China Begins to Bring Mentally Ill ‘Back to Society’

China Begins to Bring Mentally Ill ‘Back to Society’

For Foreign Policy, Christina Larson looks at efforts within China’s mental health sector to improve care and help patients lead productive lives:

For a long time, mental illness in China was invisible. Late Communist ruler Mao Zedong’s ideology-driven vision of a rational society officially made no concession for it. After 1949, his new government set about closing most of the psychiatric hospitals opened since the 19th century by Western missionaries. (Some asylums have been used to involuntarily lock up political dissidents, as happened in the Soviet Union — a practice that has not entirely ended in China.) Even earlier, as Arthur Kleinman, a Harvard University psychiatrist who has researched mental illness in China since 1978, explained to Foreign Policy, psychosis meant social death in China. “In traditional village society, seriously mentally ill people were defined as not fully human and removed from their network of connections,” said Kleinman. “They were not allowed to give or receive gifts at weddings, funerals, and other social occasions. The level of stigma was both deeper and qualitatively different than in other [countries].”

But beginning in the late 1980s, Chinese disability advocates began to petition for passage of the country’s first mental health law, hoping to clarify both the rights of people with mental illness and the state’s obligations to them. But it took more than a quarter-century until the law was finally enacted, in May 2013, with the broad goals of expanding access to quality care and sharply limiting involuntary confinement. “It’s a very important step forward — a serious attempt to engage an enormous problem,” said Kleinman, who added that he is cautiously optimistic. “The real issue is implementation; that’s true of any law, and especially in China.”

China’s opaque legislative process makes it difficult to trace the law’s progress. But Chinese society is starting to realize, and discuss, the profound toll of mental illness. China is home to an estimated 173 million people with mental illness, and 158 million of those never get professional diagnosis or treatment, according to research published in the Lancet, a British medical journal. In China, major depressive disorder is now the second-leading cause of “years lived with disability,” according to the latest Global Burden of Disease survey by the World Health Organization. As the country ages and urbanizes, rates of mental illness, particularly depression and dementia, are also rising. [Source]

Two recent documentary projects also look at mental illness in China from different perspectives. A photography series by Yuyang Liu shows patients in their homes, while a documentary from Reuters profiles Chen Wei, an activist who set up China’s first support group for people with depression. Read more about mental illness in China, via CDT.


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