China Mills | The University of Sheffield (original) (raw)

Books by China Mills

Decolonizing Global Mental Health is a book that maps a strange irony. The World Health Organizat... more Decolonizing Global Mental Health is a book that maps a strange irony. The World Health Organization (WHO) and the Movement for Global Mental Health are calling to ‘scale up’ access to psychological and psychiatric treatments globally, particularly within the global South. Simultaneously, in the global North, psychiatry and its often chemical treatments are coming under increased criticism (from both those who take the medication and those in the position to prescribe it).

The book argues that it is imperative to explore what counts as evidence within Global Mental Health, and seeks to de-familiarize current ‘Western’ conceptions of psychology and psychiatry using postcolonial theory. It leads us to wonder whether we should call for equality in global access to psychiatry, whether everyone should have the right to a psychotropic citizenship and whether mental health can, or should, be global. As such, it is ideal reading for undergraduate and postgraduate students, as well as researchers in the fields of critical psychology and psychiatry, social and health psychology, cultural studies, public health and social work.

Journal articles and book chapters by China Mills

While people living in poverty talk about isolation, shame, and humiliation as being key aspects ... more While people living in poverty talk about isolation, shame, and humiliation as being key aspects of their lived experiences of suffering, until recently, there has been no international data on these aspectsmaking them "missing dimensions" within poverty analysis and within research into suffering. Drawing upon international fieldwork and datasets from Chile and Chad, this chapter examines the relevance of social isolation, shame and humiliation in contexts of poverty, to research on suffering. The chapter suggests that the use of particular indicators of shame, humiliation, and social isolation can better recognize distributions of suffering. It can also help identify individuals and sub-groups within those living in multidimensional poverty -or of the general population at large -that are affected by concrete and particularly hurtful situations. Consequently, they can help to identify levels of suffering which are Mills, Zavaleta, Samuel

Social and Personality Psychology Compass

The positive association between ‘ mental illness’ and poverty is one of the most well establishe... more The positive association between ‘ mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘ mental illness’ . Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically
reconfigure 'symptoms’ of oppression, poverty, and inequality as 'symptoms’ of 'mental illness’ . This raises
the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of
poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality.

CUSP: Critical Cultures and Cultural Critiques in Psychology

Pills hidden under tongues, inside socks, flushed down toilets. Pretending to ‘ feel better’ , pr... more Pills hidden under tongues, inside socks, flushed down toilets. Pretending to ‘ feel better’ , pretending to comply. How can we begin to trace the secrets, concealment and resistance that haunt psychiatry? How might we read this alongside the concealments of the colonised, enslaved, and oppressed – the ‘ laziness’ , formulaic deference, wilful submissiveness, playing dumb, and playing dead ( Scott, 1990) . If colonialism is historically and arguably currently entwined with psychiatry, then how might resistance to colonialism provide a lens through which to read resistance to psychiatry? This paper draws upon postcolonial theory, at the edges, in the spaces in-between, to engage with how strategies of resistance to colonialism may be read alongside and used to illuminate resistance to psychiatry. Resistance that is secret, sly, covered up. Resistance that is cryptic, opaque and veiled. Stitched together in a fragmentary bricolage, the paper seeks to move between postcolonial and critical psychological theorizations to read the stories of pretending ( to take medication, to feel better) that run like a thread through many people’ s stories of surviving the psychiatric system. Depending on the lens through which we look, such pretending may be ambivalent, seductive, a ‘ symptom of oppression’ , or subversive. Taking this further, this paper wonders what this might mean for more wide scale resistance to psychiatry and the pills it prescribes as they travel across borders into the countries, minds and bodies of the global South.

This is an interview with China Mills about her time spent at Bapu Trust learning about local app... more This is an interview with China Mills about her time spent at Bapu Trust learning about local approaches to supporting people who experience mental distress in India. It was published in the Indian Express (Pune), on the 24th December 2014.

Movement for Global Mental Health newsletter

Children and Society

While the World Health Organization calls to ‘scale up’ access to psychotropic drugs for children... more While the World Health Organization calls to ‘scale up’ access to psychotropic drugs for children in the global South, research from the global North has found that long-term use of psychotropic drugs may be at best ineffective, or at worst harmful. Questioning what counts as evidence within the Movement for Global Mental Health, this article maps the physical, psychological and sociopolitical effects of increasingly global psychotropic interventions into children's lives. This psychiatrisation will be read alongside colonisation, leading to the uncomfortable question of whether every child should have the right to a psychotropic childhood.

