Recovery and Advocacy: contextualizing justice in relation to recovery from mental illness in East Asia

Given the backdrop of generally under-funded psychiatric care, overwhelming medical dominance, and a lack of vigorous advocacy for adequate mental healthcare, this chapter sets out to discuss the concepts of recovery and advocacy both in relation to each other and in relation to their particular socio-economic-cultural context in the Asian setting, as applied to mental health issues. The chapter has several aims. The first aim is to spell out why recovery and advocacy are two complicated and perhaps problematic concepts in the Asian context. The second aim is to deconstruct the forces that shape the concept and expectation of recovery and an individual's own power position in advocacy in cultures where the individuals and their families are held responsible for the care and recovery of the ill person. The third aim is to discuss the conflicting situation of mental health professionals (particularly psychiatrists, psychologists, nurses, social workers, and occupational therapists) in Asia, as many of these professionals endorse the universal values of respect, love, and care for patients on the one hand, while on the other hand they do not consider themselves appropriate for advocacy on behalf of patients. The fourth aim is to discuss why knowledge-based psychoeducation can help as well as subjugate caregivers at one and the same time. The fifth aim is to explore the dilemma of working within the cultural constraints of harmony and submission versus “going radical”, and to discuss how cultures of modesty or the “middle way” guide the development of alternatives to professional/paternalistic dominance. In relation to these ethical and other issues, the chapter draws on the author's experience of working with caregivers in Hong Kong, Taiwan, Korea, Thailand, and Malaysia.