Mental Health in China

[smilingdodo]

What is the attitude of Chinese people towards mental health issues?

[DavyJonesLocker]

Getting better but still a long way behind western countries. Everything seems to get classified under one broad heading of "mental health" issues with no real concern about how to diagnose it properly.

My friends wife has some pretty serious mental health problems and she found that here in Beijing hospitals just weren't interested and simply prescribed some run of the mill drug like an antidepressant. 

 

As regards attitude, I think younger  people are more accepting that it's a proper and potentially serious illness. However unfortunately there still is a strong stigma attached to it and many people still  reluctant to admit it or feel ashamed to talk to people about it. 

 

 

 

[Xiao Kui]

It's my impression that there's still quite a stigma associated with counseling , psychology, and psychiatry in China, so even though many younger Chinese would admit a need for these services I know very few who are seeking them out.  Recently, however, I heard a young Chinese professional very excited about coaching sessions with a career coach, so I think that life coaching has great potential in China, at least for providing general counseling, and maybe even to address mental health issues that don't require medication.  I think the greatest potential for counseling to become mainstream in China would be under the banner of coaching.  On one hand it opens the door for all kinds of unqualified people to offer this service, on the other hand a lot of Chinese are just looking for a friend to talk to them who's a little outside their circle so they can express themselves without fear of judgment. Counseling and coaching are the ideal solutions, but in a pinch a hapless foreigner will do! 

[smilingdodo]

Why is there a strong stigma attached to mental health issues in China? Is that different from the one existing in western countries?

[mungouk]

Well it's still a stigma everywhere but...

https://www.economist.com/china/2017/01/28/china-wakes-up-to-its-mental-health-problems

 

Do you expect China to have a progressive attitude to anything, compared to "the West"?

 

 

 

[smilingdodo]

Thank you mungouk for your reply.

 

I don't expect China to have a progressive attituted to anything. What I am saying is that in "the West" as well there are prejudices against mental health issues.

[mungouk]

Hi @smilingdodo, I think it would be more useful to us if you could be more specific with your question (as a general rule on forums, this is useful).

 

What is it that you really want to know?  From what you will have read here (and generally), attitudes to MH in China are behind those in the west. 

 

I am also interested in this for personal reasons and it would be interesting to know how it might affect applying for a work visa or obtaining medication.

 

Good to have an open discussion!

 

 

[smilingdodo]

There is a lot I would like to know since it is not a frequently discussed topic ?

 

For example, how would family and friends react in front of a loved one who suffers from mental health issues? How about school or workplace?

 

Hope this is more clear  

[edelweis]

I searched for mental health professionals per country and found this:

http://www.who.int/gho/mental_health/human_resources/psychiatrists_nurses/en/

but there is just no data for China ...

Edit: maybe that it telling in itself...

Edit again: actually this page shows 1.53 psychiatrist / 100000 inhabitants in 2011...

http://apps.who.int/gho/data/node.country.country-CHN

 

[Alex_Hart]

On 11/3/2018 at 12:17 AM, smilingdodo said:

For example, how would family and friends react in front of a loved one who suffers from mental health issues? How about school or workplace?

 

This is going to vary a lot, I think. Purely anecdotal, but I know two children who were pulled out of normal schooling for anxiety disorders; some parents responded to this with jealousy that the parents could afford to homeschool while other parents thought the parents were letting the kids get away with something. Even the staff (mostly composed of college-educated 20 somethings) shared these views. 

 

Also anecdotal: My girlfriend's grandmother clearly has some sort of problem. The grandma regularly forgets names/faces (even of her children), she refers to my 28-year-old girlfriend by the name of the grandma's deceased sibling and sometimes thinks her son is her father. She often thinks she's somewhere else (e.g. when she was visiting a son in Guizhou, she was confused because the "river in front of her house disappeared" (her house is in Zhejiang)). I was rather shocked that the main reaction among the kids/grandkids was laughter, with lots of cooing about how cute grandma is when she forgets everything. I think this sort of thing would cause shock/worry/fear in most Americans, but my girlfriend's family chalked it up to old age and left it at that. I was rather perplexed by the whole thing, brought to mind Foucault's ideas on madness.

 

I don't have it ready to cite, but I did see an article in the local Hangzhou paper about new government clinics opening for people with mental illness. They made a big deal about it, but it sounded like it was only for the elderly from the article. 

