Stigma: Social suffering for social exclusion and social insecurity. From the ethnography of mental illness to the ethnography of HIV/AIDS in China.

摘要

This dissertation examines the cultural genesis and social mechanisms of stigma related to mental illness and HIV/AIDS in China. In Chinese society where concern about human rights is weak, if it is not completely absent, because of the moral common sense of what makes a person, people with mental illness and HIV/AIDS are categorized into the group of non-persons. Non-persons do not experience social acceptance. They are socially excluded. They do not have rights. And thus they are stigmatized and discriminated against. This dangerous cultural form of moral common sense, and the ways families, local communities, and state institutions respond to perceived social insecurity--the threat allegedly posed by people who have mental illnesses and HIV/AIDS---mutually shape each other. They work to maintain and strengthen the cruel and injurious stigma associated with mental illness and HIV/AIDS.;This dissertation is based on two and a half years of fieldwork in China: one year in Hubei Province studying the chronic mentally ill, and one year in Beijing and a half year in Yunnan Province studying HIV/AIDS patients.;In the Chinese context, people with mental illness are considered to be non-persons on account of their mental disabilities; while people with HIV/AIDS are regarded as non-persons because of what they are believed to have done that caused their HIV/AIDS status. I trace how people with mental illness and HIV/AIDS are socially excluded from their existing social relationships and social networks in their local communities. I highlight families as a major site of stigma to describe the micro socio-dynamic process of stigmatization in the local context. People with mental illness usually experience a terrible identity transformation: from being a person to being a non-person and, in the extreme case of psychosis, to being a non-human who is rejected and abandoned by the family. People with HIV/AIDS generally experience the reverse transformation: from being a non-human in the family to being a non-person in society.;Through comparison of mental illness and HIV/AIDS, I connect Chinese society and its community-centered social value system to the stigma associated with mental illness and HIV/AIDS. I analyze how discrimination is understood in Chinese daily life and explore the links between disadvantaged groups and the stigmatized. Ultimately this research implies the need to develop human rights-concerned legislation and national policies. It also strongly supports the development of humanitarian ethics-centered professional education and institutional reform in health care systems and public education among the general population in China in order to counteract the catastrophic effect of stigma associated with mental illness and HIV/AIDS and other human conditions.