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| | Changing needs and new perspectives for psychiatry and mental health services in China | | 2006-5-16 4:36:59 Special Lecture for the 102 JSPN Zou Yizhuang M.D,Ph.D |  Changing needs and new perspectives
for psychiatry and mental health services in China
Prof ZOU Yizhuang, M.D.Ph.D.
Scientific Secretary of Chinese Society of Psychiatry (CSP)
Vice Superintendent of Beijing Huilongguan Hospital
Beijing China
Chinese people have a long history of treating mental disorders by Traditional Chinese Medicine (TCM).
Classic of Medicine>was written in about 475BC which established seven emotion categories and treatment principals.Modern
psychiatry in Mainland China was established in 1930s, developed in 50s, back and force in 60-70s, restored in 80s and
accelerated in 1990s and 2000s.Chinese psychiatry has to keep changing in limited time, due to fast progress in the
country.
To understand the changing needs and new perspectives of China, it has to know the present situation in psychiatry and mental
health service in China.China is a country with an approximate area of 9,597,000 sq.km, population of 1292.378 million (WHO,
2000), lower-middle-income country (based on World Bank 2000 criteria).The proportion of health budget to GDP is 5.5 % (WHO,
2000) and 2.35 % of the total health budget on mental health.Less than 15% of the population are entitled to comprehensive
health insurance that covers psychiatric disorders.Mental health legislation has been in the processing phase since 1986, but
was not finally issued.The Criminal Law (1980), the Criminal Procedure Law (1980), the Civil Law (1987), the Civil Procedure
Law (1982), the Law on the Protection of Disabled Persons (1990), the Law on Maternal and Infant Health care (1994), and the
Marriage Law (2001) deal with some mental health issues.However, a comprehensive mental health legislation is deemed
necessary for many resaons.Chinese mental health policy is initially formulated in 1987.The components of the policy are
prevention, treatment and rehabilitation.The MOH convened a group of experts and developed the National Mental Health Project
of China (2002-2010).The three main areas of focus are integrated care & multisectoral links, equity, community care;
training of mental health professionals, increasing research; and development of mental health legislation.A national
disaster mental health response plan is being estanblished.China has 16,000,000 severe psychosis (Li, 1992) and other common
mental disorders 63,000,000 (WHO, 2002), totally 83,000,000 to 90,000,000 (child and elderly are not included).The annual
suicide rate was estimated at 23/100,000, accounting for 3.6% of all deaths.The rate in women was 25% higher than in men,
primarily due to large number of suicides in young rural women.Rural suicide rates are three times higher than urban rates
across both sexes, for all age groups, and over time.China has 16383 psychiatrists (MOH, 2004), 5-10% of psychiatrist-
population rate compared to developed countries.The non-treatment rate of mental disorders is high, 50% of schizophrenia and
90% of clinical depression are never treated due to low awareness, stigma and non-insurance.
Psychiatric needs keep changing in China.Many of them may have existed for a long time, but have become more important
recently: we need not only treat severe psychosis, but also mild and moderate disorders; not only provide service, but also
do education; not only therapy, but also prevention; not only focused on inpatient, but also outpatient, community and family
especially; providing service not only through psychiatry hospital, but also general hospital; not only public hospital, but
also private; practice not only clinic based, but also ethic based, policy based and evidence based.Attention is needed on
urgent service for disaster and public crisis like SARS.
New perspectives in psychiatry include: mental health legislation, ethic and human rights have to be considered through
practice; every person should have the right to get mental health service; government should pay more attention to social
security and insurance; service model is important for efficiency, quality, and equity.There should be some change to the low
resource for especially high loading in mental health.Who should be the team to provide mental health? Psychiatrists alone or
team based? Who is in the team?
As a populated developing country, China may have needs and perspectives similar to some countries from which she could
learn, but there are always some differences and she has to create her own way to fit the service for one fifth of the world
population. | | [CLOSE] |
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Ministry of Health, (2003) No.013
ICP:No.040657