Mental Health, Migration and the Chinese Mega-City

We have known, since at least the early twentieth century, that there is an association between living in a city and being diagnosed with a mental illness. But questions around the specificity of relationship between urban life and have continued well into the twenty-first century. We still don't know, for example, exactly why mental illness clusters in cities; we don't know how it relates to experiences of urban poverty, deprivation, overcrowding, social exclusion, and racism; and we don't know the precise biological and sociological mechanisms that turn difficult urban lives into diagnosable mental health conditions. What we *do* know is that migrants into cities bear a disproportionately large share of the burden of urban mental illness; we know that dense living conditions seem to exacerbate the problem; and we know that the general stress, tumult and precarity of urban living can, sometimes, create the basis for the development of clinical problems.

If there are unanswered questions around the relationship between mental health and the city, these questions are particularly acute in contemporary China: China has urbanised at an unprecedented rate in the last decade, and has now become a majority urban society. But whereas in nineteenth-century Europe urbanization came from a growth in population, in twenty-first century China the situation is different: most of the growth is from rural migrants coming into the cities. In China, then, the link between urban transformation and mental illness is a critical issue: (1) Development in China is related to migration from the countryside into the cities; (2) Unrecognized and untreated mental disorder is a key factor in casting individuals and families into poverty and social exclusion; (3) Effective development of urban mental health policu requires far greater understanding of the related problems of urban stress, precarious living conditions and mental disorder

This project is an attempt to understand the relationship between migration and mental health in one Chinese mega-city: Shanghai. Given what we know about the relationship between urban mental health and particular patterns of social life (poverty, migration, dense housing, and so on), it starts from the position that this question requires new input from the social sciences. At the heart of the project is an attempt to mix what we know about mental health in contemporary Shanghai with a new kind of close-up, street-level data on what the daily experience of being a migrant on Shanghai is actually life - especially with regard to stress, housing, and access to services. We will then connect these two forms of knowledge to produce a new kind of survey for getting a new sociological deep surveying instrument for mapping migrant mental health in Shanghai.

The project, which is split between researchers in the UK and China, asks: (1) How is mental disorder actually patterned in Shanghai, and how is that pattern affected by recent migration? (2) How are immigrants absorbed in Shanghai, and what is daily life actually like in Shanghai's migrant communities? (3) What policies, services, or laws might alleviate mental health among migrants in Shanghai? (4) What can be learned in Shanghai for similar problems in other developing mega-cities (such as Sao Paolo or Lagos).

This project should also us to also produce new data on two of the major research-areas that are prioritised under this join UK-China research-scheme: 'Migration and public services,' where we will look at the relationship between the welfare system and migration, and analyse the services that currently help to alleviate this problem, as well as migrants' access to those services; (2) 'Inequalities and everyday life,' where we will develop a close-up, street-level analysis of the lived inequalities of everyday migrant life in Shanghai, and try to understand how urban inequality might contribute to the development of mental health problems?

This project has an impact on four key groups:

1. Impacts for migrant communities in Shanghai.
The project will have the sharpest impact on the urban migrant community in Shanghai, and in particular on the 200 individuals that we interview, as well on their close social networks, vis-à-vis the relationship between the reality of their lives, and policy interventions around mental health in Shanghai. Two impacts are sought here: (1) ThE project is committed to helping with the design of enhanced services, leading ultimately to improved better mental health, and opportunities for improved community relations among Shanghai migrant communities. (2) By creating realistic, accurate portrayals of migrant struggles, the project will contribute to the de-stigmatization of rural migrants in Shanghai. We will also undertake a 'respondent validation' exercise in the second round of interviews that we undertake with participants, a standard procedure in qualitative work whereby initial findings are shared with respondents who are invited to comment, correct and elaborate on our initial conclusions.

2. Impacts for the wider public in China.
The wider public will benefit through an enhanced public understanding of the life circumstances of migrant. Through carefully-targeted policy briefings, we will especially seek impacts on professionals concerned with health and social care, who will get a new understanding of the lived experience of being a migrant, details on the variety of migrant experiences and populations, data on the mental health of the migrant community, and opportunities for new training to enhance community based services. For professionals esepcially, we will provide papers summarizing our findings, and create modules for pre- and post-qualification professional staff integrated into their normal education and professional development structures.

3. Impacts for policy-makers, in China and elsewhere.
For policy-makers, our findings will promote evidence-based public-service effectiveness, by providing data on the mental health of the migrant community, empirically accounting for patterns discovered, so that better services can be developed by the Shanghai City Council and local health services. Additionally, the project has potential impact for policy-makers in cities such as Sao Paulo, Mumbai, and Lagos - for whom our data may also help to re-think urban mental health interventions. We will provide short briefing papers summarizing our findings, and invite Chinese policy makers to the final session of each of our workshops in Fudan, to discuss summaries of our interim ideas, as well as attendance at our final conference. For policy-makers in other countries, we will produce short, academic and policy publications in other languages, specifically drawing on the wider international lessons to be drawn from the Chinese case.

4. Impacts on the NGO and commercial sector in China.
The small but growing NGO and commercial sectors in China will benefit from new data, expert briefing, and new analyses of the social circumstances of migrants groups. We will provide briefing papers summarizing our findings, inviting their representatives to the final session of each of our workshops in Fudan, to discuss summaries of our interim ideas, and to invite debate about the issues as they emerge, and inviting attendance at our final conference.