 

It would be a good topic for further study. 

 

EDIT: As to serious issues that affect people of all ages, e.g. bipolar disorder or what not, I don't know. I asked my girlfriend what her family would do if she told them she had depression and she snorted, said they'd tell her to drink more hot water and maybe find some Chinese medicine for her to eat. 

[mungouk]

Very interesting @Alex_Hart... is the concept of dementia/alzheimers well understood in China?  

 

[Alex_Hart]

13 hours ago, mungouk said:

Very interesting @Alex_Hart... is the concept of dementia/alzheimers well understood in China?  

 

I'm not sure. I've never really looked into this so maybe somebody else can provide a better answer.

 

Western news agencies (like the above linked Economist article) often stress the terrible conditions for those with psychological issues in China, including dementia/Alzheimers, and I do not doubt it. Based on personal experience with my girlfriend (who has chronic health issues) and the hospitals, I have very low expectations whenever dealing with the Chinese medical system. Considering the stigma that surrounds psychological ailments even in more developed countries, and the poor state of health care especially in rural China, it isn't surprising. You'll likely find a very different awareness of dementia/Alzheimers in Shanghai compared to rural Anhui. This sort of geographical divide is common everywhere in the world but is exasperated in a country as large and newly developed as China.

 

From news reports here in Hangzhou, I would say geriatric care is an area with growing exposure (as it is in other countries), at least more so than other psychological issues. The local government has been stressing the need to take care of your parents and there have been a few campaigns to equate "absent children" (those who work in the city while their parents live in the country) with unfilial behavior. They've also been building hospitals for older people who are suffering from 老年病 (which I take to include Alzheimer's, though I'm not sure). Personally, I don't think my girlfriend's family really understands it - they think it's normal for old people to be forgetful and experience a breakdown in communication. 

[Zbigniew]

18 hours ago, Alex_Hart said:

They've also been building hospitals for older people who are suffering from 老年病 (which I take to include Alzheimer's, though I'm not sure).

I know it as 老年痴呆症. 

 

There is increasing awareness of Alzheimer's in China. Inevitably a larger burden of care falls on the families of those affected than is the case in, say, the UK with its state healthcare system.

 

Even so, having Alzheimer's sufferers in your family in the UK is no bed of roses. My own very elderly parents both have Alzheimer's, one severe, and their primary carers are definitely their children rather than the state. It's partly my knowledge of how individual Chinese families I know cope, and have to cope, in similar situations to mine that has made me a better carer myself. Ultimately you realise you just have to roll your sleeves up and do what's necessary, whatever it takes.

[Alex_Hart]

3 hours ago, Zbigniew said:

Even so, having Alzheimer's sufferers in your family in the UK is no bed of roses. My own very elderly parents both have Alzheimer's, one severe, and their primary carers are definitely their children rather than the state. It's partly my knowledge of how individual Chinese families I know cope, and have to cope, in similar situations to mine that has made me a better carer myself. Ultimately you realise you just have to roll your sleeves up and do what's necessary, whatever it takes.

加油！Agreed, knowing the lengths many Chinese families need to go to is humbling.  While illness is a trial to both the patient and caregiver anywhere in the world, today's NYT article on this situation really sheds light on the depth of the problem for the sick and poor in China.

[mungouk]

... and given the demographic hump China is about to experience, it's only going to get more serious in the next 20-30 years. 

 

[smilingdodo]

@Alex_Hart If I were to undergo a research on this topic, where would you recommend me to look at?

 

Another question: does anybody know films or documentaries that show the current situation of mental health in China?

[Zbigniew]

4 hours ago, smilingdodo said:

Another question: does anybody know films or documentaries that show the current situation of mental health in China?

Here's a snapshot to get you started:

https://m.youtube.com/watch?v=MafNnwbK7fQ

[Alex_Hart]

On 11/14/2018 at 5:52 AM, smilingdodo said:

@Alex_Hart If I were to undergo a research on this topic, where would you recommend me to look at?

 

I'd recommend checking out a scholarly book/article and then looking at its sources. Their citations will give you more ideas on how to proceed. Might be difficult depending on what direction you want to go. A lot of the articles I saw after a quick look were largely done in the medical field - doesn't seem to be as much in the social sciences or history of mental health in China. The news articles (someone mentioned the Economist article, for example) generally don't have any citations. Here is a short overview.

