Conceptualising stigma(tisation) of mental health in ‘mixed contacts’ context: a cross-disciplinary case study of workplaces in Hong Kong

Abstract

Cross-disciplinary studies indicated that stigma and stigmatisation constitute ‘a barrier to help-seeking’ and lead to the ‘risk of relapse in remitted individuals.’ (White et al., 2017: 264; see also Zhu et al., 2016b) Hindering the treatment process, stigmatisation poses threat to the wellbeing of persons with mental illnesses and burdens the socio-economic system by inducing productivity losses (Zhu et al., 2016a; Milligan-Saville et al., 2017). The need for developing culturally informed methods to eliminate stigma is listed as one of the Top 25 grand challenges in global mental health (Collins et al., 2011: 29). Complementing the endeavours in search for a universal measure in fighting stigma, scholars across disciplines have argued that an effective counter-measure could only be found upon rich socio-cultural and anthropological understanding of the local community (Yang et al., 2014: 508). The sociolinguistic perspective on the stigma(tisation) of mental health is still in its infancy; however, the discourse analytic techniques could provide powerful methodological tools for unveiling the discursive strategies that have been reinforcing enregistered stigma and activities of stigmatisation. This paper is part of a wider project that aims at building an interdisciplinary connection between sociolinguistics and Global Mental Health. Workplaces could be conceptualised as environments of ‘mixed contacts’, which are defined in Goffman’s seminal work (1963:12) on stigma as “the moments when stigmatized and normal are in the same ‘social situations”.’ While political correctness of Goffman’s reference terms is debatable, the underlying main idea of his work holds strong after all these decades. In particular, Goffman maintains that the contact among individuals with varying degrees of exposure to mental health difficulties and cultural beliefs opens up the potential sense of insecurity and uncertainty that may lead to the stigmatisation of the unfamiliar (Goffman, 1963: 13-14; see also Tsang et al., 2003). Drawing upon the results of statistical analysis from 500+qualitative surveys and theme oriented discourse analysis (Roberts and Sarangi, 2005) of 30 participant interviews, the paper analyses the structural and cultural stigmatising practices in workplaces in Hong Kong. The statistical generalisations derived from the qualitative surveys provide an overview of the mental health situation across the sampled workplaces and indicate the presence of inbuilt stigmatising practices. Expanding on the statistical results, the analyses of the interviews explores the cultural resources employed by members of the workplaces in justifying and/or resisting stigmatisation and reflects upon the opportunities and difficulties of destigmatisation that arise from multicultural contact. Instead of proposing a particular way of conceptualising stigma(tisation) in relation to mental health and multiculturality, this pa per explores the plausibility of developing a cultural specific framework for understanding the ‘local’ practices of stigmatisation and corresponding counter-measures. The paper begins with a brief review of the classical and contemporary concepts of stigma and stigmatisation. It then moves on to a critical analysis of the survey results and participant interviews. This leads to the discussion on the impact of multicultural contact upon the processes of de-/stigmatisation in workplaces.