Skip to main content
Part of complete coverage on

Dubious shrinks, political prisoners inside China's mental health care system

By Johan Nylander, for CNN
May 6, 2014 -- Updated 1247 GMT (2047 HKT)
Wu Yuanhong, a mentally ill Chinese man, sits in a cage, which he has been kept in for more than a decade by his family, at their home in Lijiachong village in Jiangxi province.
Wu Yuanhong, a mentally ill Chinese man, sits in a cage, which he has been kept in for more than a decade by his family, at their home in Lijiachong village in Jiangxi province.
STORY HIGHLIGHTS
  • There are 1.5 therapists for each 100,000 mental illness sufferers
  • Unqualified therapists prey on the weak, worsening their condition
  • Human Rights Watch says mental hospitals are filled with political prisoners

Editor's note: Johan Nylander is a freelance journalist who has lived in Hong Kong since 2011. He reports mainly on the politics, business, and culture of China.

(CNN) -- Wu Yuanhong, a man suffering from schizophrenia in China's southeastern Jiangxi Province, was forced by his mother to live in a small metal cage for 11 years after he beat a young boy to death.

Reports of Wu's dire situation surfaced in Chinese media last May, accompanied by images of the 42-year old sitting in the cage in his underwear, his feet shackled by a heavy chain.

Cases similar to Wu are not unheard of in China. Work pressure, the breakdown of traditional family structures, and other aspects of China's rapid modernization have brought an increase in psychological stress to the population.

There are often reports of violent, random attacks, killings and suicides. One of the most memorable was when a depressed 27-year-old factory worker tried to feed himself to a pair of Bengal tigers at a Chengdu zoo by jumping into their cage last February.

Lagarde: China won't have hard landing
On China: The future of tech
On China: Government and tech

Not enough help

The country's public health system is struggling to keep up with the demand in mental health care.

Around 173 million Chinese suffer from a mental disorder, according to a 2009 study published in British medical journal The Lancet. But there are only 20,000 psychiatrists, equaling 1.5 for each 100,000 people, or a tenth of the ratio in the United States.

Professor Michael Phillips, director of the Shanghai Mental Health Center at Shanghai Jiao Tong University, estimated that only 5% of people who currently have a mental illness in China have received psychiatric care from a professional.

"The factors that affect the low care-seeking rates are many," he said. "Lack of awareness that they suffer from a psychiatric condition, lack of locally available mental health services, fear of stigma, belief that seeking psychological help will be useless, costs, etcetera."

Dubious therapy

As a response to the massive demand for help with mental health problems, under-qualified mental health practitioners have sprung up across the country.

Dr. Sammy Cheng Kin-wing, Hong Kong-based chairman of the Division of Clinical Psychology, part of the Hong Kong Psychological Society, said he receives many complaints from the public.

Commonly complaints are about unregistered psychologists who give unprofessional advice to clients, fail to provide proper assessments and break confidentiality.

"Many people are setting up practices in mainland China. Some are well-trained, but that's just a minority. Because the need is so great, the unqualified can still run their businesses and offer treatment. I've been in contact with patients who feel very angry over services received, sometimes with emotional state worsened during treatment. They said they would never see a psychologist again," said Cheng.

Professor Phillips agreed that "charlatans occur everywhere" and "there are uneducated subgroups in China that are gullible."

"In terms of professional services there are certainly locations with sub-standard levels of care, primarily because of a lack of trained personnel," he added.

'Ankang'

Ironically, while those in genuine need of help have been unable to get any, the government has used confinement in mental institutions as a way to silence political dissenters, human rights activists claim.

Nicholas Bequelin, a senior researcher at Human Rights Watch (HRW) in Hong Kong, said it's a method that has been used increasingly over the past decade, calling it "an absolute violation of medical ethics."

One of those alleged to have been a victim of the practice, is Xing Shiku. Chinese Human Rights Defenders say he has been incarcerated in a psychiatric hospital in Heilongjiang Province for more than six years. Xing, they say, had been filing complaints to the central government about corruption and other problems related to the privatization of the state-owned company where he worked.

These mental institutions are called "ankang" ("peace and health") hospitals and are managed by the Public Security Bureau. Treatments include beatings and electric shocks, according to HRW. As of 2011, there were some 20 "ankang" institutions operating in China.

Although China's National Health and Family Planning Commission did not directly respond to the allegations, they stated that "China's mental health organizations strictly follow laws when practicing diagnosis and treatment." They added that diagnoses of mental disorders are made according to the Chinese Classification of Mental Disorders and International Classification of Diseases.

Baby steps

"The very first test of the mental health law will be whether those held in psychiatric facilities for political reasons are immediately released."
Sophie Richardson, Human Rights Watch

The government has taken steps to address the shallow mental health system, such as financing mental health services and provide training for primary care providers. Most notably, a new mental health law was introduced last year -- it took 27 years to pass the legislation.

Among the most significant changes was a new set of rights for patients, including not being hospitalized against their will.

Despite constructive changes, HRW argues that there are still plenty of loopholes.

"The very first test of the mental health law will be whether those held in psychiatric facilities for political reasons are immediately released," the organization's China director, Sophie Richardson, said in a statement.

