Paper short abstract:

This paper, based on an institutional ethnography of Japan's disaster mental health system, addresses the development of professional identities and the interplay between standardized laboratory research and intervention as linked to broader questions about the management of suffering.

Paper long abstract:

The expansion of standardised mental health and psychosocial interventions in humanitarian response highlights how living with disasters and extreme events can be a catalyst for rapid social change. Providing a brief overview of a clinical ethnography based at a laboratory specializing in disaster mental health, the paper considers how catastrophe is treated as a metonymy of mental suffering, casting this in terms of the interplay between standardized clinical work and laboratory research: technê, and episteme. It then looks at how disaster mental health interventions connect to broader beliefs, values, and morality in the development of professional identities, before evaluating the instrumentality of rationalities turned towards local suffering. It is argued that practice, in the case of clinicians working in the disaster-struck areas of Iwate, Miyagi and Fukushima, is a form of world-making; an ethical and moral commitment that both supplants and imaginatively recasts normative knowledge.

Moreover, whilst academic and clinical infrastructures must be understood as sites where social power is exerted both on and through its members, such spaces also offer novel and unexpected ways for individuals to act. In line with previous studies of healthcare, an anthropological view could offer critical analysis of the moral and cultural ideologies involved in disaster mental health intervention.

Focus in this research is placed on the clinical interlocutor as active in the very process of constructing and interpreting what needs to be done, what can be done, and what should be done to best support the families and survivors of the disasters. Looking beyond the epidemiological literature to explore the social influences and power dynamics at work within the psychosocial field, this research critically considers the role of disaster mental health as a force for social change through the proliferation of psychiatric discourse as a language of resistance and a form of social critique.