The Stigma of Mental Illness in China: Past, Present and Future

We’ve all seen the grungy, old-school, mid-20th century, horrifying mental institutions made popular in movies such as Shutter Island. Fortunately, for the sake of morality and the patients who suffer, most developed nations have improved their mental health sectors by making them a lot more humane. On the other hand, China’s mental institutions and the stigma associated with mental illness are lagging way behind the aforementioned countries.

“The Forgotten People, the State of Chinese Psychiatric Wards”  is a collection of pictures taken by Chinese photo journalist Nan Lu 25 years ago. If you clicked the link, you, like most people, were probably appalled. It’s a horrific sight, and to be honest there doesn’t seem much difference between these psychiatric wards and a Gulag. For some more modern images, typing a quick “China mental institutions” in the CCP’s favorite search engine will bring up a few that are just as stomach turning, especially if you crank up that VPN.


The stigma of mental illness in China

China has a particularly disturbing history concerning the mentally ill. The first mental institutions in the country were set up in 1849 by visiting Western missionaries. If the ill were to leave and walk the streets, they’d be ridiculed, laughed at, stoned, or even arrested. For this reason, since many of the sick were locked up and rarely seen in public, many Westerners in China at the time observed that China had a much lower percentage of mentally ill people than Europe or America.

Even now, “Mental problems are always seen as a source of shame to a person and his or her entire family”, says Xie Ben, Professor of Forensic Psychiatry at Shanghai mental Health Centre. Professor Cheon from the Northwestern University Department of Psychology in  Cross-Cultural Psychiatry  reemphasizes this data, saying that “studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners,” and that Asian communities have a “greater desire for social distance from mental illness.”

Using modern research methods, The Psychiatric Bulletin speaks about Chung and Wong’s 2004 research entitled “Experiences of stigma among Chinese mental health patients in Hong Kong,” which states “Chinese young people and their parents perceive mental illness as being ‘crazy’ and associated with violence.” [Note: while it’s true some chemical imbalances do cause violent behavior, as you’ll read below, the overwhelming majority of people with mental illnesses do not act violently].

This stigma means that it is hard for people to go find help. People suffering are forced to keep it an isolated burden. However, this also perpetuates the association of violence with mental illness as the times when it is discussed is usually in relation to a random act of violence, like the spree of school stabbings that occurred between 2010 and 2012.

Action has been taken

In response to those school stabbings, China passed its first mental health law, which came into force in May 2013. This was a massive milestone because it showed that officials are actually acknowledging a culturally sensitive issue— when usually the government’s preferred response is to shrug their shoulders and act like nothing is wrong.  According to the Wall Street Journal Blogs, this new bill protects the rights of the mentally ill, bans involuntary mental health evaluations unless the patient has violent intentions, makes hospitals provide counselling services for patients and ensures that institutions protect patients’ rights and personal information. The law also requires more doctors to be trained in the field of mental health since it’s estimated that 100 million people in China suffer from some kind of mental illness, and there are only 17,000 certified psychiatrists.

With all the positives from this new act, perhaps the most important aspect of them all is that human rights activists believe this new bill will stop the CCP from “silencing critics” by locking them up in insane asylums— a common trend that many have accused China of doing in the past. The most public case was that of Wang Wanxing, a pro-democracy activist, who was locked in a police-run mental institution in 1992 for 13 years.

The future

Even though it is extremely difficult to change the public’s view (especially when that public constitutes 1.4 billion people), and not enough time has passed to tell whether officials are successfully implementing the new measure, it does seem that for now China has taken the right steps towards fixing the mental health industry. By doing so, and addressing this problem, they’ll inevitably lighten the stigma associated with mental disorders. However, like so many other things in China from the One Child Policy, the booming economy, and the roaring military expenditures, only time has the answers. These questions continue to twist and curl the tail of the dragon into an even bigger question mark year after year.