Zhiying Ma

Intimate Institutions: Psychiatry, Family, and the Rise of Biopolitical Paternalism in Contemporary China’ examines families’ involvement in the care and management of persons diagnosed with serious mental illnesses in China, especially during the recent mental health legal reform. Over the last three decades, most psychiatric inpatients in China have been hospitalized against their will, by their families. The first national Mental Health Law, effective since 2013, reinforces families’ rights and responsibilities in psychiatric care. Using the language of paternalism, the law makes the family the primary unit to mediate liberty, wellbeing, and security in contemporary China. The book maps the workings of ‘biopolitical paternalism,’ a mode of governance that constructs mentally ill patients as subjects of perpetual risk management, that legitimizes the state’s population management as paternalistic intervention, and that displaces the paternalistic responsibilities onto families. This biopolitical paternalism produces harm and ethical unease within families and aggravates health disparities across the mentally ill population. Yet it also creates new political potentials for caregivers. My analysis sheds light on families’ complex involvement in state power and social transformations, on how the biopolitics of population governance interplay with intimate ethics of care, on paternalism as a mode of governance prevalent in the contemporary world, and on the entanglements of institutional arrangements and intimate relations in producing chronic shortfalls of healthcare provisions.