Ma Hong,M.D*, Yanling He,M.D**, Yizhuang Zou,M.D,Ph.D***, Mingyuan Zhang,M.D**
The mental health service has developed mainly since 1949, especially since 1979. Now we have 641 psychiatric facilities with beds 110 thousand and 16 thousand psychiatrists. Each province has psychiatric institutes located in cities and partially in counties except Tibet.
All medical schools have classes for medical psychology and psychiatry, and nearly 20 of them have Ph D or M.S. program for psychiatry. Ten psychiatric research institutes has been established and 4 of them become WHO cooperative research and training centers. They are Mental Health Research and Training Cooperative Center in Beijing and Shanghai, Children Mental Health Cooperative Center in Nanjing, and Substance Abuse Cooperative Center in Changsha. There are 5 journals and periodicals on psychiatry and 10 related.
The Chinese Society of Psychiatry, independent from the Chinese Association of Neurology and Psychiatry in 1993, has special committees on biopsychiatry, social psychiatry, child and adolescent psychiatry, forensic psychiatry, transcultural psychiatry, addictive psychiatry, and woman mental health. Additionally, other associations related to mental health including the Chinese Association of Mental Health, the Chinese Society of Psychosomatic Medicine, the Chinese Association of Behavioral Medicine, the Chinese Society of Mental Hospital Administration, the Chinese Society of Psychiatric Rehabilitation and the Chinese Association of Rehabilitation for Mental Disables were also established. The communications to international academic associations, including U.S. were also built up. There are several governmental or non-governmental programs for collaborative research and/or exchange with some countries. Some of these are with Harvard Medical School.
The "psychiatrist" in China, means the doctors working in mental health institutions, not the same meaning as the other countries. Based on the statistics from China Health Yearbook, 2003, less than 1 percent (0.9%) of all licensed practitioners.
There is not a comprehensive faculty consisting of social workers, occupational therapist and psychotherapist in China. Hospital-based and some other services are provided by psychiatrists.
Due to lack of specialist education, the training usually takes place in a master-apprentice way. The affiliated hospitals of universities have established a 5-year resident training system. But other hospitals will arrange the training according to their own conditions. Very obviously, without a national standard it is nearly impossible to guarantee the quality of training.
In 1999, the secretary-general of WHO, Dr. Brundtland visited China and a high-level advocacy meeting was held by Ministry of Health. Since then, a differentiation of mental health services has taken place.
In collaboration with our government, some psychiatrists had participated in the policy making, health education and legislation from 2000. With the help of their international colleagues, these psychiatrists have also introduced lots of advanced information and services to China. It is good to see their efforts had led to some reforms in regional mental hospitals. Now they are playing a more and more important role in advancing the mental health work of our country.
On June 7th, 2002, Ministry of Health authorized the establishment of National Center for Mental Health, China-CDC which is located at Institute of Mental Health, Peking University.Under the professional leadership of China-CDC, National Center for Mental Health, China-CDC will be responsible for the following main duties:
1. To provide scientific evidence and counseling for establishment of national laws, policies, rules, regulations, criteria, and plans related with prevention and control of mental disorders.
2. To instruct the setting up of national mental disorder surveillance system in order to monitor mental disorders, to constitute database, and to analyze data regularly.
3. To organize, monitor and evaluate preventive and therapeutic algorithm for mental illness.
4. To be responsible for professional guiding and training for mental health professionals.
5. To organize and implement international and domestic collaborative programs and exchanging activities.
6. To investigate and dispose of prevalence of mental disorders and emergent events, and to provide technique support for prevention and management of disaster.
7. To promote mental health education and health improvement, and to facilitate up building of social mental health environment and formation of population mental health behaviors.
8. Practical, scientific research and so on.
Although mental health service in China has greatly improved during the past 50 years, it is still far from satisfactory comparing to the great and increasing demands. Nevertheless, on one hand, the proportion of mental health professionals to the large population is very low. On the other hand, following the social economic development, food and clothing are no longer all of the life, psychological health as well as physical health are paid more attention than ever before. The prevalence of some mental health problems is increasing significantly at the same time, such as alcohol and substance dependence, dementia and other mental disorders among elderly, social change related problems, and unhealthy behavior related illnesses. The illness spectrum in China has been close to developed countries.
Looking at mental health in China, there is so much to do. The following three are the most important.
1. Improving the mental health team.
2. Integrating psychiatry with general medicine.
3. Expanding mental health services.
Mental health is very important. Mental health problems are so common. The etiology of most mental disorders is unknown and the current treatment is far from ideal. How to improve mental health service further is a difficult problem of the world and is also the common desire of mental health workers all over the world. Although Chinese psychiatry is still young and with limited resources comparing to developed country, we sincerely wish to collaborate with international partners to make greater contribution in mental health.
* Mental Health Institute, Peking University
** Shanghai Mental Health Center
*** Beijing Hui Longguang Hospitai
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Ministry of Health, (2003) No.013
ICP:No.040657