The new law is a big step in the right direction, most commentators say. But a voluntary admissions system will further increase the need for more mental health practitioners and community-based services, potentially sending a system already in disarray into further decline.

While a wholesale reform of the mental health system is needed, one expert says no number of laws and certifications can help therapists gain the most important skill of all: a nuanced understanding of human emotion.

Harry Hoffmann and his wife Tina, a psychological counselor, run Da Wen, a counseling and coaching private practice in Kunming, Yunnan Province. Part of their business is to train those who wish to become therapists themselves.

"I met a man from Chengdu with a master degree in psychology who said 'I have learned nothing about inner feelings and emotions (from school). Can you help me to gain those skills?'" said Hoffmann. "For me, therapy is almost like art, with a set of ethical guidelines and a holistic health approach."

Factory life far from home leaves China's migrant workers vulnerable

ADVERTISEMENT
Part of complete coverage on
See CNN's complete coverage on China.
July 30, 2014 -- Updated 0712 GMT (1512 HKT)
All you need to know about the tainted meat produce that affects fast food restaurants across China, Hong Kong, and Japan.
July 18, 2014 -- Updated 0230 GMT (1030 HKT)
Some savvy individuals in China are claiming naming rights to valuable foreign brands. Here's how companies can combat them.
July 16, 2014 -- Updated 0911 GMT (1711 HKT)
Is Xi Jinping a true reformist or merely a "dictator" in disguise? CNN's Beijing bureau chief Jaime FlorCruz dissects the leader's policies
July 8, 2014 -- Updated 0344 GMT (1144 HKT)
With a population of 1.3 billion, you'd think that there would be 11 people in China who are good enough to put up a fight on the football pitch.
July 4, 2014 -- Updated 0631 GMT (1431 HKT)
26-year-old Ji Cheng is the first rider from China to compete for competitive cycling's highest honor.
July 7, 2014 -- Updated 1124 GMT (1924 HKT)
China's richest man, Wang Jianlin, may not yet be a household name outside of China, but that could be about to change.
July 4, 2014 -- Updated 0414 GMT (1214 HKT)
Hong Kong's narrow streets were once a dazzling gallery of neon, where banks and even bordellos plied their trade under sizzling tubular signs.
July 3, 2014 -- Updated 2357 GMT (0757 HKT)
When President Xi Jinping arrives in Seoul this week, the Chinese leader will have passed over North Korea in favor of its arch rival.
July 3, 2014 -- Updated 1159 GMT (1959 HKT)
Three more officials have been given the chop as part of China's anti-corruption drive, including former aides to the retired security chief.
July 1, 2014 -- Updated 1305 GMT (2105 HKT)
As thousands of Hong Kongers prepare for an annual protest, voices in China's press warn pro-democracy activism is a bad idea.
June 30, 2014 -- Updated 0437 GMT (1237 HKT)
Hong Kongers are demanding the right to directly elect their next leader, setting up a face-off with Beijing.
July 1, 2014 -- Updated 0656 GMT (1456 HKT)
The push for democratic reform in Hong Kong is testing China's "one country, two systems" model.
June 30, 2014 -- Updated 1156 GMT (1956 HKT)
Along a winding Chinese mountain road dotted with inns and restaurants is Jinan Orphanage, a place of refuge and site for troubled parents to dump unwanted children.
June 26, 2014 -- Updated 0836 GMT (1636 HKT)
CNN's Kristie Lu Stout invites Isaac Mao, Han Dongfang, and James Miles to discuss the rise of civil society in China and social media's crucial role.
June 26, 2014 -- Updated 0334 GMT (1134 HKT)
Chen Guangbiao wants rich people to give more to charity and he'll do anything to get their attention, including buying lunch for poor New Yorkers.
June 26, 2014 -- Updated 1144 GMT (1944 HKT)
Architects are planning to build the future world's tallest towers in China. They're going to come in pretty colors.
June 23, 2014 -- Updated 1147 GMT (1947 HKT)
Anna Coren visits Yulin's annual dog meat festival. Dogs are part of the daily diet here, with an estimated 10,000 dogs killed for the festival alone.
June 19, 2014 -- Updated 0638 GMT (1438 HKT)
People know little about sex, but are having plenty of it. We take a look at the ramifications of a lack of sex education in China.
June 13, 2014 -- Updated 0812 GMT (1612 HKT)
Hong Kongers have reacted angrily to a Chinese government white paper affirming Beijing's control over the territory.
The emphasis on national glory -- rather than purely personal achievement -- is key.
June 16, 2014 -- Updated 1614 GMT (0014 HKT)
A replica of the Effel Tower in Tianducheng, a luxury real estate development located in Hangzhou, east China's Zhejiang province.
What's the Eiffel Tower doing in China? Replica towns of the world's most famous monuments spring up all over China.
June 11, 2014 -- Updated 0013 GMT (0813 HKT)
Rapid development hasn't just boosted the economy -- it has opened up vast swathes of the country, says a man who has spent much of his life exploring it.
June 10, 2014 -- Updated 0654 GMT (1454 HKT)
The World Cup is apparently making a lot of people "ill" in China.
ADVERTISEMENT