In the past year new information has emerged concerning the state of mental healthcare and the mentally ill in China. According to the World Health Organization, mental illness supersedes heart disease and cancer as the most taxing health concern in China’s healthcare system. An estimated 100 million people in China have some type of mental disorder although some say this number is likely higher due to the dearth of information available and the lack of public awareness regarding mental illness. Xinhua reports that “twenty percent of all ailments and injury-led disabilities in China” are caused by mental illness. Dr. Huang Yueqin, director of the National Center for Mental Health, told Telegraph that she estimates only about 5 percent of those with illnesses are aware of it and receive treatment. (It is important to note the range of illnesses covered under these statistics, which include anxiety and Internet addiction as well as depression and schizophrenia.)
The history of mental healthcare in China has been shaky at best. No healthcare facilities existed in the country until physician Dr. John G. Kerr opened the Canton Refuge for the Insane in 1898. Although he initially received little support, the need for such an institution was clear. At the time, most severely ill patients were treated harshly, often restrained. Kerr insisted on treatment that emphasized freedom and space over chains and imprisonment. Over time the Refuge grew to hold 500 beds and changed the way mental illness was viewed in China.
With the closely-knit family culture of China, the mentally ill have traditionally been taken care of at home. Because of the social stigma and lack of education attached to mental illness, family members can lose face. Consequently, the ill are sometimes hidden or poorly treated. Often people with mental illness receive no treatment or treatment using Chinese herbal remedies.
During China’s tumultuous mid-century, all asylums were closed. In the fifty years hence China has not had adequate healthcare for the mentally ill and in some ways the situation has become similar to that faced by Dr. Kerr. Instead of caring for the mentally ill, they may be poorly treated, neglected, and even left to their own devices where they do themselves and others harm. A recent article in the China Daily reported a string of killings perpetrated by one mentally ill man who was repeatedly released because he was found to have a mental disorder and was not acting of his own volition.
All segments of the Chinese population face problems related to mental health from rural women who bring China’s suicide rate to the highest in the world to businesspeople affected by the economic downturn to victims coping with the trauma and loss caused by the Sichuan earthquake.
Clearly there is a need for more education, legislation, and healthcare for the mentally ill. Few people are diagnosed and most Chinese have little to no framework to think about mental illnesses, especially in rural areas. Even those who have been diagnosed often reject treatment because the medical bills are more than they can afford. With the small number of psychologist, psychiatrists, and mental health facilities in China, it would be extremely difficult to treat any surge in mentally ill patients.
To be fair every developing country faces this issue and while change has been a long time coming, the fact that this issue has become a topic of conversation is a huge step forward for China. For the first time ever the five-year plan (2007-2012) has mental illness as a primary field of research. In April, the Municipal Health Bureau said it would make psychiatric departments mandatory in more hospitals in Beijing where it is estimated that 150,000 people are afflicted with a serious mental illness and there are only 6,900 beds to accommodate them. In instances such as the Sichuan earthquake it has been encouraging to see the powers that be seek help to better meet the needs of the people. As knowledge grows within the Chinese medical system and government, I believe we can expect to see more positive changes that will educate the public on matters of mental health and that will protect and treat those with mental illness so that they are able to live more sustainable, healthy lives.