NPC passes first mental health law

After more than 25 years of talks, legislation approved that will end arbitrary forced confinement of people on grounds of mental illness

PUBLISHED : Saturday, 27 October, 2012, 12:00am
UPDATED : Wednesday, 17 January, 2018, 12:47pm

After more than a quarter century of discussion, the National People's Congress Standing Committee has passed the first national mental health law, including a ban on forced confinement.

Psychiatrists called the law, which also requires all full-service hospitals to set up psychiatric departments, a major step towards improving mental health care for millions of Chinese and ending human rights abuses in which thousands have been sent to hospitals against their will.

Human rights advocates have long complained that loopholes in regulations have allowed people to use the threat of confinement as a weapon against enemies, with some doctors locking up patients solely on the word of others.

Experts predicted that admissions to psychiatric wards would soon plummet while many already institutionalised will leave. The outflow could potentially create a new problem in trying making sure the truly ill still get care, psychiatrists said.

"I estimate that 80 per cent of patients are staying at the country's psychiatric hospitals against their will," Dr Michael Phillips, who heads Shanghai Mental Health's suicide prevention centre. "Most of them will choose to leave the hospitals."

No figures on the number of people in the nation's nearly 600 mental institutions are available, but it is estimated more than 100 million mainlanders suffer from mental illness. More than 16 million cases are believed severe.

Fewer than a tenth of people believed to be suffering from depression had been treated, said Professor Xiao Shuiyuan , dean of Central South University's School of Public Health in Changsha , Hunan .

Talks about a mental health law began as early as 1985, but have long been bogged down by debate on oversight responsibilities, admissions criteria and accreditation standards.

Last year, Health Minister Chen Zhu admitted that loose standards on forced confinement were one of the biggest problems facing the mental health system. The NPC Standing Committee approved the draft yesterday at the end of its four-day session.

The law would still allow some involuntary confinements in psychiatric wards, provided the patients have been diagnosed by a qualified psychiatrist as a risk to harming themselves or others.

Huang Xuetao , a Shenzhen-based lawyer known for her successful attempts to defend people wrongly held in psychiatric hospitals, said she welcomed the change in law, but the government should also guarantee legal aid to those sent to hospital involuntarily.

Phillips, who has practised psychiatry on the mainland for more than two decades, said the so-called voluntary principle had long been practised in developed countries, but it was usually supported by robust services.

China has only 20,000 licensed psychiatrists and 200,000 beds designated for people with mental health problems.

"There will be various challenges for society," Phillips said. "If those [with a mental illness] live at home, their family members will find it hard to take care of them. If they stay at community-based rehabilitation facilities, these resources are in seriously short supply on the mainland."

Xiao, the Central South University professor, said the authorities must speed up training for new psychiatrists. "The scarcity of mental health professionals in our country can't be solved in a few years. It may take decades."