In China, some dissenters imprisoned in psychiatric hospitals

From The NY Times:

LOUHE, China — Xu Lindong (pictured), a poor village farmer with close-cropped hair and a fourth-grade education, knew nothing but decades of backbreaking labor. Even at age 50, the rope of muscles on his arms bespoke a lifetime of hard plowing and harvesting in the fields of his native Henan Province.

But after four years locked up in Zhumadian Psychiatric Hospital, he was barely recognizable to his siblings. Emaciated, barefoot, clad in tattered striped pajamas, Mr. Xu spoke haltingly. His face was etched with exhaustion.

“I was so heartbroken when I saw him I cannot describe it,” said his elder brother, Xu Linfu, recalling his first visit there, in 2007. “My brother was a strong as a bull. Now he looked like a hospital patient.”

Xu Lindong’s confinement in a locked mental ward was all the more notable, his brother says, for one extraordinary fact: he was not the least bit deranged. Angered by a dispute over land, he had merely filed a series of complaints against the local government. The government’s response was to draw up an order to commit him to a mental hospital — and then to forge his brother’s name on the signature line.

He was finally released in April, after six and a half years in Zhumadian and a second mental institution. In an interview, he said he had endured 54 electric-shock treatments, was repeatedly roped to his bed and was routinely injected with drugs powerful enough to make him swoon. Fearing he would be left permanently disabled, he said, he attempted suicide three times.

Mr. Xu’s ordeal exemplifies far broader problems in China’s psychiatric system: a gaping lack of legal protections against psychiatric abuses, shaky standards of medical ethics and poorly trained psychiatrists and hospital administrators who sometimes feel obliged to accept anyone — sane or not — who is escorted by a government official.

No one knows how often cases like Mr. Xu’s occur. But human rights activists say confinements in mental hospitals appear to be on the rise because the local authorities are under intense pressure to nip social unrest in the bud, but at the same time are less free than they once were to jail people they consider troublemakers.

“The police know that to arbitrarily detain someone is illegal. They have to worry about that now,” said Huang Xuetao, a lawyer in Shenzhen, in Guangdong Province, who specializes in mental health law. “But officials have discovered this big hole in the psychiatric system, and they are increasingly taking advantage of it.”

Worse, Ms. Huang said, the government squanders its meager health care resources confining harmless petitioners like Mr. Xu while neglecting people desperately in need of help.

She and a colleague recently analyzed 300 news reports involving people who had been hospitalized for mental illness and others who had not. “Those who needed to be treated were not and those who should not have been treated were treated and guarded,” their study concluded.

Liu Feiyue, the founder of Civil Rights and Livelihood Watch, a Chinese human-rights organization, said his group had compiled a database of more than 200 Chinese citizens who were wrongly committed to mental hospitals in the past decade after they filed grievances — called petitions in China — against the government.

He said he suspected that the real number was much higher because his organization’s list was compiled mostly from accounts on the Internet.

“The government has no place to put these people,” he said.

China no longer discloses how many petitioners seek redress, but the government estimated in 2004 that more than 10 million people write or visit the government with petitions each year. Only two in a thousand complaints are resolved, according to research cited in a study this year by Tsinghua University in Beijing.

In annual performance reviews of local government officials, reducing the number of petitioners is considered a measure of good governance. Allowing them to band together, and possibly stir up broader unrest, is an significant black mark that can lead to demotion.

The most dogged petitioners are often classified as crazy. In an interview last year, Sun Dongdong, chief of forensic psychiatry at prestigious Peking University, said, “I have no doubt that at least 99 percent of China’s pigheaded, persistent ‘professional petitioners’ are mentally ill.” He later apologized for what he said was an “inappropriate” remark.

Yan Jun, who heads the Ministry of Health’s mental health bureau, declined repeated requests for an interview on whether petitioners were wrongly confined and other issues with the mental health system.

Yu Xin, a director of Peking University’s Institute of Mental Health and an advocate of mental health reforms, said he did not believe that the confinement of petitioners was a widespread problem.

