Despair for families of mentally ill
Scores of middle-aged and older people sit outside a consultation room at the Shanghai Mental Health Centre, waiting to see a senior psychiatrist. One 49-year-old woman among them says most are not seeking treatment for themselves but for their children or grandchildren.
'I am here to seek advice on my 23-year-old son's depression,' she says, refusing to give her name. 'Since being identified with the disease six years ago, he seldom goes to the hospital himself, fearing the social stigma.'
She said he lost his job as a driver six months ago after his employer became aware of his mental state. He now stays at home, spending most of his hours on the computer and shrugging off his parents' suggestions that he look for another job.
'He is our only child and the only one we can rely on when we get old. But I look at his situation and feel really helpless,' she says, bursting into tears.
Experts say the families of the mentally ill face many ordeals, both economic and spiritual, on the mainland, mainly due to the low priority the government places on mental health and a generally unfriendly social environment.
There are only 16,000 licensed psychiatrists on the mainland, while the number of people suffering from various kinds of mental illness is estimated at 100 million according to Jiang Kaida, a top psychiatrist at the centre. That includes 26 million people hit by depression.
A study by the Chinese Centre for Disease Control and Prevention said that at the end of 2005 the mainland had just 572 medical institutions capable of treating mental problems, with just 132,000 beds in total. There has been no more recent update.
Most mental patients are cared for at home by family members and the authorities believe that is how it should be - rather than a government responsibility - and barely invest anything in mental health care according to a report entitled '2010-2011 Psychosis and Social Observation' by two Shenzhen-based non-government organisations, the Equity and Justice Initiative and the Psychosis and Social Observation Volunteer Group.
The mother in Shanghai said she faced a long trip from the suburban Qingpu district for each hospital visit and had to ask for at least half a day's leave from her job as a domestic helper each time.
Her family had explored many ways to treat the disease and had even hired a psychic, at a cost of several thousand yuan, to perform a superstitious ceremony at their home.
'I knew clearly that the psychic was a fraud but I still chose to try the service,' she said. 'Of course, it wasn't effective.'
A man in the waiting room travelled from Anhui to seek treatment for his 17-year-old son, who developed depression five years ago after coming under enormous pressure from his teachers about his academic performance.
'At that time my boy couldn't concentrate his attention, felt anxious and was always thinking of things. Sometimes he said he felt pain in his head and he thought of killing himself,' the man said.
He had taken his son to top hospitals in Nanjing and Beijing and was now trying Shanghai.
'I own a small business in my hometown, but I've asked my partners to handle its operation and I have to spend all my hours caring for my son,' he said. 'I have read many books on psychiatry and I joke that I am as qualified as a medical graduate now.'
The mother from Shanghai and the father from Anhui both complained that medical costs were high and medical insurance coverage limited.
'I once took my son to receive psychological counselling and the specialist told us to resort to community rehabilitation and social networking,' the mother said. 'But there is no such community unit in my district and no one wants to make friends with my son after finding out about his disease.'
There are few psychiatric rehabilitation centres in mainland communities. The central government vowed two years ago to spend 10 billion yuan (HK$12.2 billion) on building facilities for people with mental issues but experts say that falls well short of what is required.
Jiang said the extremely small number of psychiatrists on the mainland was partly due to the government's indifference to mental issues and partly due to the low status of psychiatrists compared with other doctors.
On average, the psychiatrists' incomes are about a third of their counterparts, according to the China Economic Weekly.
Jiang said the government should offer incentives to medical students to encourage them to practise psychiatry. He also suggested mobilising grass-root doctors in clinics across the country to join an intensive six-month psychiatric programme so that they could recognise mental ailments at an early stage.
The mother from Shanghai said social discrimination and her son's inability to study or work like a normal young man had once led her to consider suicide. 'But doctors told me my son can recover and I must carry on my life for his sake.'
The number of people on the mainland that are estimated to suffer from depression