Beijing weighs individual care

Lack of manpower hinders efforts by health workers, doctors say.

Beijing is working on guidelines to help communities provide individual care for people suffering from mental health issues, said a health official.

The official, who declined to be identified, said he expected the guidance to come out by August.

According to the Beijing Health Bureau, there are 71,000 people registered as suffering from mental illness.

As directed by the National Health and Family Planning Commission, mental health hospitals currently take down patients’ names, phone numbers and addresses with either their consent, or that of their relatives or guardians.

When patients are discharged, community healthcare centers are supposed to get in touch, set up a health profile and pay regular visits to monitor their condition.

Additionally, individual care is offered in cities where there is abundant money and manpower left after this basic public service, said the official.

'It takes a team to provide individual care, consisting of police officers, civil affairs officials, community volunteers, family members and psychiatric physicians who administer medication,” he said.

'Patients and family eventually learn to better control their condition and become socially engaged again.”

However, two recent attacks show there is still room for improvement.

On Monday, a 50-year-old man allegedly stabbed four people in Xicheng district, leaving a woman dead and a 2-year-old boy seriously injured.

The suspect was hospitalized from September 2012 to January 2013 for mental illness, said the police.

The killing came shortly after another incident on July 17, when a 27-year-old man stabbed two people to death in Chaoyang district. The attacker told the police he had a mental disease.

'Tests need to be done to determine if the suspects were of clear mind when they committed the stabbing,” said a doctor who only disclosed his surname as Wang in a community healthcare center in Haidian district.

However, Wang admitted that a relapse of mental illness can be unpredictable and that some of her patients are reluctant to disclose their mental health condition.

'Some give fake addresses or addresses of relatives, thus we cannot find them after they get out of the hospital,” said Wang.

Zhang Na, a doctor in Huilongguan community healthcare center in Changping district, has encountered similar issues.

'We have made profiles for more than 300 people in our community, but about 50 of them or their family members are refusing our regular visits,” said Zhang. 'We can only ask the neighborhood committee about how they are doing generally.”

Both Wang and Zhang believed some patients’ reluctance comes from a stigma about mental illness. Patients, they said, don’t want others to know about their condition.

On the other hand, the lack of manpower further impedes efforts.

'The doctors in community healthcare centers are general physicians. They already have a lot of work on their hands,” said Guo Hongli, deputy head of the Beijing Mental Health Care Institute.

Yang Lei, a doctor with Peking University Sixth Hospital, a mental health hospital in Beijing, said he discovered that among the patients who returned to his hospital due to relapse, hardly any were visited by community health workers.

'These patients may have avoided such services, but on the other hand, sometimes community health workers do not have enough energy for the job,” he said. 'There are communities where a health worker has to track hundreds of mental health patients.”

However, only a small number of people with mental health issues are prone to violence and it’s not wise to call for more restrictions on them just because of a few violent incidents, Yang insisted.

'Mental health patients should not be held accountable for the lack of management and prevention efforts,” he said.

Cao Yin contributed to this story.