Political use and abuse of psychiatry in China
Political abuse of psychiatry is the misuse of psychiatry, including diagnosis, detention, and treatment, for the purposes of obstructing the human rights of individuals and/or groups in a society. In other words, abuse of psychiatry (including that for political purposes) is the deliberate action of having citizens psychiatrically diagnosed who need neither psychiatric restraint nor psychiatric treatment. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience. As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances. Nowadays, in many countries, political prisoners are sometimes confined and abused in psychiatric hospitals.
In 2002, Human Rights Watch published the book Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era written by Robin Munro and based on the documents obtained by him. The British researcher Robin Munro, a sinologist who was writing his dissertation in London after a long sojourn in China, had travelled to China several times to survey libraries in provincial towns and had gathered a large amount of literature which bore the stamp 'secret' but at the same time was openly available. This literature included even historical analyses going back to the days of the Cultural Revolution and concerned articles and reports on the number of people who were taken to mental hospitals because they complained of a series of issues. It was found, according to Munro, that the involuntary confinement of religious groups, political dissidents, and whistleblowers had a lengthy history in China. The abuse had begun in the 1950s and 1960s, and had grown extremely throughout the Cultural Revolution. During the period of the Cultural Revolution, from 1966 to 1976, it achieved its apogee, and then under the reign of Mao Zedong and the Gang of Four, which established a very repressive and harsh regime. No deviance or opposition in thought or in practice was tolerated.
The documents told of a massive abuse of psychiatry for political purposes during the leadership of Mao Zedong, during which millions of people had been declared mentally sick. In the 1980s, according to the official documents, there was political connotation to fifteen percent of all forensic psychiatric cases. In the early 1990s, the numbers had dropped to five percent, but with beginning of the campaign against Falun Gong, the percentage had again increased quite rapidly.
Chinese official psychiatric literature testifies distinctly that the Communist Party's notion of 'political dangerousness' was long since institutionally engrafted in the diagnostic armoury of China's psychiatry and included in the main concept of psychiatric dangerousness.
Despite international criticism, the People's Republic of China seems to be continuing its political abuse of psychiatry. Political abuse of psychiatry in the People's Republic of China is high on the agenda and has produced recurring disputes in the international psychiatric community. The abuses there appear to be even more widespread than in the Soviet Union in the 1970s and 1980s and involve the incarceration of 'petitioners', human rights workers, trade union activists, followers of the Falun Gong movement, and people complaining against injustices by local authorities.
It also seemed that, China had hardly known high security forensic institutions until 1989. However, since then, the Chinese authorities have constructed the entire network of special forensic mental hospitals called Ankang which in Chinese is for 'Peace and Health'. By that time, China had had 20 Ankang institutions with the staff employed by the Ministry of State Security. The psychiatrists who worked there were wearing uniforms under their white coats.
The political abuse of psychiatry in China seems to take place only in the institutions under the authority of the police and the Ministry of State Security but not in those belonging to other governmental sectors. Psychiatric care in China falls into four sectors that hardly connect up with each other. These are Ankang institutions of the Ministry of State Security; those belonging to the police; those that fall under the authority of the Ministry of Social Affairs; those belonging to the Ministry of Health. Both the sectors belonging to the police and the Ministry of State Security are the closed sectors, and, consequently, information hardly ever leaks out. In the hospitals belonging to the Ministry of Health, psychiatrists do not contact with the Ankang institutions and, actually, had no idea of what occurred there, and could, thereby, sincerely state that they were not informed of political abuse of psychiatry in China.
In China, the structure of forensic psychiatry was to a great extent identical to that in the USSR. On its own, it is not so strange, since psychiatrists of the Moscow Serbsky Institute visited Beijing in 1957 to help their Chinese 'brethren', the same psychiatrists who promoted the system of political abuse of psychiatry in their own USSR. As a consequence, diagnostics were not much different than in the Soviet Union. The only difference was that the Soviets preferred 'sluggish schizophrenia' as a diagnosis, and the Chinese generally cleaved to the diagnosis 'paranoia' or 'paranoid schizophrenia'. However, the results were the same: long hospitalization in a mental hospital, involuntary treatment with neuroleptics, torture, abuse, all aimed at breaking the victim's will.
In accordance with Chinese law that contains the concept of "political harm to society" as legally dangerous mentally ill behaviour, police take into mental hospitals "political maniacs", defined as persons who write reactionary letters, make anti-government speeches, or "express opinions on important domestic and international affairs". Psychiatrists are frequently caught involved in such cases, unable and unwilling to challenge the police, according to psychiatry professor at the Peking University Yu Xin. As Liu's database suggests, today's most frequent victims of psychiatric abuse are political dissidents, petitioners, and Falun Gong members. In the beginning of the 2000s, Human Rights Watch accused China of locking up Falun Gong members and dissidents in a number of Chinese mental hospitals managed by the Public Security Bureau. Access to the hospitals was requested by the World Psychiatric Association (WPA), but denied by China, and the controversy subsided.
The WPA attempted to confine the problem by presenting it as Falung Gong issue and, at the same time, make the impression that the members of the movement were likely not mentally sound, that it was a sect which likely brainwashed its members, etc. There was even a diagnosis of 'qigong syndrome' which was used reflecting on the exercises practiced by Falung Gong. It was the unfair game aiming to avoid the political abuse of psychiatry from dominating the WPA agenda.
In August 2002, the General Assembly was to take place during the next WPA World Congress in Yokohama. The issue of Chinese political abuse of psychiatry had been placed as one of the final items on the agenda of the General Assembly. When the issue was broached during the General Assembly, the exact nature of compromise came to light. In order to investigate the political abuse of psychiatry, the WPA would send an investigative mission to China. The visit was projected for the spring of 2003 in order to assure that one could present a report during the annual meeting of the British Royal College of Psychiatrists in June/July of that year and the Annual Meeting of the American Psychiatric Association in May of the same year. After the 2002 World Congress, the WPA Executive Committee's half-hearted attitude in Yokohama came to light: it was an omen of a longstanding policy of diversion and postponement. The 2003 investigative mission never took place, and when finally a visit to China did take place, this visit was more of scientific exchange. In the meantime, the political abuse of psychiatry persisted unabatedly; nevertheless the WPA did not seem to care.
Wahid Alam is a journalist