Much Awaited – Mental Health Law Passed in China
On the 26th of October, 2012 the mental health law was finally passed in China after it was drafted about fifteen times since the early 1980s. Many feared that they would never see this historic day, which is a significant step forward for China and mental health. We at BasicNeeds are immensely thankful to the Government of China and to all those who were involved in the process of enabling China to arrive at this milestone.
So what does the passing of the mental health law mean? The international media has focused mostly on one element of the law which relates to involuntary hospitalisation of people. This has been heavily criticised in the past, but now with the passing of the law, admission to hospitals should be voluntarily, except if the individual is believed to cause harm to themselves or others. This is a significant change to the current situation where most hospitalisations are involuntary. However, only 5 articles of the law directly deal with voluntary hospitalisation, and there are 82 articles that make up the law, which means that 77 articles of the law have not been discussed in much detail. I want to therefore try to look at some of these other elements of the law and try to understand what difference they will make to the lives of millions of people who have no mental health services in China.
Since the BasicNeeds model is very much centred on working with mentally ill people within their community, many of the articles of the mental health law that involve the community are of great interest to us. Several articles of the law specify that county level governments need to be more responsible and they must have an annual budget for mental health work. According to the law, responsibility is also given to village committees and residents committees, who should assist mentally ill people and their families, take part in dissemination of mental health information, etc. The law also states that employers need to assist mentally ill people find suitable work and possible tax cuts will be provided for employers who collaborate on this front.
An important element of the BasicNeeds model is also ensuring sustainable livelihoods. Therefore, we are happy to see the importance of livelihoods recognised by the law. The law further encourages more mental health training and education to be provided for different sectors and individuals, including community health staff, teachers, people with mental illness and their carers, school children, and even preschool children.
- In order to try to highlight what I have described above, I have quoted a few sections from the mental health law in no particular order:
- Governments at all levels shall increase their financial investment in order to be able to carry out planned mental health work.
- Village committees and residents committees shall assist local governments in carrying out mental health work.
- Township hospitals and community health service centres shall provide technical guidance
- for village and residents committees to carry out community mental health activities and promote mental health education activities.
- Departments of health and administration of government at or above county level shall organise medical establishments to prove free basic public health services for mentally ill patients.
- Governments at or above county levels and relevant departments shall take effective measures to ensure that children of school age who are mentally ill, continue with compulsory education, to assist mentally ill patients who have the ability to engage in productive labour to do so, and to offer job services for patients that have recovered.
As it can been seen by some sections from the law as quoted above, there is a greater sense of responsibility being given to local governments and community groups. This is very much what we are doing at BasicNeeds in our pilot project in the Hebei province. We are working with the county level government to put forward a mental health plan, providing training at all levels which includes doctors from the surrounding towns and villages, and working with residents committees. We are happy that with this law is not only an option for local governments to take more interest in mental health work but also a requirement. The big question is how is this going to happen? Where is the funding going to come from? Although the law is very extensive it is often not specific, but this is a great start as a strong framework has been built. We at BasicNeeds hope to be able to ensure that this law is not just a framework but a vehicle for change.