Zhiying Ma, PhD

1) Family and Mental Healthcare in China 

In China, for the past few decades, people diagnosed with serious mental illnesses (SMIs) have been placed under the guardianship of their close relatives, who would decide on their hospitalization and treatment. Despite intense public discussion on patient rights, the 2013 Mental Health Law (MHL) has reinforced the family’s rights and responsibilities in patient management. Why does the family continue to occupy such a critical role in Chinese psychiatry? Dr. Ma addresses this question by examining the family’s involvement in medicine as technological, institutional, and ideological configurations, with the aim of illuminating the changing ethics, affects, and political economy of care and population governance in contemporary China. 

Between 2008 and 2014, Dr. Ma conducted 32 months of fieldwork in psychiatric hospitals, community mental health teams, social work centers, family support groups, and human rights agencies in China. She interviewed policymakers and other stakeholders, attended conferences and legislative debates, and reviewed archival and media materials. Based on this rich trove of data, she identified the workings of “biopolitical paternalism,” a mode of governance evidenced in mental health. It legitimizes the state’s population management as paternalistic intervention, while displacing the paternalistic responsibilities onto patients’ families. This biopolitical paternalism produces ethical tensions and intimate vulnerabilities in households, as well as health disparities across the population, but it is also being destabilized by caregivers’ everyday supplemental practices of care and their sociopolitical demands. These findings have been published in a book and several journal articles/book chapters.  

Across the world, biomedicalized techniques of rule are redefining individual wellbeing and population security, and neoliberal economic policies constantly relegate responsibilities for achieving these new ideals to private agents while creating longings for the state. Therefore, biopolitical paternalism is increasingly relevant for understanding and critically engaging with forces and impacts of social governance beyond China and mental health.    Dr. Ma is working with students to trace the manifestations and continued evolution of biopolitical paternalism, such as during the COVID-19 pandemic. 

2) Development of Community Mental Health and Peer Support in China 

While enclosed psychiatric hospitals have dominated the landscape of mental healthcare in China over the past few decades, community mental health has received increased attention and investment since 2004. This concept is not new, however. In the 1970s and 1980s, psychiatrists in various parts of China experimented with local approaches to community mental healthcare provision, which were praised by the World Health Organization as models for developing countries. 

Why has community mental health re-emerged in China as the frontline of social development? How do policymakers and practitioners translate forms of global knowledge and make them commensurable with domestic situations (or vice versa), given the diverse and ever-shifting visions and techniques of China’s governance? How do these forms of knowledge shape people’s everyday practices and experiences of care? To explore these questions, Dr. Ma works with students and research assistants to conduct fieldwork in community mental health teams and social work agencies, interview psychiatrists, policymakers, and other stakeholders involved in designing and implementing various community mental health initiatives, analyze archival materials on the development of these initiatives, and survey public discussions around mental health in media. 

As an attempt to learn the practice of community mental health by doing and to promote person-centered, rather than symptom-focused, recovery as engaged researchers, Dr. Ma and her team have been working with stakeholders in China to develop peer support services for persons with SMIs, or the use of paraprofessionals with lived experience of SMIs to help others with SMIs meet their personal goals. From 2019 to 2021, with the support of the University of Chicago Yuen Research Fund, our team worked with local partners in Guangzhou to run a pilot project that used a community-based participatory research (CBPR) approach to develop a culturally responsive peer support service manual. The project then trained seven peer supporters and placed them in two social work agencies to serve over sixty clients. From 2022 to 2026, with the generous support of the Cyrus Tang Foundation, we are scaling up and standardizing peer support services in Guangzhou and Yunnan. We use qualitative and quantitative research methods to systematically evaluate the services’ fidelity, feasibility, effectiveness, and client satisfaction. We also work with a CBPR team to formulate guidelines for training, certifying, placing, and supervising peer supporters. These findings and experiences will help us advocate for the adoption of peer support in regular community mental health services across China. 

3) Intersecting Justice: A Participatory Approach to Disability Rights, Care, and Welfare 

Since the United Nations adopted the Convention on the Rights of Persons with Disabilities in 2006, a disability rights movement has been sweeping the globe. It champions persons with disabilities as autonomous individuals and demands that nation-states change laws and institutional practices to support their rights. However, in China and some other countries, persons with disabilities are often seen as deficient and dependent, requiring rehabilitation, protection, and welfare subsidies. In fact, governments may argue that socioeconomic rights exemplified by welfare provision are more fundamental than civil and political rights typically featured in advocacy. 

Moreover, in neoliberal economies, the support for persons with disabilities typically falls on paid and unpaid caregivers, most of whom are women. While some disability rights activists tend to downplay disabled people’s need for care/support to highlight their autonomy, caregivers might advocate for services that reduce their burden at the cost of ignoring the voices and equal personhood of disabled people.  

How do debates between rights and welfare, autonomy and care unfold at the conjuncture of global disability rights and local social histories? How do they impact the lives of disabled people and their caregivers, especially in marginalized communities further away from the urban centers? How can we envision care practices, social services, and welfare policies that recognize the personhood and needs of all parties involved, address the multi-faceted nature of marginalization, and strengthen public responsibility and accountability?  

Driven by these questions, Dr. Ma and her team are working with persons with disabilities and their organizations, social service agencies, and other stakeholders in China to examine the service experiences, needs, and barriers of various groups of disabled people, and to analyze strategies of disability rights advocacy and their impact. We compare disability-related social policies and service needs across different countries. We also explore the meanings and practices of peer support among persons with disabilities as an alternative form of care.