Mental health in China

The concept of mental health in China is influenced by Confucian ideology as well as an emphasis on family. In contrast to Western thought, the Chinese emphasize "highly personal duties and social goals" rather than the individual, and personal rights. Failing to fulfill one's duties within the family and society can lead to common symptoms of psychological distress, such as feelings of guilt and shame.Mental health is a growing issue in China with estimates of 100 million sufferers of mental illness.

China's first mental institutions were introduced before 1849 by Western missionaries. After the establishment of the People's Republic of China in 1949, the treatment model was indigenized during 1949–1963. During the Cultural Revolution (1964–1976) strong political control governed diagnosis and treatment as well as detention and discharge of mental patients. Later, due to the modernization and reform advocated by Deng Xiaoping, western models of treatment and rehabilitation were gradually introduced by psychiatrists. After more than 25 years of planning and fundraising, American medical missionaries opened the first mental hospital in China in 1898. In 19th century China, the mentally ill were usually confined by their families in a dark room of the house, essentially neglected. If left to wander in the streets, they were often mocked and laughed at, and sometimes stoned. If they did anything wrong, they could be arrested and thrown into prison. Because the mentally ill were largely invisible, some missionaries argued that mental illness was not as prevalent in China as in Europe or the United States. John G. Kerr, MD (1824–1901), an American Presbyterian medical missionary, disagreed – and he worked long and hard to change the treatment of the mentally ill. When he opened his Refuge for the Insane, Kerr declared some new principles: first, insane patients were ill and should not be blamed for their actions; second, they were in a hospital, not a prison; and third, they must be treated as human beings, not as animals. He pledged to conduct a course of treatment based on persuasion rather than force, on freedom rather than restraint, and on a healthy outdoor life with a maximum of rest, warm baths, and kindness. He also wanted to provide patients with gainful employment wherever possible. The directors of the Canton refuge worked closely with local Chinese officials and local police, who did not know how to handle insane people and were glad to refer them in large numbers to the refuge. 6 Chinese officials paid the refuge an annual allowance for taking care of the patients. Local families also brought in patients, and some were sent from Hong Kong by the British authorities. The hospital was eventually expanded to 500 beds, and it operated with considerable success until it finally closed in 1937.

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