But he criticized the absence of safeguards, saying China badly needed a national mental health law, national guidelines for involuntary commitment and better ethics training for psychiatrists. Given the current legal vacuum, he said, “Mental health professionals must be very careful not to be used by local officials.”

A decade ago, Human Rights Watch accused China of locking up dissidents and members of the Falun Gong spiritual group in a cluster of Chinese mental hospitals run by the Public Security Bureau. The World Psychiatric Association requested access to the hospitals, but China refused, and the controversy died down.

In a recent interview, Levent Kuey, the association’s secretary general, said that the organization had not taken further action because it had concluded that it was better to help China to improve its mental health system than to ostracize it.

Mr. Liu’s database suggests that petitioners are today’s most frequent victims of psychiatric abuse, outnumbering political dissidents and Falun Gong members combined.

Wu Yuzhu, a hospital administrator in the eastern province of Shandong, said in 2008 that local officials had delivered many obviously sane petitioners to him for confinement.

He admitted them, he said, because public security officers accompanied them and because his own staff felt powerless to challenge the diagnoses of government-hired psychiatrists. He added that his hospital, the Xintai Mental Health Center, was cash-strapped and welcomed government-subsidized patients.

Indeed, hospital officials sometimes cite petitioning as the sole reason for a patient’s confinement. Commitment papers for one 44-year-old man, hospitalized for two months in 2008 in Hubei Province, stated simply: “The patient was hospitalized because of years of petitioning.”

According to legal experts, relatives, legal guardians or local public security bureaus, which among other duties are charged with tamping down dissent, can involuntarily commit a psychiatric patient. But Ms. Huang, the mental health lawyer, described existing regulations and procedures as “a mess.”

Only 6 of China’s 283 cities have a local mental health ordinance. “There is no way for patients who are committed for treatment to complain, appeal or prosecute,” Ms. Huang’s report states. The report says that hospitals tend to grant releases only with the agreement of whoever committed the patient, although they also release patients who need continued treatment but whose bills go unpaid.

Chen Miaocheng discovered the system’s blind alleys in 1995, when his employer, with his brother’s permission, forcibly committed him to Huilongguan Hospital in Beijing.

According to medical records, doctors there diagnosed Mr. Chen as paranoid schizophrenic. After six months of treatment and medication, they decided that he no longer suffered from hallucinations and was able to care for himself, the records show.

But he was never released. After 13 years, Mr. Chen, who had repeatedly pleaded to be let out, died in the hospital of pneumonia.

This past June, a Beijing district court ruled that the company, China Petroleum and Chemical Corporation, did not violate Mr. Chen’s rights by hospitalizing him and that his death was not related to his confinement. Li Renbing, who represented Mr. Chen’s family, says that the court never addressed the issue of why Mr. Chen was not released.

“There should never be a situation where once you are sent to a mental hospital, you are left to rot there forever,” he said.

Mr. Li says Mr. Chen’s is an extreme case of wrongful confinement. But petitioners who end up in mental hospitals often find themselves similarly powerless.

Consider 36-year-old Jin Hanyan, who decided in 2008 after six years of failed petitions to complain directly to Beijing officials that she had been unfairly denied a government job.

On her arrival last September, she said, she and her younger sister were handcuffed, stripped of their cellphones and documents, and driven to their hometown in Hubei Province by men who described themselves as public security officers.

Four days later, Ms. Jin’s sister was committed to the city’s psychiatric hospital. Ms. Jin was confined to the psychiatric ward of the Shiyan City Red Cross Hospital — an institution with no affiliation to the International Red Cross — nine miles away.

Xue Huanying, a nurse, was not happy to see her. In a conversation secretly taped by Ms. Jin’s father, the nurse said that the government was forced to confine Ms. Jin at a cost of 5,000 renminbi, or about $735 a month, merely to stop her useless petitions.

She said petitioners were repeatedly hospitalized for that reason. “Lots of people like this! Lots!” she shouted.

“I’ve seen so many petitioners. I have never seen one who has been caught for no reason,” she continued. “I mean, you are just an average person. Just how far do you think you’re going to get by going up against the government? Right, exactly what can you do as an average citizen, a farmer working the land? Can you afford to anger those above you?”