Annual Review of Critical psychology (ARCP) 10, Jun 2013

Written from two different locations, two different continents, this paper reflects the authors' ... more Written from two different locations, two different continents, this paper reflects the authors' political and social engagement with the issue of normalization of oppression, and medicalization of distress and social suffering, as seen in particular practices of psychology and psychiatry in India; a sub-continent in which neither authors are currently located. The paper reflects a shared concern about the mobilization of certain kinds of oppression as
'normal', as normalised; oppression that remains ungrieved for; oppression in the guise of help and liberation; oppression of women by women, and by men; oppression through medicalization of the idioms of distress. The paper in this sense offers a re-reading of why psychology practiced through western-centered or uncritical,
apolitical lenses, is fated to generate scholarship that glosses over political struggles, multiplicities and complexities, cracks and edges. Bypassing the imposition of a linear narrative, this paper, as a disjointed performative space, encourages a deconstructive reading; a reading 'in between', an 'in between' reading; both
of the paper, of psychology, and of the socio-political scenario in which psychology and psychiatry in India are put to work. The paper is part of conceptualizing a shared project of de-centering and de-familiarizing psychology and psychiatry, and how they are currently thought and practised in particular contexts, within the
contours of complex social structures in India.

Asylum: Magazine for Democratic Psychiatry Vol. 19.1, pp.11-12, 2012

'Distress or Disability', based on symposium at Lancaster University, 15-16th November 2011.

This paper will explore how the statistically ‘normal’ child of neo-liberal developmental psychol... more This paper will explore how the statistically ‘normal’ child of neo-liberal developmental psychology colonises legal understandings of dis/abled children, drawing spatial and topographical boundaries between those within and those outside of childhood (Rose 1999). This silences childhoods that don't 'fit', rendering them doubly diminished, and becomes the standard norm by which all childhood is judged (Pupavac 2002), permeating legal decisions around who gets to be born and how dis/abled children get to live. In examining legal assumptions around abortion, genetic screening and medical treatment for children labelled as mentally ill, I will explore how the law, as a system of normativities, performs material and discursive violence on the (un)lived experiences of those children who push the law to the point rupture. I will thus address the assertion that ‘the principal organising binary [in children’s lives] is no longer legal and illegal, but normal and abnormal’ (Shildrick, 2005:32).

Ethnographica Journal on Culture and Disability, Jan 1, 2011

Conference Presentations by China Mills

Many people living in poverty name social connectedness within communities as being both intrinsi... more Many people living in poverty name social connectedness within communities as being both intrinsically and instrumentally important for survival and wellbeing. Yet many people also talk about how shame and social isolation – as some of the impossible choices posed by poverty - can erode these connections, and ‘kills people’s spirits’ (as one participant explained to us in the research to be discussed in this paper). Yet despite being key aspects of people’s lived experiences of poverty, there is little international data on shame or social isolation, making them ‘missing dimensions’ within poverty analysis.

Embedded within the increasing focus on psychosocial dimensions of poverty, this paper will weave together recent and ongoing qualitative research into social isolation (both in connection to shame and as a dimension of its own), with proposed attempts to measure social isolation in order to generate internationally comparable data. It will further explore how the complexities raised in the qualitative work undertaken (for example, what people told us about how concepts such as reciprocity and trust function within contexts of poverty) point to the need, and yet pose challenges for, the measurement of social isolation internationally. It will also outline why any attempts at measurement should include both objective and subjective indicators. Thus, the research discussed in this paper raises some important questions, for example; what is social isolation? How might it be measured? Is it, and how is it, experienced in diverse contexts, and how does it effect people’s wellbeing? What are the connections between poverty, social isolation, and shame? And what are the implications of this work for policy?

How do spoof, ‘fake’ psycho-pharmaceutical adverts work to queer the ‘real’ adverts, and the diso... more How do spoof, ‘fake’ psycho-pharmaceutical adverts work to queer the ‘real’ adverts, and the disorders they market the drugs for? How do they crip conceptions of normality and sanity?