 

I found this bibliography online with a section on Psychology and Negotiations in Contemporary China. You could see if any of the titles spark your interest. I've bolded a few that look like they might be relevant, though I haven't actually looked them up or anything. 

Quote

PSYCHOLOGY & NEGOTIATION (Includes topics ranging from thought reform to psychology and bargaining. See preceding sections, and sections below, e.g. on villages & "units," other topics.)

Bakken, Børge, Exemplary Society: Human Improvement, Social Control...*... ............................................... OUP'98

Blackman, Carolyn, Negotiating China: Case Studies and Strategies ................................................. Allen&Unwin'97

Bond, Michael H., Beyond the Chinese Face: Insights...* ..................................................................... DS721.B617'91

Chen, Nancy, Breathing Spaces: Qigong, Psychiatry, and Healing in China .................................................................

Chen, Theodore, Thought Reform of the Chinese Intellectuals ('60) ............................................................ 17247.2524

Chin, Robert and Ai-li, Psychological Research in Comm. China, 1949-1966 ................................................ 6403.252

Chinese Patterns of Behavior: Psychological/Psychiatric Studies, David Ho+, ed ............................ Z3108.P7C48'89

Farquhar, Judith, Appetites: Food and Sex in Postsocialist China ..................................................................................

The Handbook of Chinese Psychology, Michael Bond, ed ................................................................................. OUP'96

Human Rights Watch&Geneva Initiative on Psychiatry, Dangerous Minds:Political Psychiatry…Era ......... HRW’02

Jankowiak, William, Sex, Death & Hierarchy in a Chinese City ....................................................... DS796.H84J36'93

Koningsberger, Hans, Love and Hate in China: A New Yorker's Chinese Notes ............................................. 1722.536

Lifton, Robert, Thought Reform & the Psychology of Totalism * .................................................................... 6466.585

Lin Tsung-yi+, Chinese Societies and Mental Health ................................................................................... HKOUP'93

Lowinger, Paul & Livingston, The Minds of the Chinese People ..................................................... RA790.7.C6L58'83

Mixed Motives, Uncertain Outcomes: Defensive Conversation in China, J. Broomelhorster, ed .................. Rienner'97

Munro, Robin, China’s Psychiatric Inquisition: Dissent, Psychiatry and the Law in post-1949 .............. Simmonds’06

Normal and Abnormal Behavior in Chinese Culture *, Arthur Kleinman, ed ........................................ RC451.C6N67

Pearson, Veronica, Mental Health Care in China * ................................................................................................... '95

Phillips, Michael, and Veronica Pearson (psychiatric social work; for articles, see LTW) * ..........................................

Psycho-Sinology: Dreams in Ch. Culture, Carolyn Brown, ed .............................................................. BF1078.P74'88

The Psychology of the Chinese People, Michael Bond, ed ....................................................................... DS721.P78'86

Pye, Lucian, Chinese Negotiating Style ......................................................................................................... Quorum'92

Pye, Lucian, The Spirit of Chinese Politics (new ed.) ................................................................................. 75766.742.2

Ran, Mao-Sheng, Family-Based Mental Health Care in Rural China ............................................................ HKUP’05

Rickett, Allyn and Adelle, Prisoners of Liberation ................................................................................. 17241.194.769

Ruan Fangfu, Sex in China...Sexology in Chinese Culture ......................................................................... HQ60.J83'91

Solomon, Richard Mao's Revolution & Chinese Political Culture ........................................................... 75766.865.02

Tung Chi-ping, The Thought Revolution ................................................................................................. 17241.193.916

Wilson, Richard W., Learning to be Chinese: Political Socialization on Taiwan .......................................... 7505.975

Wolf, Arthur, Sexual Attraction & Childhood Association: A Chinese Brief... ............................................. Stanford'95

Yue Gang, The Mouth that Begs: Hunger, Cannibalism, and the Politics of Eating ......................................... Duke'99

Zhang Jingyuan, Psychoanalysis in China: Literary...1919-49 ........................................................... PN56.P92Z47'92

Zito, Angela, & T. Barlow, Body, Subject, and Power in China ............................................................ DS721.B615'94

(See also sections on social control, education, and others.)

4

 

[smilingdodo]

@Zbigniew Thank you!

 

@Alex_Hart Thank you! That's very helpful, I'll definitely have a look!