When studying a timeline of mental health care in China, one could be forgiven for assuming the outlook was bleak. Government reports and private studies both confirm that a growing number of Chinese people suffer from mental disabilities and that most of them do not have access to adequate health care and treatment.
In big cities like Beijing or Shanghai where awareness of these problems is on the rise, a lack of trained professionals impairs many health institutions' abilities to treat or even diagnose mental ailments, many of which are still relatively unknown in China.
In rural areas, the outlook is worse as despite tremendous efforts to increase health coverage to every village and remote townships, these hastily-built clinics are ill-equipped to deal with emergencies falling outside the realm of general medical treatment.
October 10 marked World Mental Health Day and the relevant watchdogs released figures showing worrying trends. Shanghai's health department places the city's instances of mental illness at 1.55 percent, up from 0.32 percent in the late 70s and that only 20 percent of China's mentally ill are currently receiving treatment.
However, with the CPC making specific mention of mental health for the first time in the 11th Five-Year Plan (2006-2010), Chinese understanding of such afflictions and their treatment should gradually improve.
In the meantime, a highly encouraging sight is that of the growing number of privately-run community centers which are welcoming patients around China. Providing the mentally disabled with specially-tailored environments within which they can live happily, be taken care of, taught life-skills and even get the chance to earn a salary.
Foremost among these is the Hui Ling network of community centers extending to Beijing, Xi'an, Xining, Tianjin, Chongqing, Wuhan and Qingyuan. The network was first started in 1990 by Ms Meng Weina in Guangzhou and Mr. Fernando Cagnini with the first of three Beijing centers opening in 2000. Its Guangzhou center has since evolved to encompass both a collective caring unit and a family residence center.
Hui Ling's three centers in the capital, are located in Jingshan, Gulou and Fangzhuang. Each caters to a different level of mental disability, with that in Jingshan welcoming over 20 patients on a daily basis, specializing in those who suffer from less debilitating conditions.
Upon visiting the center, a very pleasant surprise awaits. Nestled inside the hutong complex north of the Forbidden City and located inside an attractive and fragrant courtyard, Beijing Hui Ling provides an ideal location for the care and rehabilitation of its denizens.
Staffed by full-time teachers and staff as well as by volunteers, Hui Ling provides a curriculum of study and of activities tailored to their wards. Much of it depends on the calm and peaceful setting but also on the determination of those who work there.
"Hui Ling welcomes people from differing social background, people from both fortunate and poor families," said Miss Patricia Crouan, a social worker from France volunteering at Hui Ling, on October 24. "Our goal is to provide each of our patients with life-skills, enabling them to fend for themselves by teaching them to cook and clear while earning an income by teaching them to paint and make trinkets which are then sold to tourists. A part of the profits is then converted into a small salary for them."
Beijing Hui Ling, as a day center, caters to those living outside, generally with their families. Among its patients, disabilities range from severe autism to trisomy, but through careful tutoring, challenges that are normally beyond their capabilities are overcome. Furthermore, the monthly cost of 400 yuan to the families for daily care is significantly lower than other institutions, allowing those from more disadvantaged backgrounds to benefit from care.
The "Three Primary Colors" workshop, with its full-time music and art teachers, coaches trainees in arts and crafts production, increasing both revenue for the center and the trainees themselves but also enabling them to gain skills transferable to external workplaces.
But Hui Ling's implementation in Beijing did not happen without trouble. Local residents were nervous at the idea of such a community center and problems also spread to the families of the patients themselves.
This intolerance stems from the lack of understanding of mental diseases among the general Chinese population, said Mr. Zong Xuening, development director for Beijing Hui Ling.
However, one of Hui Ling's clear successes has been in opening its doors to the public and helping to re-educate its visitors as to the true nature of mental illnesses. When this writer visited the Jingshan center, the wedding of two German social workers had just concluded. The bridegroom had heard about Hui Ling and traveled to China to celebrate his wedding there. The patients were beautifully dressed, presented a range of song, dance and music for tourists while selling their handicrafts and looked very at ease in society. This is a far cry indeed from traditionally held images of the mentally ill who were ostracized from society and hidden away.
"As the government's attitude has shifted positively, so is that of Chinese people with many of those visiting the center touched by the handicapped and the foreigners working with them," said Mr. Zong.
"One of Hui Ling's continuing goals has been constant reflection on how to improve his services," added Miss Crouan. "Our work and activities focus on individual autonomy. We have a deep-held responsibility of allowing these people to fully integrate society and the world of work."
The Qingyuan Hui Ling branch has already met with success in this field by focusing its efforts on work for its patients, both inside the center and outside for different companies and three of its members have found full-time employment.
The future of Beijing Hui Ling looks bright, if financial difficulties can be overcome. In addition to continuously seeking charitable donations and trainee sponsorships, Hui Ling also seeks material donations to help supplement their existing set-up.
Unfortunately, it seems that all the goodwill of the world will not always trump financial realities. For the last few years, Beijing Hui Ling had been sponsored by German charity, Misereor. In 2006, a re-assessment by Misereor led to the conclusion that Beijing was developed enough for the three Hui Ling centers there to find local sponsorship and the support was moved to the Xi'an branch.
A further problem is that of finding reliable and well-trained Chinese staff. While medical universities are now offering psychiatric courses, the discipline only regained popular acceptance a decade ago and many graduates are not finding jobs due to a lack of infrastructure.
Miss Crouan notes that although the students that volunteer at the center are full of goodwill, they suffer from a disparity between their strong theoretical knowledge and practical applications thereof. The concepts of self-reliance among mentally disabled people and of them being fully participating members of society often seem shocking to medical students who have not yet been confronted with these realities.
Despite these clear problems, the principles upon which Meng Weina and Fernando Cagnin founded Hui Ling over 15 years ago have never been more necessary as today. With mental health at last finding the attention it deserves at all levels in China, hope for the future remains as long as beacons such as Hui Ling are allowed to guide the way.
(China.org.cn by Chris Dalby, October 30, 2006)