These spoof ads point to a creeping psychiatrization of our everyday lives, a psychiatrization globalised through ‘mental health literacy’ campaigns and psycho-education in low-income countries of the global South. This paper will explore how this psychiatrization interlaces with colonial subject formation. For while pharmaceutical adverts and psychiatry interpellate, hail, ‘make up’, and elicit particular subjects – as pharmaceutical citizens, neurochemical selves; there is also a force at work in ‘making up’ these subjects, through the power of the gaze, that for Frantz Fanon; objectifies, seals, crushes and abrades. But how does medication broker subjectivity? How does it, as the ads claim, restore us to ourselves, make us whole again?

This paper will attend to the visual, to mechanisms of looking, to psychiatric fields of visibility. In India, many mental health Non-Governmental Organisations (NGOs), go to rural areas to ‘identify’ people with ‘mental illness’, making them visible through diagnostic systems developed in the global North, and medicating them. They say these people are ‘invisible people’. So how do medication and psychiatry make people visible? What ways of ‘seeing’ do they make possible? For Homi Bhabha (1994) invisibility does not signify lack; instead it works to disrupt identification and interpellation through refusing presence. Thus how might these ‘invisible people’, those who refuse to ‘reproduce hegemonic appearances’ (Scott, 1990), work to disrupt the gaze of psychiatry? Might invisibility; the doubling, dissembling image of being in two places at once (Bhabha, 1994), work as both a ‘symptom’ of oppression, and a means of subversion?

To read psychiatrization as a colonial discourse opens up possibilities to explore how the secret arts, the hidden transcripts, of resistance of the colonised might be read in people’s resistance to psychiatry – from the slyness of mimicking normality, to the mockery of ‘spoof’ drug adverts. How the ‘disembodied eyes’ of the subaltern that see but are not seen, might disrupt and subvert both the presumed ‘I’ of the unitary ‘whole’ subject, and the surveillant, penetrative ‘eye’ of psychiatry.

How medication might work to make people visible is more troubling if we read invisibility as camouflage and potential subversion. It suggests that medication might make people more vulnerable in their submission to sociality, in their domestication. But with what conceptual tools can we establish whether being invisible is an act of resistance through camouflage, a strategy solely for survival, or a mark of adaptation and assimilation? Perhaps certain forms of psychiatric ‘looking’ allow us not to ‘see’; enable us to encounter difference and yet defer it, domesticate it– to recuperate the hegemonic, the status quo, in the final look.

In this paper I will explore how spoof adverts may mimic ‘real’ ads in a similar way to how some people mimic normality, slyly; a ‘resemblance and menace’ that mocks the power of the ‘real’ and the ‘sane’, their very power to be a model (Bhabha, 1994:86). Will you be able to tell the difference between the ‘real’ and the ‘fakes’?

Social and Personality Psychology Compass

CUSP: Critical Cultures and Cultural Critiques in Psychology

Movement for Global Mental Health newsletter

Children and Society

Annual Review of Critical psychology (ARCP) 10, Jun 2013

Asylum: Magazine for Democratic Psychiatry Vol. 19.1, pp.11-12, 2012

'Distress or Disability', based on symposium at Lancaster University, 15-16th November 2011.

Ethnographica Journal on Culture and Disability, Jan 1, 2011

In high income countries, where debates rage about over-prescription of psychiatric drugs to chil... more In high income countries, where debates rage about over-prescription of psychiatric drugs to children and adults; millions of children in lower-income countries of the Global South, where the majority of the world’s disabled children live, died from mainly preventable causes because they were unable to access clean water or basic medication (UNICEF).This ‘global letting die’ (Rose, 2008:6) forces recognition of the multiple ways that lives may not count as worth living, on a global scale. Debates around access to medication in low-income countries lead to complicated questions about whether some diseases are more ‘real’ than others, and about the social nature of impairment. Such questions are key areas of disjunction for situating distress within a social model of disability, particularly in areas of the world where the social model of disability has not emerged. This paper is situated in this messy space; grappling with the possibilities of a global critical disability studies that moves against a simplistic globalisation of ‘Western’ models of mental health and disability, rethinking the ‘us and them’, the other, the life not worth living.

