Prominent human-rights lawyer Jin Guanghong was walking down a street in Beijing one day in April 2011 when he was grabbed by several unidentified men, who threw a black hood over his head and stuffed him into the back of a car. The men, believed to be national security officers, later placed him in a psychiatric hospital where doctors tied him up, force-fed him medicine and gave him unknown injections, all against his will. When he was released about 10 days later, he had no idea about what exactly had happened to him during the frightening ordeal.
Jin’s story is just one of hundreds of thousands of similar incidents each year in China, in which people—many with no obvious mental disabilities—are locked up against their will in China’s psychiatric institutions, according to a report released today by Chinese Human Rights Defenders (CHRD) titled The Darkest Corners: Abuses of Involuntary Psychiatric Commitment in China.
The report describes grim conditions and human-rights abuses in these institutions, where the patients have little hope of legal protection or redress. They are denied the right to make decisions regarding their own lives, such as medical treatment, admission, and discharge. Many are subjected to forced medical treatments, violence, and other forms of mistreatment, such as electric-shock therapy.
CHRD tells the story of Cheng Tianfu, who said he was subjected to electric shocks for refusing medication. In the report, he describes horrific treatment reminiscent of George Orwell’s dystopian novel 1984:
“They inserted electric needles into both sides of my temples. After the power was connected, the doctor—while twisting the switch to increase the voltage—roared, ‘Don’t you dare refuse medication, don’t you dare refuse medication!’ I suddenly felt that my head was going to explode. An unspeakable pain engulfed my every nerve, every cell, and every bit of me was trembling fiercely! I stared angrily and clenched my teeth. The doctor stuffed my mouth with a stainless steel ruler wrapped in cloth to prevent me from biting my tongue off.”
“Those locked up for ‘mental disability’ are one of the most vulnerable groups in China,” said Renee Xia, international director of CHRD. “Not only are they deprived of their liberty on the basis of alleged disabilities; those who violate their rights face little legal oversight or accountability.”
The Convention on the Rights of Persons With Disabilities, which China ratified in 2008, stipulates that “persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life.” However, the CHRD report said that when people with psychosocial disabilities are forcibly brought to many hospitals in China, staff ignore their will and objections, recognizing the committing party—usually family members, employers, police, or other state authorities—as the “guardians,” who are then allowed to authorize both the admittance as well as the discharge of the patient.
According to one estimate, some 800,000 people are admitted to psychiatric hospitals in China each year, and an official at the Chinese Center for Disease Control and Prevention Center for Mental Health says that more than 99 percent of those treated for mental illnesses (including those involuntarily committed) have not gone through legal procedures regarding the appointment of guardians.
The authors of the CHRD study went on to say that the current system of psychiatric confinement is open to significant abuse.
“Those who have the means—power and money—to either compel or pay psychiatric hospitals to detain individuals out of a desire to punish, silence, or simply get rid of them have been able to do so with impunity,” said the report. “Although people who initiate a commitment usually allege that the prospective patient suffers from psychosocial disability, there are cases in which government officials bring a “patient” to a hospital, admit that the individual is not mentally ill, and the hospital commits them anyway.”
In practice, hospitals often admit patients taken there against their will simply on the basis of an allegation made by the police, other government officials, family members, or employers that the person might have a psychosocial disability, according to the report.
“It’s usually a mixture of the hospitals’ feeling compelled by the government, which has a lot of power, and because they receive money for incarceration,” says Wang Songlian, a CHRD research coordinator. “We know of cases where the nurses say to the patient, ‘I know you’re not ill, but I have to keep you here anyway.’”
In some instances, the treatment of people committed to hospitals appears to border on the absurd.
In one case documented by CHRD, a psychiatric hospital held a woman because the police “suspected [her] to be mentally ill,” since they thought she had a “peculiar personality” and that she “spoke in extreme ways.”
In another case documented in the report, a man was sent to a psychiatric hospital after taking photos of a protest. The court upheld his commitment to the hospital, saying that the taking of the photos was behavior that “disturbed public order” and that the police were fulfilling their statutory duty by putting him in a psychiatric hospital for diagnosis.
