Country's mental health services lacking

Harvard to collaborate in China on program to train psychiatrists

Psychiatrist Yao Xueyang says he has been overloaded with work ever since he started at Yichang Mental Health Center six years ago.

"We have about 30 doctors here, with four to five working in the outpatient department. They receive an average of 100 patients each day," he said, adding with a sigh: "The physical pain patients inflict on doctors and nurses, severe or not, can be seen every day."

There are only about 40 psychiatrists in all of Yichang, a city in Central China's Hubei province with a population of about 4 million. That means one psychiatrist for every 100,000 people.

A nurse combs the hair of a new patient at the Mental Health Center of Zouping, Shandong province, on Friday. Dong Naide / for China Daily

In Western countries, such as the United States, Britain and Germany, there are more than 11 psychiatrists serving 100,000 people.

"The personnel shortage has existed at my clinic for years, not to mention lower-level hospitals," Yao said. "Because of the high risk of being hurt by patients, low pay and wide social stigma, very few people want to enter the field of psychiatry when they graduate from medical school, let alone work in less-developed areas of China."

China has had a serious lack of qualified psychiatrists for a long time, particularly in central and western areas. Figures from the Ministry of Health showed that in 2010 there were only about 20,000 psychiatrists to serve the country's population of 1.3 billion, about one-fourth of the international level.

Statistics from China's National Center for Mental Health said in 2009 about 170 million people had some sort of mental illness, and the number of patients with severe mental health problems exceeded 16 million.

The distribution of mental health medical staff is also extremely uneven. Most mental health medical staff work in big cities in eastern areas, with about 29 percent in central regions and less than 23 percent in western areas.

In addition, more than 80 percent of mental health specialists are working at psychiatric hospitals and less than 20 percent are working at general hospitals, county-level and community hospitals, according to the Health Ministry.

"In medical schools, psychiatry is not as popular as cardiology or endocrine medicine. Students have fewer periods for psychiatric study," said Wu Yuefeng, a doctor at Xi'an Mental Health Center in Northwest China's Shaanxi province. "When they graduate, students prefer to work or study further in eastern areas, where rich psychiatric resources are concentrated."

Take the Guangxi Zhuang autonomous region as an example. From 2008 to 2012, psychiatric hospitals in the area recruited 160 professional psychiatric medical staff, while 54 quit.

Of them, 39 had worked for less than three years, a source with the local health department said.

To make things worse, social stigma makes few people who suffer from mental illness willing to seek medical treatment.

For a long time, mental illness was taboo in China, though the situation has improved in recent years.

"Even patients that have fully recovered often face the prospect of losing their jobs, housing and marriage. Mental problems are always seen as a source of shame to a person and his or her entire family," said Xie Bin, professor of forensic psychiatry at Shanghai Mental Health Center.

"Psychiatry's marginalization in both medical school and society means that general doctors, especially those at community hospitals, often are ignorant of mental disorders and consequently fail to diagnose or treat them."