China led the 'BRICS' countries of emerging powerful economies that gathered in South Africa this summer. Rebecca Holmes profiles its mental health services.
Just because a country is wealthy doesn’t mean the mental healthcare needs of its people will automatically be met. On a recent visit to China, Rebecca Holmes, BasicNeeds’ Programme Officer for Asia saw first-hand how many poorer people in China still don’t have access to basic mental healthcare services.
This is something we might not expect from a country that has one of the largest GDPs in the world. However, different perceptions around the importance of mental health mean that even wealthy countries can overlook the needs of those who find it difficult to make their voices heard, such as those affected by mental illness.
Recently I was in China in a city called Baoding - around 150km from Beijing Capital, visiting the 6th People’s Hospital of Hebei. This is the only specialist mental health hospital in the whole of Baoding – a Prefecture which spans nearly 22,000km of mountainous terrain and has a population of around 11.5 million.
The hospital is modern and well-equipped. It has a capacity of 550 in-patient beds, with 429 staff, 123 of whom are medically trained. Hebei 6th People’s Hospital is also the Provincial centre for psychological treatment, training and research. These fantastic facilities demonstrate that mental health is increasingly recognised as a priority area for investment by the Chinese government. However, none of this will be any good if mental health services remain centralised in areas like Baoding city, where many people, especially those who are poorer, are unable to access them.
To see what mental health services are like outside Baoding, I travelled with a team of psychiatrists and mental health workers to visit two clinics established by the BasicNeeds Hebei Foundation in the townships of Langya and Yixian - about an hour’s drive from the city. Pulling up outside Langya hospital, it was clear that the facilities here were a far cry from what we had seen in Baoding.
The medical team carried the boxes of medication through the entrance of the small building and set them down at the end of a corridor where people had begun forming a queue. On average about 30-40 people attend this monthly mental health clinic, where they can be assessed by the psychiatrist from Baoding and collect medication.
At this clinic, and the one in Yixian township we went onto later, the medication is completely free. Without the BasicNeeds clinics, these patients would have to pay for medication themselves. We spoke to some of the people who attend the clinics, and they told us the costs of medication can be extremely burdensome for poorer families, and treatment was frequently skipped as a result. Also, prior to the establishment of the BasicNeeds clinics in Langya and Yixian, most patients had to make the long journey to Baoding or even Beijing to obtain treatment. At the Yixian clinic alone, over 140 people regularly attend each month. The need for local and affordable mental health services could not be more clear.
The Chinese government passed a law in 2012 which recognised and strengthened the rights of people living with mental illness in China. For instance, it is now illegal to confine someone with a mental illness in a psychiatric hospital against their will or force them to undergo medical treatment. This shows great strides have been made in China with regard to mental health and human rights. However, with most mental health services still limited to a few urban locations and only available at significant cost for the poorest, a large amount of work is yet to be done to address this treatment gap in practice.
Rebecca Holmes is a programmes officer at BasicNeeds, an international mental health charity.
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Image: Yixian Hospital