China's Mental Health Problem, A Result of Rapid Development?

On Friday, hours before the attack at Sandy Hook Elementary School that killed 27 people including 20 children, a mentally disturbed man identified as Min Yongjun injured 23 children and one adult with a knife outside of a school in China. Though all the victims managed to survive this time, that hasn't always been the case. In the spring of 2010, a similar stabbing incident in Fujian province involving a mentally ill man, Zheng Mingsheng, left eight students dead, with five more critically injured. Zheng was heard screaming, "They don't allow me to live and drive me crazy. I will not spare them!" while stabbing people.

Some details about last week's attacker have slowly been released to the public. Xinhua News Agency reported that police said the knife-wielding assailant was an obsessed believer in the Dec. 21, 2012, doomsday predictions. 

With the incidents of China's mentally ill lashing out and targeting schools and students, the question of 'Why?' remains. 

Xu Haoyuan, 63, is a psychiatrist in China and host of "Dr. Xu's Psych-hotline" a daily radio talk show on Beijing Education Radio. She graduated from medical school in Henan, where last week's school attack took place, and later earned a master's and Ph.D. from the University of Notre Dame in the U.S.. Xu's stated goal is for the show to shed light on China's mental health issues and promote public awareness of the problem.

As China's politics and economics have drastically changed, the nation's health care system, for the most part, has not developed.

"Just like in the U.S., the psychological health of the society in China now is inferior compared to what it was like 50 years ago," Xu Haoyuan said. "The sharp increase in mental health problems is a natural result of the market economy," she said in another interview with China Daily.

"These incidents rarely happened in the 1950's, '60s and '70s. The great changes in China have deprived individuals of their usual support and psychological balance. At the same time, our mental health care system is bare and inadequate. I'm not surprised at all that such incidents happen," Xu said. 

Xu was referring to China's understaffed and poorly equipped psychiatric hospitals. The Ministry of Health's Center for Statistics Information said that in 2009 there were 19 million people diagnosed with psychological problems. Yet, only 637 psychiatric hospitals and 88,117 health care providers were available in China. 

Until recently, mental illness in China carried a stigma; people rarely admit to mental health problems, and appropriate treatment is even more rare. Some believe that mental problems cannot be remedied in a way that would stop the extremely mentally disturbed from committing crimes. But Xu argues that if "detected at an early stage and treated properly, the wounds will be healed. Even though there might be scars, that won't affect your life much."

It cannot be said for certain that competent psychiatric help for Min Yongjun or Zheng Mingsheng could have prevented their brutal school attacks, but Xu believes a combination of social reform and an improved mental health care system is worth investing in, to at least mitigate the risks. 

"If we can stop the widening gap between the rich and the poor, and even narrow it, build a comprehensive health support system -- especially by creating a team of clinical social workers -- the situation can be much better." 

Jiang Wenran, a professor of political science at the University of Alberta in Canada, also sees increasing social stress in China, and agreed with Xu that alleviating social problems would likely curb mental breaks among the population -- not only in China, but in the U.S. too.

"For a society to reduce or eliminate violence of such kind as we have seen in China and the U.S. schools lately depends more on building a more just and caring society. The overall social fabric must be strong and harmonious so people seek help rather than using such violence against school kids," Jiang said. 

The taboo status of mental illness is slowly fading and the Chinese are talking about it more (as can be seen, for example, from the fact that Dr. Xu's psychiatry show has recently moved to a daily, from a weekly, format.) Private efforts, such as her Heart to Heart psychological education center, which provides training on mental health for teachers and other professionals, are picking up the slack. But the challenge is to focus public policy on the problem.