Ms. Jin said she was forced to swallow three pills a day, given injections that made her so dizzy she could barely walk, tied to her bed and beaten.

When she complained, she said, the head of the psychiatric ward told her: “We will treat you the way officials tell us to.”

She was released seven months later after relatives hired a lawyer. “What they are trying to do is completely destroy your mind and weaken your body to the point where you go crazy,” she said. “That’s when you will stop petitioning, they hope.”

The hospital declined to comment on her case.

The travails of Xu Lindong, imprisoned for six and a half years in two mental hospitals, began when he tried to help his illiterate neighbor, Zhang Guizhi, pursue a claim for a four-foot-wide strip of land next to her home. The two lived a stone’s throw apart in a village of about 2,000 people, surrounded by cornfields. Mrs. Zhang, who is handicapped from polio, claimed that officials had wrongly given her property to a rich neighbor.

After losing her claim in court, Mrs. Zhang and Mr. Xu began hauling a cardboard box full of documents from petition office to petition office, hoping to find a sympathetic ear higher up the bureaucratic ladder. In September 2003, Mr. Xu said, he was picked up by public security officers in Beijing. Instead of hauling him home as usual, he was driven to Zhumadian Psychiatric Hospital. He said a doctor asked him exactly two questions before admitting him: his name and address.

Mr. Xu said he spent most of the time locked in his room, lying on a thin green mattress on a iron bed. He was allowed outside only two or three times a year, he said. Hospital staff sometimes covered his head in blankets so he could not breathe, he said, and invited other patients to beat him up.

During one electric-shock treatment, he said, he bit his tongue so badly that for weeks afterward he could eat only by putting bits of food on the tip of a finger and pushing them down his throat.

Mr. Xu’s brother said in an interview that it took him four years to discover his brother’s whereabouts. He tried to hire a lawyer, he said, but lawyers shunned the case for fear of drawing the local government’s wrath.

Finally, news of the case reached journalists at a local newspaper and China Youth Daily, a national publication, which published articles about his case. Two days later, Mr. Xu was released. Four local officials were fired, including the man who served as the county Communist Party secretary when Mr. Xu was committed.

Mr. Xu is now ensconced back in his simple concrete and brick house, furnished with a broken-down wooden dresser and bed. “I hope by exposing this, society will progress,” he said, sitting on a low stool, feet clad in blue plastic sandals.

Some villagers are upset that he is talking about his experience. Spotting him on a dirt road recently, one neighbor turned her back in a grand gesture, fanning herself furiously and shouting curses over her shoulder.

“Fine, fine, you are right,” he replied, unruffled.

Local officials, on the other hand, are showering him with visits and gifts: a case of canned soft drinks, new metal-rimmed eyeglasses, an electricity hook-up to his house and about $300 in compensation for his seven years of confinement and torture.

“If the hospital’s doctors had not diagnosed him as mentally ill, this whole situation would not have happened,” said Zhang Weili, the district government’s vice director of propaganda. “I don’t want you to think this is a government that intentionally harms its citizens.”

After Mr. Xu’s case came to light, he said, officials swept the county’s records for similar instances and found none. Somehow, however, they missed Mrs. Zhang, the handicapped 65-year-old neighbor whose land dispute landed him in confinement to begin with.

Mrs. Zhang said she was forced into a different mental hospital and released a year later only after her daughter hired a lawyer. She not only never won back her small strip of land, she said, but was forced to abandon her village home for a squalid tenement to avoid harassment by her neighbors.

“I have always known that I would never win against the government,” she said. “But I am just so angry I can’t get over it. If this is the last thing I do, I will keep fighting them.”

Mr. Xu’s brother initially opposed his brother’s efforts to help Mrs. Zhang, arguing it was not his family’s business. Now he is also infuriated. “I just cannot swallow this injustice,” he said. “The government wants to protect its power. It is not here to protect its citizens.”

Still, he said, “Eventually the truth comes out.”