Chinese Mental Healthcare Reform: Employees Forced To Hit Target Numbers Of Mentally Ill Residents

China has seen a disturbing rise in the amount of violent crimes by mentally disturbed people recently, shedding light on the nation’s mental healthcare shortcomings. But the provincial capital city of Zhengzhou, located in the central province of Henan, seems to have the opposite problem: it doesn't have enough mentally disturbed people.

According to a report by the Southern Metropolis Daily, a state-run newspaper known for publishing more outspoken editorials and reports than the average, someone with the Department of Health in Zhengzhou leaked a document showing that districts were required to report at least two cases of severe mental illness for every 1,000 residents. The report went on to say that officials sent warnings to sub-district administrators that they were short of the target.

However, health workers are saying that the target is unattainable. “The requirement is too high,” Huang Linlin, a mental health employee in the Linke district, said in publication. “We have registered 12 patients at the moment.” But that number is way off their quota: “According to the requirements, our target is 71.”

The Linke sub-district is located in the province’s Jinshui district. According to the South China Morning Post, this means that mental health workers will need to diagnose at least 2,023 people as mentally ill among the area’s one million residents, in order to meet the province’s requirements.

Does this mean mental health care has drastically improved over a few short years? Probably not. Instead it reflects China’s serious push to crack down on undiagnosed or misdiagnosed cases of mental health issues. Following a spate of often fatal stabbings, committed by mostly undiagnosed mentally ill people in the past few years. The order follows an initiative announced last July by the national Ministry of Health. The goal of reporting is to identify and register everyone who has been diagnosed with a severe mental illness, and keep an accurate, updated account of cases in each province, city and county. According to the South China Morning Post, if reports do not reach the target numbers, administrators could face penalties.

The directive plans to raise the quota again by 2015; that would result in 0.5 percent of China’s population being defined as mentally ill. While that seems high, research by the Ministry of Health estimates that in 2011 almost eight percent of China was living with some type of mental illness, varying in severity. But the definition of mental illness it uses is extremely loose: included in that eight percent of mentally-ill Chinese there is a range of mood or anxiety disorders, like depression, as well as more severe conditions, like delusional disorder or schizophrenia.

Chinese health authorities introduced the country’s first mental health law this past May. It requires all full-service hospitals in the country to set up psychiatric departments and offer mental health services. The law also superseded a previous norm which allowed the involuntary treatment of patients.