Who confers recognition and representation of violence, and what is it that is being represented... more Who confers recognition and representation of violence, and what is it that is being
represented? How do terms such as ‘violence’ and ‘child’ work, what do they
foreclose and what are they used to justify? Drawing on previous research with
children who hear voices, this paper will attend to how medical and media
representations of children who hear voices or self-harm are dominated and
monopolized by bio-psychiatry and the pharmaceutical industry, working to establish
what will count as publicly recognized violence, and what will not. These dominant
schemes of intelligibility normalise the absence of children with mental illness and
pathologise their presence within mental health legislation and rights discourse. But
what delimits what we understand as discursive rather than material violence, and
how do the two converge? To engage with how this discursive violence interweaves
with material violence on the bodies of children with mental health problems, I will
explore psychiatry’s use of force in medicating children with mental health problems,
and its construction of such children as incompetent. Thus a category of children
who cannot refuse receives a legal formulation and are subjected to ‘treatment’ that
would in other circumstances be constituted as legal battery and child abuse. To
engage with these issues I will draw upon Judith Butler’s ‘politics of grievability’ and
Giorgio Agamben’s ‘bare life’, putting them in conversation with each other over a
topic they rarely if ever discuss, the child with mental health problems.

The current incitement of mental health into a discourse of global emergency and crisis suggests ... more The current incitement of mental health into a discourse of global emergency and crisis suggests an abnormal deviation from a normal order, yet mental illness may also be read as a ‘normal’ reaction to that (dis)order – as a ‘healthy’ response to the ‘unhealthy’ globalisation of Neoliberalism. Yet making the claim that mental health problems, such as Depression, are a ‘normal’ response to inequitable market relations in the global South, may also be normative, as it glosses over a simultaneous globalisation; that of bio-psychiatric explanations of distress. This globalisation of bio-psychiatry enables new and emerging global bio-psycho-socialites; both reframing personhood, and thus what counts globally as a ‘life worth living’; while simultaneously framing what psycho-political demands these emergent bio-social communities can make. This paper will draw upon research by the author in India, focussing on India’s emerging mental health survivor movement, and NGOs relationships with the pharmaceutical industry. While ‘mental illness’ is a global ‘burden’ in WHO and World Bank literature; it is an emerging untapped market for the pharmaceutical industry in India. In an increasingly globalised psychopharmacological world, access to medication, ‘scaling-up’ of psychiatric services, and closing the ‘treatment gap’ between low and high income countries, are equated with social justice and equality. While human rights abuses within psychiatry are discussed within global mental health literature, much mental health user / survivor, and psychiatrists’, critiques of psychiatric services and medication from the global North (and from within India) often remain invisible. What does it mean for particular aspects of survivor critique to be taken on as a global concern, and others to be rendered invisible? It seems imperative to explore how survivor critique might be mobilised to fruitfully interrogate calls to ‘scale-up’ psychiatric services in the Majority world. This might enable a re-reading of the ‘treatment gap’ through a post-colonial lens, as a subversive ‘space in-between’ that might make alternative ways of knowing mental health and illness; normality and abnormality; possible worldwide.

Law and Childhood StudiesCurrent Legal Issues Volume 14, 2012

Social Indicators Research, 2016

Social isolation is a deprivation of social connectedness. It is a crucial aspect that continues ... more Social isolation is a deprivation of social connectedness. It is a crucial aspect that continues to be named by people as a core impediment for achieving well-being and as a relevant factor for understanding poverty. The notion of social isolation has been discussed within a diversity of theories that have provided rich insights into particular aspects of social isolation. However, there is no agreement on the core components of this social malady or on how to measure it. Although the challenge of conceptualising and measuring social connectedness is daunting, this paper argues that existing research in several fields provides solid ground for a common concept and for the construction of basic internationally comparable indicators that measure specific aspects of social isolation. In particular, this paper aims to contribute to the debate on social connectedness and its measurement in three ways: presenting a working definition that, while doing justice to the rich insights advanced by different theories, stresses relational features in the life experience of people; (2) emphasising the relevance of

Most governments and policy makers define poverty by income. Yet poor people define their poverty... more Most governments and policy makers define poverty by income. Yet poor people define their poverty more broadly, including lack of education, health, housing, empowerment, employment, personal security and more. As such, no one factor is able to capture all the aspects that contribute to poverty, making poverty a multidimensional concept. One dimension of poverty that has been often overlooked is social connectedness. This paper argues that social connectedness is an important missing ingredient of multidimensional poverty, with social isolation being a central component. We illustrate the concepts of social isolation and social connectedness using examples from South Africa and Mozambique, and the First Nations of Canada, as well as the work of Special Olympics International around the world.