Survivors, users, or peers? Translating identities and decolonizing mental health in China.

Abstract

In recent years, new identities have emerged for psychiatric "patients" in China, such as "users," "survivors," and "peers." This article draws on my long-term research on and engagement with the country's mental health field to explore the emergence of these identities as translations of globally circulating ideas and practices. Rather than viewing them as mere derivatives of Euro-American originals, I demonstrate that they are strategic translations initiated by activists and academics to resist the hegemony of biomedical and institutional psychiatry, and that they have created opportunities for policy and service reform, recognition, and empowerment. However, my analysis also reveals that the global and local authority these translations leverage has produced exclusion and marginalization. In particular, the mandate for self-advocacy against institutions underlying activists' promotion of the user and survivor identities could overlook people's vulnerability, dependency, and differences in communities. Meanwhile, attempts by academics like me to establish peer supporters as recognized paraprofessionals within the system could reproduce existing hierarchies and generate new frictions among persons with lived experience. I suggest that academics, activists, and other stakeholders involved in translating identities in the Global South should critically examine the processes and their potentially oppressive power effects, to reflect on our gatekeeping roles and center the diverse leadership of impacted individuals, and to boldly experiment with new forms of translation together for continuous (self-)decolonization.