The Discrimination Against People with Schizoprenia in Japan

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Mental illnesses and socio-cultural dynamics have a long association with each other from historical times to the present (Foucault 1988). The image of the mad person has evolved through the ages and across cultures, where he or she has been revered or treated as an outcast, or as an important accessory in contemporary mental health services (Jilek 1971). Whatever the image, the ‘mad’ person has been considered as being different from others in the population. As Foucault’s (1988) seminal work ‘Madness and Civilization’ shows, the ‘mad’ person has gone from being assimilated into ‘normal’ society to being segregated as an outcast and labeled in numerous ways through the centuries. With the advent of ‘modern’ society, the hegemonic biomedical mental sciences have now been heralded in popular culture and imagination as a solution for most mental health problems. These biomedical mental sciences i.e.,the neuro- and the “psy- disciplines” (Rose 1998) have been instrumental in shaping new personalities for the ‘mad’ (Martin 2007) . However, they have also played a pivotal role in generating identities moulded around what is considered as ‘normal’ and in propagating ‘medicalization’ of mental disorders (Conrad 1992). But, the first step to form an identity is by defining it and naming it, which in psychiatry is predominantly done by the ‘psychiatric bible’ - “the Diagnostic and Statistical Manual of Mental Disorders (DSM)” (Castillo 2013). Anthropological analysis views diagnosis not only as a powerful discursive practice which authoritatively defines but also materially creates and shapes the objects under its scrutiny (Barrett 1996).

However, in medically pluralistic societies like India and Japan (Lock 1982:21...

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...y did it not hint at “decay” or “silliness” as the previous term (Takei et al 2005) but it also implied that the person with this diagnosis could improve with treatment and had a better prognosis (Sato 2006).Thus, patients in remission would not be subject to stigma and discrimination as the negative meaning that the older term had about poor prognosis and ‘mental disorganization’ could be avoided with the usage of the new term (Kim and Berrios 2001). From this case study of schizophrenia in Japan, one can see that diagnostic labels and terms in biomedical psychiatry are not simply terms that make sense in diagnostic manuals and to clinicians. Rather, they are social entities, i.e., they take on a life of their own when they leave the clinic: through interactions between patient and doctor, between patient and family members, through history, culture and semantics.

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