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BEIJING, Apr 21 2011 (IPS) - Long considered a sign of weakness or a bourgeois indulgence, psychiatry is slowly entering the mainstream here, with a growing number of Chinese willing to talk through their problems with a therapist.
But treatment options remain grossly inadequate – despite worries that China might be on the verge of a mental health crisis as the population deals with massive social upheaval and the ghosts of the past. The mental health sector is chronically under-funded and many therapists lack proper training, leaving those in need of treatment with limited options.
While official statistics put the number of Chinese suffering from a mental disorder at 7 percent, other studies have pointed to a much more prevalent trend. According to a study by The Lancet, a British medical journal, one in five adults in China – totaling 173 million people – have a mental disorder. The study found that only one in 12 Chinese who needs psychiatric help ever sees a professional.
A recent Health Ministry survey found that incidents of mental disorders had climbed more than 50 percent from 2003 to 2008, and doctors have reported depression and anxiety to be on the rise.
For much of Chinese history, the treatment of mental illness was left to practitioners of traditional medicine. At the time of the Communist Revolution, China had only 60 psychiatrists for a half a billion people. Despite the trauma caused by the disastrous Great Leap Forward and Cultural Revolution, the idea of talking through one’s problems remained stigmatised long after Mao Zedong’s reign.
Those traumas have never been properly addressed for many Chinese, and while China’s economic boom has undoubtedly improved the lives of millions, it has also ushered in complex new realities, the pressures of which are becoming increasingly evident.
Suicide is a leading cause of death among young people and migrant workers. Last year, a spate of high-profile suicides hit Foxconn Technology Group, which makes products for Apple Computers. The pressure on single men – exacerbated by a widening gender gap – was identified as one of the root causes of a series of murderous attacks last summer by middle-aged men upon children.
But the country has an acute shortage of control and prevention institutes and therapists, said Fan Li, vice-president of the Chinese People’s Liberation Army General Hospital, in an interview with China News Agency. He said the rate of young children suffering from mental problems has reached 15 to 20 percent, higher than the international level.
Fan noted that in 2005 there were only 572 medical institutes for mental health, with 16,383 registered therapists – roughly one therapist for every 10,000 people, well off the government’s target of one therapist for every 1,000 people.
Despite a lack of treatment options, the idea of therapy has become much more mainstream. Chinese television regularly airs “Dr. Phil”-inspired programmes that feature guests talking through their problems with an expert.
Zhong Jie, an assistant psychology professor at Peking University, runs a small psychotherapy practice, seeing five to seven patients a week at his office in north Beijing.
“They come in to visit me to help with problems – anxiety, depression, health, relationships,” Zhong tells IPS. “Chinese people are thinking about a new system to deal with mental health. I don’t know the result, but this is a chance to get our society and our government to help Chinese people and organise a new modern mental health system.”
The government has pledged to invest more in mental health, designating billions of dollars for new and improved psychiatric hospitals. The country added some 50,000 hospital psychiatric beds from 2003 to 2008.
Cheng Xi, a certified therapist and member of both the Chinese Psychological Society and the China Association of Mental Health, says the government has acknowledged the rise of mental health problems and is addressing the problems: establishing a suicide hotline, demanding hospitals have psychiatric departments, and creating psychological counseling programmes in schools.
But China has never adopted a national mental health law, and few people have insurance to cover psychiatric care. Despite pledges to improve insurance, last year a Health Ministry official said only 45,000 people were covered for outpatient treatment and only 7,000 for inpatient care.
There is also a shortage of inpatient beds, too few accredited professionals and a virtual absence of care in rural areas.
Because there are so few treatment options, psychiatric hospitals often charge exorbitant rates. According to a report in Shenzhen Special Daily last year, rates can reach RMB 300 (46 dollars) an hour to see a registered therapist. Those who can afford the fee often have unrealistic expectations of treatment; some therapists have reported being abused verbally and physically by patients who did not get the results they expected.
Chen says the government needs to create better institutions, improve training for therapists and lower prices for treatment. He says that although more Chinese are willing to talk about their problems, high fees and poorly trained professionals discourage many.
“Many therapists can’t advise patients,” Chen says, “because they just don’t know how.”
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