China: End Arbitrary Detention in Mental Health Institutions

Rights Concerns Remain as First Mental Health Law Comes Into Effect

(New York) - As China's first ever Mental Health Law came into force on May 1, 2013, Human Rights Watch said the law has major shortcomings including that it does not eliminate the country's system of involuntary confinement.

The involuntary confinement for people with mental disabilities is devoid of court oversight and falls far short of the requirements of the Convention on the Rights of Persons with Disabilities, which China adopted in 2008.

"After 27 years in the making, the enactment of this law fills an important legal void. It even states that psychiatric treatment and hospitalization should be based 'on a voluntary basis,''' said Sophie Richardson, China director. "But the new law does not close loopholes that allow government authorities and families to lock people up in psychiatric hospitals against their will, without recourse."

Human Rights Watch is concerned that the law will not protect against involuntary, arbitrary detention of people on the basis of disability. It is estimated that between 70 and 80 percent of all patients in psychiatric hospitals are involuntarily incarcerated. Close relatives, employers, and the police would be able to send "suspected mental disability sufferers" who have harmed, or who are at risk of harming, themselves or others to psychiatric hospitals for evaluation. And if they are found to have a "serious" mental disability, based solely on the opinion of psychiatrists, then they can be forcibly committed. The law does not provide any further details or definitions on what constitutes a risk, or how serious a risk must be to justify forcible measures. The law also fails to guarantee the right to a lawyer and to a clear judicial review process by which to appeal such arbitrary detention. It also restricts a person's right to communicate with those outside of the institutions during the "acute onset of illness" or "to avoid hampering treatment."

Human rights abuses in mental health institutions in China are extensively documented. Patients are frequently deprived of the right to make decisions regarding treatment and confinement; forced medications and violence are rife. In one widely-publicized case in 2008, an elderly woman involuntarily committed by her family was found beaten to death in a psychiatric hospital in Shandong Province.

The use of these institutions to incarcerate political dissidents, activists, and petitioners is also well documented, including in Human Rights Watch's 2002 report, Dangerous Minds. Without strong procedural safeguards, the law is unlikely to change the current situation that has been documented by Chinese human rights groups where police and local authorities pay and pressure psychiatric hospitals to detain alleged troublemakers.

In 2011, steel-plant worker Xu Wu gained national attention for escaping from a mental health institution in Wuhan. He had been incarcerated there for over four years on the orders of the police and his employer for complaining about his labor conditions to government authorities.

Under the new Mental Health Law, the police continue to be in charge of running some psychiatric institutions known as "Ankang hospitals" where abuses including beatings and electric shocks have been documented. Staff at "Ankang" ("peace and health"), including medical and nursing personnel, are typically full-time officers in the Public Security Bureau, and all inmates are persons who have been detained for criminal offenses committed while allegedly under the influence of severe mental disabilities. As of 2011, there were some 20 Ankang institutes operating in China.

As Mental Health Law goes into effect, these abuses continue. Chinese Human Rights Defenders reported on April 25, 2013, that worker Xing Shiku has been locked up in a psychiatric hospital in Heilongjiang Province for over six years for filing complaints to the government about corruption and problems related to the privatization of the state-owned company where he worked. The hospital refused to release him following his wife's request. Hospital authorities insisted that only the local officials paying his hospital fees - precisely the people who had committed him to the institution - could have him released. His wife has since been detained repeatedly in a black jail for petitioning about his case.

"The very first test of the Mental Health Law will be whether those held in psychiatric facilities for political reasons are immediately released," Richardson said. "The longer-term value of this law will be seen in whether it actually ends arbitrary detention of people with mental disabilities and ensures their access to mental health care on the basis of free and informed consent."