Wednesday, May 16, 2012

China's Mental Health System- Fascinating Stuff (at least I think so)

Ah, finally, a substantial blog post, this has been a long time coming, I am so glad to be able to post again.
I have recently put some time into researching China’s mental health system.  Being a communist country, I knew it would be nothing to brag about.  It does look as though they are slowly beginning to put the time and effort into an improved system but they still have a long way to go.  I was taught to take any news articles and such on China with a grain of salt though, often times the full truth is not disclosed, so please do keep that in mind as you read my blog post.  The system is probably still at least somewhat if not a good bit worse than what the articles I have read speak to it being. 

China sure is not exempt from mental health issues by any means, no country is.  In fact, China has a good many people suffering from mental health issues.  In 2009, China’s National Center for Mental Health released statistics showing that about 170 million individuals in China were suffering from some sort of mental illness.  The number of individuals with severe mental health issues was in upwards of 16 million people.  I always say this in relation to America and I will say it in relation to China, it is my opinion that these statistics are always lower than what the actual numbers are.  The reason I say this is because there is no way to account for all the individuals suffering from a mental illness that never actually receive treatment.  That issue exists in the U.S. and it is probably tenfold in China.

To sum the issues up:

  • China lacks qualified psychiatrists
  • There are disparate numbers of psychiatrists in the central and western regions of China compared to the big cities.  Psychiatrists are very unevenly distributed between cities and rural areas.
  •  Many new psychiatrists do not last very long working in the field of mental health in China
  • Stigma is a huge problem in China, mental health problems are always seen as a source of shame to an individual and their family
  •  Treatment is expensive and can be difficult to obtain
  • Individuals in need of treatment cannot always receive the treatment they need, however, individuals without a mental illness can be thrown in a mental health hospital by the authorities and medicated when it is not needed just to “shut them up” so to speak.
Lack of qualified Psychiatrists/Uneven distribution of Psychiatrists
According to Psychiatrist Yao Xueyang who works at a mental health center in Yichang, "Because of the high risk of being hurt by patients, low pay and wide social stigma, very few people want to enter the field of psychiatry when they graduate from medical school, let alone work in less-developed areas of China”.  Those that do study psychiatry typically choose to work in areas where the psychiatric resources are concentrated, in the eastern areas.

China has lacked qualified psychiatrists for a long time now.  In 2010, statistics showed that there were only about 20,000 psychiatrists to serve a population of 1.3 billion.  That is about a quarter of the international level.  Most of these psychiatrists work in big cities in the eastern areas, the central regions and western regions are even more sparse in psychiatrists.  Over 80% of the psychiatrists in China work in psychiatric hospitals leaving less than 20% to work in general hospitals and out in the community.
“There are only about 40 psychiatrists in all of Yichang, a city in Central China's Hubei province with a population of about 4 million. That means one psychiatrist for every 100,000 people. In Western countries, such as the United States, Britain and Germany, there are more than 11 psychiatrists serving 100,000 people” (Hongyi, W).

On top of psychiatry not being the area of choice for many medical students in China, many of those who choose that area of study do not last long once they begin to practice.  39 out of 160 new psychiatrists in the Guangxi Zhuang region between the years of 2008-2012 lasted 3 years or less.

Stigma… Oh.So.Bad!
So, we’ve got not enough qualified psychiatrists to serve the number of mentally ill individuals in the country.  Then we’ve got many new psychiatrists not lasting very long in the mental health field in China.  How dare I add more to this mix?  Well I must, the stigma in China leaves very few people actually seeking the help they need and deserve. Mental illness was completely taboo in China up until recently, strides have been made but it is still far worse of a stigmatic issue in China than it is here in the U.S and that is really not saying much since it is nothing to write home about here in the U.S.  Not to downplay the issue of stigma in the U.S. at all, as we all know my lifelong goal is to fight the stigma I and other individuals with mental illness face.
"Even patients that have fully recovered often face the prospect of losing their jobs, housing and marriage. Mental problems are always seen as a source of shame to a person and his or her entire family," said Xie Bin, professor of forensic psychiatry at Shanghai Mental Health Center.  Psychiatry is brushed over and marginalized in medical school in China leaving general doctors ignorant to the symptoms of mental disorders leading them to neglect to provide proper diagnosis and treatment.

Many people who are in need of medical attention for their mental health concerns are unable to receive the necessary help. This is typically due to a couple reasons. One reason, because it is too costly and there are not enough psychiatrists to meet the needs of everyone.  Another reason is because of the huge social stigma that is attached to mental health concerns in China.

There are also individuals who are psychiatrically healthy but are labeled as being "mentally ill".  This is done by authorities who are in search of a reason to detain them in mental health hospitals. The New York Times documented a 54-year old man named Xu Lindong. He was forced to spend six and a half years in Chinese mental hospitals and was given 54 unnecessary electrical shock therapy treatments all as a result of a land dispute.          

So, what are my thoughts?
Well of course my thoughts are that this is a huge shame that so many individuals are lacking the care that they need and deserve.  It is also extremely unfortunate that shame is always felt by an individual with a mental health concern and by their family. I find it extremely bothersome that individuals without mental illnesses are given treatments they don’t need while individuals with mental illnesses who need those treatments are unable to obtain them.

What it comes down to is that the system is horrible!  Individuals deserve the treatment that they need for their illness, but, what can be done about it?  Really, what can be done about it?  Unfortunately, I believe the answer to that is not much.  It is a country living under a communist regime.

Before I fully analyze the mental health system in China from my view point, I want to do a write up on the mental health system in the European countries and the mental health system in America and analyze the three of them together.  This is fascinating stuff to me, I hope it is to you as well and that I’m not boring you with too many facts and statistics.

The next posting will come soon this time, I promise.

"Being defeated is often temporary; giving up makes it permanent." ~ Marilyn von Savant

As always, thanks for reading! Until next time…