Beijing hospital raises standard of care for the mentally ill
Greenery surrounds the Huilongguang Hospital, where groups of men and women gather near the benches and enjoy Beijing's autumn breeze.
Some smoke, some chat and others just sit around, like ordinary people in a park. Only a hollow look in their eyes and their wrinkled gowns hint at the fact they are schizophrenia patients.
The relaxing atmosphere at one of the capital's major mental hospitals is quite different from 40 or 50 years ago, when psychiatric institutions were widely described as 'homes for mad people' and run like prisons.
The hospital, 20km north of central Beijing, is a teaching institute for Peking University and one of the biggest and most advanced mental hospitals on the mainland, with more than 1,300 beds and 1,250 staff.
For the past 10 years, the hospital has been modernising both its outlook and treatment.
Having got rid of the heavy metal gates and small windows, there are now more open spaces for exercise, curtained partitions between beds and activity rooms - including the 'sunshine' room next to a garden where patients can do arts and crafts.
Interactive computer programs were introduced recently to help schizophrenia patients recover.
But like all health-care institutions on the mainland, mental hospitals face the challenge of trying to treat a big number of patients with very limited resources.
Chen Yanfong , a professor in psychiatry at the hospital, said that compared with many developed countries, China still put too few resources into mental health.
He said 16 million mainlanders suffered from serious mental illness, while another 40 million suffer from depression.
The government started providing free medical treatment for the former two years ago, with most receiving treatment in hospitals.
Patients covered by employment insurance pay about 10 per cent of the medical cost. Employers or insurers have to pay 30 to 40 per cent and the government pays about 50 to 60 per cent.
Professor Chen said the serious shortage of psychiatrists in rural areas meant some town-level medical practitioners were being trained as what the local people called 'three-illness doctors'.
'Those doctors are trained to treat three major problems - skin diseases, mental illness and pneumonia, that is why we call them three-illness doctors,' he said.
Professor Chen said mental health was a rising concern on the mainland.
'People in China are subject to increasing stress following economic development. In the cities, people are getting more competitive and in the rural areas, people feel they have difficulties in catching up with the cities' living standards,' he said.
White-collar workers suffered from stress, he said, and some had insomnia. Rural dwellers felt inferior because of the wealth gap.
Migration had also created its own unique type of mental illness.
'During the Lunar New Year, many labourers flock back to their hometowns, hundreds of millions of people are on trains and planes. They sleep outside train stations and suffer from the hardship,' he said.
'Such a harsh situation has triggered mental problems among some commuters; we call it the travelling psychosis.
'We have treated some patients who suffer insomnia and anxiety after the trips.'
Doctors are looking for new, cheaper ways to reach out to more patients. One way is to harness the internet.
In 2001, the Chinese Medical Association's psychiatry committee and the Huilongguang Hospital jointly launched a Chinese Psychiatry Online website, which provides online consultations and information about mental health.
There are now about 85,000 registered users and more than 92,000 psychological tests have been conducted online.
Zou Yizhuang , the website's director and the hospital's vice-superintendent, said doctors from different areas provided expert views for online consultations.
Users from different provinces could take online psychological tests and arrange a one-to-one online consultation with doctors. Each cyber consultation cost 20 yuan.
'We stick to the principles that doctors will not prescribe any drugs through online consultations. They just give an expert view and refer patients to relevant clinics or hospitals for follow up care.'
Professor Zou said the website contributed to the development of community care on the mainland.
'It cuts the travelling time to see a doctor, especially for people in rural areas. Many patients also worry about the stigma of going to a mental hospital.
'It is a hopeful mode of community care in China.'
More home visits and community care have allowed schizophrenia patients at Beijing Huilongguang hospital to be discharged earlier
Schizophrenia patients spent an average 417 days in the hospital in 2002, compared with today's: 240