In an interview with a Chinese human-rights NGO that did research for the report, the brother of Peng Xinlian, a petitioner (i.e., a citizen who brings a grievance against the local government to the attention of higher authorities via an official petition process—often making himself a target for political persecution, according to the CHRD) said that the head nurse at a psychiatric hospital conceded that his sister did not have a psychosocial disability, but she could not be released, because, according to the hospital: “Peng Xinlian is not ill now but this doesn’t mean she won’t be ill later.”
The report’s authors also describe the case of Cheng Tianfu, a website editor who was dragged off to a psychiatric hospital after his wife reported that he was “mentally ill,” who began to analyze who was being released and realized that the key to getting out was to stop insisting that he had no psychosocial disability.
He told a doctor that he was indeed ill, ticking off six key symptoms, and analyzing the causes of his “illness.” He was allowed to leave a few months later by the doctor who said he was recovering well.
“Often doctors and nurses say if you don’t recognize you’re mentally ill, then you must be mentally ill,” Wang told Newsweek/The Daily Beast. “It’s a Catch-22 situation sometimes.”
The report goes on to say that many of those now involuntarily committed by state agents are petitioners, dissidents and activists, including some well-known critics of the government, with many subjected to forced medication and shock treatment. The report lists 40 cases of individuals it claims were detained in psychiatric institutions after petitioning or advocating human rights—it says the actual number of politically motivated commitments is “likely much higher.”
The report says that the purpose of confinement to a mental hospital is often a means to rein in critics of the government.
In one case documented by CHRD, a petitioner was held for more than a year even though an evaluation proved she had no psychosocial disability. According to the human-rights organization, the woman claimed that the doctors often advised her that she must accept an agreement with the government before she would be allowed to leave the hospital.
The report describes how human-rights lawyer Liu Shihui videotaped a nurse telling him that two petitioners whom he had come to visit in a psychiatric hospital could only be released if they agreed to stop petitioning the government.
At present, there are no national laws, nor local regulations, that provide for judicial oversight during the commitment process. And while there are several national laws that govern some aspects of involuntary commitment, they are vague, say the researchers of this report.
And so in situations where patients have sued hospitals or the individuals who committed them, courts have refused to accept such cases, especially if police or other state units ordered the commitment, says CHRD.
The report goes on to say that lawyers who want to provide legal assistance to people being held in psychiatric hospitals are usually refused access to their clients, and they are also often threatened.
And even if a review is carried out, according to the report, psychiatrists from the same hospital are highly unlikely to overturn an original assessment made by a colleague, because the hospital has benefited financially from the income brought in by the commitment and it fears coming under pressure by the local government that initiated the commitment.
“Hospital management has been privatized, and so personal liberty is being bought and sold,” said Wang. “Hospitals don’t have much money, and so have to find a means to maintain their operations. As a result, psychiatric patients have become a commodity for hospitals.”
Cases can drag on for months or years, while the person is held against his or her will, and in some incidents, plaintiffs have passed away in the hospital while waiting for their lawsuits to be heard.
According to the report, one man spent 13 years in a psychiatric hospital after his employer, a prominent Chinese corporation, had him committed for “paranoid schizophrenia.” A Beijing hospital cleared him for release, according to the report, but the corporation reportedly refused to let him go free, and so he died in the hospital.
“The families often don’t have a lot of power over the hospitals compared to those who have committed the family member,” said Wang. “It’s about how much power the family has in relation to the ones who committed the person.”
At present, the report points out, there are no laws in China properly governing mental health. The government released a draft of the Mental Health Law for public comment in October 2011, but the law still has not been put into effect by the National People’s Congress, and it’s not yet known when it will be put to a vote.
Another factor for the phenomenon is the privatization of the management of some psychiatric hospitals since the 1980s. The authors of the report said that wealthy citizens and organizations are now able to pay institutions to incarcerate “troublesome” close relatives and employees whom they wish to get rid of.
The Darkest Corners analyzes more than 60 cases of individuals held in psychiatric hospitals in 22 different provinces and municipalities, while a Chinese NGO conducted interviews with 15 individuals who were previously detained.
The report called on China to abolish regulations adopted by local governments regarding involuntary commitment, to train legal officials in proceedings involving psychosocial disabilities, to monitor psychiatric hospitals to ensure human rights are protected, to hold people legally responsible for abuses and to develop community-based care for people with psychosocial disabilities.