PhD Candidate, Department of Social Anthropology, University of Edinburgh and Honorary Research Assistant, Department of Anthropology, The Chinese University of Hong Kong
Treating Crazy: Becoming a Hong Kong Psychiatrist
18 October 2013
“Treating crazy” was a talk that focused on psychiatrists, specifically on the process of becoming a psychiatrist, to understand how the social stigma associated with mental illness can also have a negative impact on how clinicians experience their work. Ms Hanna Mantila locates doctors at one point in a complex network that includes classification (i.e. diagnostic practice), institutions (the health care system), experts (the psychiatrists), knowledge (biomedical knowledge in this case), the people (the mentally ill patients), and international organizations and pharmaceutical companies. Medical anthropologists commonly study the “illness experience” and clinical encounters from patients’ perspectives, but Ms. Mantila put the psychiatrists at the center of her analysis, demonstrating how systemic tensions and social ideas affect socialization and professionalization.
Ms. Mantila noted that there are only around 300 psychiatrists in Hong Kong, which is a rather small number considering the population and the needs of Hong Kong. Patients have very long waiting times (even three weeks for the most urgent of cases in child psychiatry), because examination time and resources are limited. This can also affect the quality of supervision trainees receive from their supervisors, and psychiatrists’ ability to offer “psycho-education” to patients, i.e. the importance of staying on a drug regimen even when they feel well.
In her presentation, Mantila presented a number of personal accounts given by Hong Kong psychiatrists’, and urges us to understand the difficulties these doctors face. She also discussed how the severe stigmatization of patients in Hong Kong makes halfway homes nearly impossible to open, which forecloses the institution of community-based alternatives to hospitalization.
Ms. Mantila spoke about her initial findings as she only recently completed a year of fieldwork. The talk made listeners aware of the cost of the “efficiency” of Hong Kong’s public medical system, and to consider how global forms of expertise and medical practice are always shaped by a given social and economic context.