Culture, Medicine, and Psychiatry

, Volume 42, Issue 1, pp 92–111 | Cite as

Guan (Care/Control): An Ethnographic Understanding of Care for People with Severe Mental Illness from Shanghai’s Urban Communities

  • Jianfeng Zhu
  • Tianshu Pan
  • Hai Yu
  • Dong DongEmail author
Original Paper


This article investigates how the political culture of Guan (care/control) in China is played out across the platforms of the state, the community and the family through the lens of caring for people with severe mental illness in urban Shanghai. Based on ethnographic data collected from six communities in a district of Shanghai, we provide a nuanced understanding of the roles of family members, street committees and other governmental organizations in their daily practices of caring for people with severe mental illness. We show the complicated and intertwined relationships between local governmental agents and the family. We argue that the political culture of Guan, which permeates the everyday life of Chinese people, tends to objectify its subjects and reflects a long history of patriarchy in Chinese society. Without further changing such political cultural arrangements, respect for the agency of mentally ill patients, the effort of bringing humanistic psychiatric reforms to China, will be in vain.


Care Control Mental health Political culture China 


  1. Biehl, João 2005 Vita: Life in a Zone of Social Abandonment. Berkeley: University of California Press.Google Scholar
  2. Bray, David 2006 Building ‘Community’: New Strategies of Governance in Urban China. Economy and Society 35(4):530–549.CrossRefGoogle Scholar
  3. Brodwin, Paul, and Livia Velpry 2014 The Practice of Constraint in Psychiatry: Emergent Forms of Care and Control. Culture, medicine and psychiatry 38(4):524–526.CrossRefGoogle Scholar
  4. Desjarlais, Robert R. 1995 World mental health: problems, and priorities in low-income countries. New York: Oxford University Press.Google Scholar
  5. Friedman, Jack R. 2009 The “Social Case”. Medical anthropology quarterly 23(4):375-396.CrossRefGoogle Scholar
  6. Foucaullt, Michel 2003 Psychiatric Power: Lectures at the College de France 1973-1974. Graham Burchell, trans. New York: Picador.Google Scholar
  7. Kleinman, Arther and Joan Kleinman 1999 The Transformation of Everyday Social Experience: What a mental and Social Health Perspective Reveals about Chinese Communities under Global and Local Change. Culture, Medicine and Psychiatry 23:7–24CrossRefGoogle Scholar
  8. Ma, Zhiying 2014 Intimate Life Politics: Family Rights, Responsibility and Mental Health Legislation. Thinking (Sixiang Zhanxian) 40(3):42–49 (in Chinese)Google Scholar
  9. Matza, Tomas 2012 “Good individualism”? Psychology, ethics, and neoliberalism in postsocialist Russia. American Ethnologist 39(4):804–818.CrossRefGoogle Scholar
  10. Pearson, Veronica. 1992 Community and culture:a Chinese model of care for the mentally ill. International Journal of Social Psychiatry 38:163–178.CrossRefGoogle Scholar
  11. Pearson, Veronica. 1993 Families in China: an undervalued resource for mental health? Journal of Family Therapy 15:163–185.CrossRefGoogle Scholar
  12. Phillips, Michael R. 1993 Strategies used by Chinese families in coping with schizophrenia. In D.Davis and S. Hannell eds. Chinese Families in the 1980s. Berkeley: Unversity of California pressGoogle Scholar
  13. Phillips, Michael R. 1998 The Transformation of China’s Mental Health Services. The China Journal (39):1–36.CrossRefGoogle Scholar
  14. Pols, Jeannette 2016 Analyzing Social Spaces: Relational Citizenship for Patients Leaving Mental Health Care Institutions. Medical Anthropology 35(2):177–192.CrossRefGoogle Scholar
  15. Sevigny, Robert, Sheying Chen and Elaina Y. Chen. 2009 Personal Experience of Schizophrenia and the Role of Danwei:A case Study in 1990s Beijing. Culture, Medicine and Psychiatry 33:86–111.CrossRefGoogle Scholar
  16. Shen, Yuying 2014 Community building and mental health in mid-life and older life: Evidence from China. Social Science & Medicine 107:209–216.CrossRefGoogle Scholar
  17. Wutich, Amber, et al. 2014 Stigmatized Neighborhoods, Social Bonding, and Health. Medical anthropology quarterly 28(4):556–577.CrossRefGoogle Scholar
  18. Xiang, Yu-Tao, Xin Yu, Gabor S Ungvari, Edwin HM Lee, and Helen FK Chiu 2012 China’s National Mental Health Law: A 26-year work in progress. The Lancet 379(9818):780–782.CrossRefGoogle Scholar
  19. Yan, Miu Chung, and Jian Guo Gao 2007 Social Engineering of Community Building: Examination of Policy Process and Characteristics of Community Construction in China. Community Development Journal 42(2): 222–236.CrossRefGoogle Scholar
  20. Ying, Chen 2015 Shanghai Model Embraced by WHO: Paving the Way for the Rehabilitated to Return Society. In Xinmin Weekly. pp. 46–51, Vol. 842. Shanghai.Google Scholar
  21. Zhang, Li 2015 Bentuhua: Culturing Psychotherapy in Postsocialist China. Culture, Medicine, and Psychiatry 38(2):283–305.CrossRefGoogle Scholar
  22. Zhang, Li 2017 The Rise of Therapeutic Governing in Postsocialist China. Medical Anthropology 36:6–18.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.School of Social Development and Public Policy, Fudan-Harvard Medical Anthropology Collaborative Research CenterFudan UniversityShanghaiChina
  2. 2.School of Social Development and Public Policy, Department of SociologyFudan UniversityShanghaiChina
  3. 3.David C. Lam Institute for East–West StudiesHong Kong Baptist UniversityKowloon TongHong Kong

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