Discussions of mental health cannot exist in a pure biological realm without considering how it is intersectionally embedded within our political and economic structures. There is mounting evidence on the social causation and social drift effects of poverty and poor mental health. It is the day-to-day lived-experience, negligence of the structure, disproportioned power and relationships – both historic and contemporary – that constructs the patterns of mental illness in our society (Nancy Krieger) – which shape the niche where people survive with mental illnesses (Rochell Burgess).
In Hong Kong, the government has invested on destigmatisation of mental illness – yet most work appeared to go south – but that is only to be expected whn mental health is viewed with a poorly focused lens, with healthcare, social welfare, housing & labour departments working in silos. Still awaiting evaluation reports from multi million dollars campaigns.
There is an extent destigmatisation workshops and talks are going to help, when the whole societal narrative has been horrendously stagnant. When people with mental illness continue to be ignored in work and pension system, struggling in underfunded and underresourced psychiatric care systems, and unsupported by community care running purely on charities by churches and NGOs. What, then, is the government’s role in building a mental health enabling society?
“What is promoted as fiscal discipline is a political choice. A political choice that deepens the already open and bloody wounds of the poor and precarious….But austerity is also a social contract. People accept severe restraints in public spending, actively in democracies or passively in autocracies, because they accept the unpalatable prescription of abstinence…”
“…Yet the public too has a choice. And they are exercising that choice in countries across the globe……After a decade of cutting back the reach of government, the public is now demanding a stronger and more generous state. The (social) contract authorising austerity has been torn up…” Richard Horton (2017).
Ethics lies at the heart of policy-making. Open dialogue and knowledge exchange is essential in developing the consensual ethics standards that drive attitude change and destigmatisation. Ability to identify strengths locally, ensuring safe social spaces and partnership is indispensable in vitalising these ethical standards in policy making. These are what we can do – speak, act, adapt and live truthfully to your beliefs – the fruit of democracy.
Yet all these must align with a wider narrative that the Hong Kong Government listen to her people, and reflect her observations through the budget plans. There would be much more leveraging and bargaining in-between, precisely a role of the elected members in the LegCo. Change is not impossible.
I often end with brief remarks of encouragement – I’ll do the same here – A Change is gonna coming.
JosePhD 