in particular ways has a range of effects, including for how subjects are positioned within policy and discourse. Employing an approach grounded in poststructuralist and social constructionist thinking, this analysis interrogates how the subjects of mental health care were constituted and problematised in mental health policies in two distinctive contexts, unsettling the taken‐for granted assumptions which underpin these problematisations. Two policies were selected for analysis as exemplar pieces of mental health policy reform in Hong Kong and New South Wales (NSW). Subjects were constituted as ‘patientised’ individuals (in Hong Kong) encouraged to depend on professionals who help them reintegrate into the ‘normal’ community, and as ‘traumatised’ individuals (in NSW) expected to take responsibility to guide the delivery of mental health care and respected as a part of diversity in community settings. While both policies constituted subjects as ‘unwell individuals’ and enacted ‘dividing practices’, subjectivities were shaped by distinctive cultural and socio‐political contexts. This analysis shifts our attention away from a focus on the effectiveness of policy solutions to the heterogeneity and contingency of policy ‘problems’ and ‘subjects’, opening up new possibilities for ‘out‐of‐the‐box’ policy responses to mental health.