The Cochrane Schizophrenia Group

Enter the dragon: welcoming China’s first mental health law

on May 10, 2013

By Steph Sampson, Systematic Reviewer for CSzG

China

China (Photo credit: andy castro)

Research by the WHO has shown that mental health problems have overtaken cancer and heart disease in terms of ‘burden’ on the Chinese healthcare system. Approximately 7% of the population (1.35 billion people) are affected by mental illness and up until now, only five cities in China held municipal mental health regulations, with no concrete national legislation.

On October 26 2012, the first national mental health law of the People’s Republic of China was adopted by the National People’s Congress, after almost 27 years of planning and drafting. This signifies an incredibly huge step into the realm of recognition of individual rights for people with mental disorders. But what does this law mean for people with mental illnesses in China?

Under the new law, there are specific provisions relating to involuntary admission and treatment (something that is permitted only for those with a ‘severe mental disorder’ who may be at risk of harm or safety to self or others); promoting and ensuring the human dignity of people with mental disorders; restrictions on the use of restraint, and promotion of community-based treatments. There are definite notes of human rights promotion in certain articles (although not specifically mentioned), indicating a step towards recognising international obligations (particularly so, as signatory to the UN Convention on the Rights of Persons with Disabilities).

English: Leg restraint

English: Leg restraint (Photo credit: Wikipedia)

With 2013 well under-way, we are starting to see snippets of information filter through the Chinese media; reported recently in South China Morning Post, a 30-year old woman is in the process of suing a Beijing psychiatric hospital after being involuntarily admitted and kept against her will for three days. Leading up to this, her parents hired a group of individuals to forcibly take her to the local psychiatric hospital after she refused to break-up with her boyfriend. Under the new legislation, responsible individuals or institutions are legally liable to pay compensation for ‘deliberately treating persons without mental disorders as if they have mental disorders and sending them to medical facilities for treatment’. This provision will be fundamental in the cases that are expected to be seen over the coming years, as the system has been used as a political tool to silence activists, dissidents, and to rid the rich and powerful of adversaries. Furthermore, the role of the family in making decisions about those with mental illnesses has traditionally received higher priority in China, as opposed to individual patient autonomy.

As the first case of its kind, it is promising to hear that there has at least been some recognition of the remedies provided within the provision of the new law. However, there is no mention of determination of consent for people being voluntarily treated, nor is there mention of capacity to make decisions; something that is crucial in consideration when any treatment will be involved.

Dissidents and investigative journalists provide the Western World with the information on what’s happening behind the borders.  Uncertainties nevertheless remain – how will implementation, adherence and protection of individuals’ rights be ensured? With a stretched workforce of an estimated 20,000 psychiatrists certified by the Chinese Psychiatrists’ Association, combined with only around 200,000 beds designated for people with mental health problems and a reliance on general practitioners to diagnose and treat mental illness, the question is posed as to how far the new law will provide any meaningful protections. The enactment of this law is the first step, and the challenges posed can only be imagined; but the stage has been set. It is up to the contributions and continuous dialogue of mental health professionals, lawyers and policy-makers in China – and internationally – to promote the growth and strength of this ground-breaking legislation, ensuring the best (and correct) treatment is provided to people with mental illness, and to forbid abuse of the system.

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8 responses to “Enter the dragon: welcoming China’s first mental health law

  1. Mark Fenton says:

    I wonder if the use of such legislated powers will change the political landscape in China?
    Tongue in cheek though, If I understand this right, I can take my daughter to China and get her put into a mental health hospital if she refuses to break up with her boyfriend?

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