Performing Normality: Imaginaries of Return and Embodied Usability in China’s Psychiatric Welfare Hospital

• In Event: Student Forum Roundtables Session
  In Refereed Roundtable (90 minute): Roundtable 12: Health Disparities

Abstract

This paper asks why patients in psychiatric welfare institutions often appear "normal" to outside observers. Based on three years of ethnographic fieldwork in a Civil Affairs–run psychiatric welfare institution in Northeast China—including participant observation and over 30 in-depth interviews with patients and staff—I argue that "normality" is a visibility outcome produced through routine institutional arrangements rather than a transparent indicator of clinical status. The analysis advances two meso-level concepts. First, imaginaries of return capture how discharge is experienced as an externally gated possibility: beyond ward-based medical assessment, release hinges on a family's willingness to receive the patient and on local welfare and community resources that can absorb care obligations. Under this uncertainty, patients cultivate restraint and "good behavior" as a bid for returnability, striving to remain legible as manageable to those imagined to hold the keys to their release. Second, embodied usability describes a stratified regime that sorts patients by stability, self-care, and compliance, enrolling the usable into cleaning, peer monitoring, and care work. In exchange, patients receive small privileges, moral recognition, and a tenuous sense of usefulness—an institutionalized route to dignity within long-term confinement. These arrangements stabilize a calm ward while rendering "normality" highly visible, creating a "visibility trap" for short-term observers. The paper contributes to institutional sociology and global mental health by linking micro-level performance to welfare governance, placing this Chinese case in conversation with Western debates on deinstitutionalization and highlighting how different regimes redistribute the costs of care, autonomy, and public order across institutions, families, and public space.

Author

• Shiqi Zhang, Beijing Normal University