Treatable illness

But only 8 percent of these people ever sought professional help and only 5 percent had ever consulted a mental health professional, the report said.

"Many patients didn't recognize their mental illness in the first place," says Zhang Yanping, associate director of the BSRPC. "They thought it was no big deal and they were just feeling a bit low."

"Sufferers are unaware the problem is usually an illness that can be treated," the report said.

Even among those who sought help, Zhang says, many were too ashamed to see mental health doctors. Fearing discrimination, they went to general hospitals instead to have physical complications treated. "Such fears are deeply rooted."

Other people are inclined to regard the mentally ill as bad people, Zhang says. "Today in some remote countryside areas, there still lingers the superstition that mental health patients have been possessed by demons."

Lack of mental health services is another problem. Because of limited staff, only 37 percent of incoming calls to the BSRPC hotline are answered, Zhang says.

"Now we have five operators on each shift. To answer all the phone calls from Beijing there should be at least 12. To answer every call from Beijing and the rest of China there should more than 30," she says. According to a 2005 World Health Organization report, only 2.35 percent of the government's health budget in China was spent on mental health and less than 15 percent of the population had health insurance covering mental disorders.

Moreover, China's mental health sector is understaffed. According to a commentary in the August 22 Lancet issue, there are just 14,000 psychiatrists and psychologists to serve China's 1.3 billion population.

The situation is worse in rural areas, where mental health services are extremely under-resourced, lacking both professional staff and medicines, but mental disorders are more prevalent in these areas. According to the BSRPC 2007 report, 79 percent of people who committed suicide had been living in rural areas.

There is, however, a growing awareness of the problem in both government and public sectors.

Last year the Beijing health department invested 2.7 million yuan (US$395,289) in the BSRPC suicide hotline.

With more resources at its command, the center plans to install more telephone lines and hire more operators, Zhang says.

As well, mental health is now covered in a plan mapped out by the Ministry of Health whose goal is to provide universal access to basic medical services, including mental health services, by the year 2020.

"More and more people are turning to us for help," says Zhang. She attributes the increase to greater media publicity and growing awareness in society.

Professional institutions such as the BSRPC are also stepping up to tackle the problems. The center is planning programs on various aspects of mental health, such as education on the topic for normal university students, China's future teachers.

Compared with specialist hospitals, other institutions in the field play unique roles, especially by way of hotline services.

"Callers feel safe and less embarrassed talking over the phone because it's anonymous, and we never, ever release their profiles," says Meng.

To those who fear discrimination, hotlines have become major emotional release valves that also provide potential gateways to professional help.

Meng is proud of her work but realizes what she does is only a drop in the bucket.

"Callers place high hopes on hotlines, but it really takes more than us to make a difference," she says.

(Shanghai Daily September 23, 2009)