From “whom to blame” to “nothing to fear”: documentary narratives, voices, and “dependent destigmatization” of severe mental patients (SMPs) in Hong Kong

Abstract

Media often stigmatize severe mental patients (SMPs) by portraying them as dumb, sluggish, or violent. Conversely, TV documentaries, as a particular media genre, have the potential to destigmatize SMPs by entrusting them with an authentic presence and a direct voice. Illuminated by Couldry’s (2010) discussion on voice and drawing on narrative analysis, this article examines the evolving and joint endeavor of media and mental hospitals in systematically destigmatizing SMPs and in promoting the rehabilitation mode of mental health care in Hong Kong. From 1989 to 2011, Hong Kong Connections produced three documentaries. Shifting the narrative from “whom to blame” to “nothing to fear,” the documentaries establish a destigmatization agenda jointly formulated by the media and mental hospitals. SMPs’ voices steadily increase in length and prominence in the narrative’s temporal line, yet they are strictly orchestrated within the sealed narrative that is subject to the institutional interest of promoting the rehabilitation mode of mental health care in Hong Kong. The voice/narrative inequality between SMPs and mental institutions leads to the “dependent destigmatization” that indicates a dependent power relation between SMPs and powerful institutions.

Keywords:

• severe mental patients (SMPs)
• documentary narrative
• voices
• communicative resources
• dependent destigmatization

Acknowledgements

Many individuals provide me generous help on this study. Thanks to my supervisor Professor Eric Kit-wai Ma for inviting me to join the project on cultural history of Castle Peak Hospital. This opportunity evoked my initial interests in media narratives on mental illnesses in Hong Kong. Thanks are also due to my classmate Cherry Yan Yan Lam. She helped me in interviews conducted in Cantonese, which has tremendously enriched my data and comprehension on the issue. Finally, my thanks also due to my interviewees, their unselfish sharing nurtured this study. Any opinions, and conclusions, or recommendations expressed in this article are those of the author and do not necessarily reflect the views of interviewees.

Notes

¹ According to Ruggeri, Leese, Thornicroft, Bisoffi, and Tansella (2000, p. 149), those with severe mental illness have to conform to three criteria set by the National Institute of Mental Health (NIMH; 1987): “a diagnosis of non-organic psychosis or personality disorder; duration characterized as involving prolonged illness and long-term treatment and operationalized as a two-year or longer history of mental illness or treatment, and disability which was described as including at least three of the eight specified criteria” (p. 149). This study will not rigorously apply those criteria to cases but will view those who have been incarcerated and treated in mental hospitals as severe mental patients. Considering that this study aims to evaluate the documentary narratives of those with SMI, it would not harm the argument’s validity.

² The key interviewees in this study include Eric Poon (former director of Hong Kong Connections), who participated in producing The CPH is Still There (1989) and directed the latter two episodes of Hong Kong Connections in 2006 and 2011; Cheung Hung Kin (former superintendent of CPH), and Jolene Hang Chun Mui (nurse consultant of the psychiatric community service team of CPH).

³ The Anne Anne kindergarten incident in 1982 undeniably triggered public anxiety regarding the dangers of SMPs. From the 1980s to the early 1990s, strong opposition existed toward community mental care facilities, such as halfway houses, treatment and training centers for psychiatric patients, and psychiatric daycare centers in residential areas. Yip argued such fears inhibited the rehabilitation and integration of mental patients within the community (see Yip1998.).

⁴ Voices extracted from the documentary are quoted with the timeslot in which they are inserted. For example, 11:45–12:00 means that the voices are present from 11 minutes and 45 seconds to 12 minutes of the episode.

⁵ The Department of Hospital Affairs was the institution responsible for managing the affairs of public hospital service. The Hospital Authority (HA), created under the Hospital Authority Ordinance on 1 December 1990, replaced the Department of Hospital Affairs in 1991 (retrieved from http://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=10008&Lang=ENG&Dimension=100&Parent_ID=10004&Ver=HTML).

⁶ In order to explicate the utilized communicative strategies, this clip of conversation was transcribed in both Chinese (the original language used in the TV documentary) and English. The transcription system was in accord with simplified transcription symbols in Silverman (1993, p. 118). The illustration of each symbols is as follows: “(.N)” – numbers in parentheses indicate elapsed time in silence in tenths of a second; “[” – left brackets indicate the point at which a current speaker’s talk is overlapped by another’s talk; “=” – equal signs, one at the end of a line and one at the beginning, indicate no gap between the two lines; “__” – underscoring indicates some form of stress, via pitch and/or amplitude. “WORD” – capitals indicate especially loud sounds relative to the surrounding talk.