China sees resurgence in psychiatric care for ‘trouble-makers’

At the age of 17, Zhang Junjie decided to protest outside his university against the laws made by the Chinese government. Within days he was admitted to a mental hospital and treated for schizophrenia.

Junjie is one of many people identified by the BBC who have been hospitalized after protesting or complaining to the authorities.

Many of the people we spoke to were given antipsychotic drugs, and in some cases electroconvulsive therapy (ECT), without their consent.

Over the years there have been reports that hospitalization was used in China as a way to detain unruly citizens without involving the courts. However, the BBC has discovered that the issue that the law seeks to resolve has recently returned.

Junjie says she was restrained and beaten by hospital staff before being forced to take medication.

His troubles began in 2022, when he protested against China’s restrictive policies. He says his teacher saw him five minutes later and contacted his father, who took him home. She says her father called the police, and the next day – on her 18th birthday – two men took her to what they said was a Covid test center, but was actually a hospital.

“The doctors told me that I have a serious mental illness … Then they tied me to the bed. Nurses and doctors told me again and again, because of my views on the party and the government, then I must be mentally ill. It was scary. , “he told the BBC World Service. He stayed there for 12 days.

Junjie believes that his father was forced to hand him over to the authorities because he worked for the government.

A month after he was released from prison, Junjie was arrested again. In opposition to the ban on fireworks during Chinese New Year (a measure brought in to combat air pollution) he made a video of himself. Someone posted it online and the police were able to link it to Junjie.

He was accused of “picking up disputes and interfering” – a charge often used to prevent criticism of the Chinese government. Junjie is said to have been forcibly hospitalized for more than two months.

After being released, Junjie was given anti-psychotic medication. We saw a drug – it was Aripiprazole, which is used to treat schizophrenia and bipolar disorder.

“Drinking the drug made me feel like my brain was messed up,” he says, adding that the police come to his house to check if he has been drinking.

Afraid of being put to sleep a third time, Junjie decided to leave China. He told his parents he was going back to university to pack his room – but, in fact, he fled to New Zealand.

He didn’t say goodbye to family or friends.

Junjie is one of 59 people the BBC has confirmed – either by talking to them or their relatives, or by going through court documents – who have been hospitalized for mental illness after protesting or challenging the authorities.

This article was approved by the Chinese government – the country’s 2013 Mental Health Law sought to prevent this abuse, and to prohibit the treatment of someone who is mentally ill. It also clearly states that the admission of insanity should be voluntary unless the patient is a danger to himself or others.

In fact, the number of people detained in mental institutions has recently increased, China’s attorney general told the BBC World Service. Huang Xuetao, who helped draft the law, criticizes the weakness of civil society and the lack of checks and balances.

“I have come across many cases like this, the police want power while avoiding responsibility,” he says. “Anyone who knows the weaknesses of this system can abuse it.”

An activist named Jie Lijian told us that she received psychiatric treatment without her consent in 2018.

Lijian says he was arrested for protesting for better wages at the factory. He says the police interrogated him for three days before taking him to a mental hospital.

Like Junjie, Lijian is said to have been prescribed anti-psychotic drugs that interfered with his critical thinking.

After being in the hospital for a week, he reportedly refused any more medication. After fighting with the staff, and being told he was causing problems, Lijian was referred for ECT – a treatment that involves passing electrical currents through the patient’s brain.

“The pain was from head to toe. My whole body felt like it wasn’t mine. It was excruciating. Electric shocks. Blackouts. Blackouts. Then I passed out. I passed out several times. I just felt like I was passing out. I was dying,” she says.

He was reportedly released after 52 days. He now has a part-time job in Los Angeles and is seeking asylum in the US.

In 2019, a year after Lijian said he was hospitalized, the Chinese Medical Doctor Association changed its guidelines for ECT, saying it should only be given with permission, and under anesthesia.

We wanted to know more about how doctors deal with such situations.

Talking to foreign journalists like the BBC without permission could get them into trouble, so our only option was to go undercover.

We booked phone calls with doctors who work at four hospitals that, according to our evidence, are involved in compulsory hospitals.

We used the fictional case of a family member who was hospitalized for posting anti-government comments online, and we asked five doctors if they had ever experienced cases of patients being referred by the police.

Four confirmed that they had.

“The department of psychiatry has a kind of admission called ‘troublemakers’,” one doctor told us.

Another doctor, from the hospital where Junjie was admitted, seems to corroborate his story that the police continued to monitor the patients after they were discharged.

“When the police search you at home to make sure you have taken your medicine, if you haven’t, you may still be breaking the law,” he said.

We reached out to the hospital in question for a response but it did not respond.

We have been given access to the medical records of pro-democracy activist Song Zaimin, who was hospitalized for the fifth time last year, which clearly shows that political views seem to be closely related to mental illness.

“Today, he was…talking a lot, talking inconsistently, and criticizing the Communist Party. Therefore, he was sent to our hospital for treatment by the police, doctors, and the community committee. This was an accidental hospitalization,” he said. it does.

We asked Professor Thomas G Schulze, president-elect of the World Psychiatric Association, to review the articles. He replied:

“For what has been described here, no one should be accepted and treated against their will. This has led to political violence.”

Between 2013 and 2017, more than 200 people reported being wrongly hospitalized by authorities, according to a group of Chinese-based journalists who documented violations of the Mental Health Law.

Their reports ended in 2017, because the founder of the group was arrested and imprisoned.

For victims who want justice, the legal system seems to be against them.

A man we will call Mr. Li, who was hospitalized in 2023 after protesting against the local police, tried to take action against the authorities because of his arrest.

Unlike Junjie, the doctors told Mr. Li that he was not sick but the police arranged for an outside psychiatrist to evaluate him, who diagnosed him with bipolar disorder, and he was detained for 45 days.

After being discharged, he decided to fight the disease.

“If I don’t file a case with the police, it’s like I’m admitting to being mentally ill, this will have a big impact on my future and my freedom because the police can use it as a reason to lock me up at any time,” he says.

In China, records of anyone diagnosed with serious mental illness can be shared with the police, as well as community committees.

But Mr Li was unsuccessful – the courts rejected his appeal.

“We hear our leaders talk about the rule of law,” he said. “We never dreamed one day that we would end up in a mental institution.”

The BBC has found 112 people listed on an official website to provide judgments of Chinese courts who, between 2013 and 2024, tried to convict the police, local governments or hospitals of receiving such treatment.

About 40% of the complainants had complaints about the authorities. Only two won their cases.

And the site appears to have been searched – the other five cases we searched were missing from the database.

The issue is that the police enjoy “discretion” in dealing with “troublemakers,” according to Nicola MacBean of The Rights Practice, a London-based human rights organisation.

“Sending someone to a mental hospital, across the board, is much easier and more efficient for the authorities.”

All eyes are now on the fate of vlogger Li Yixue, who accused a police officer of rape. Yixue says she was recently hospitalized again after her social media post about the incident went viral. He says he is now looking after her at the hotel.

We submit the findings of our investigation to the UK embassy in China. It said last year the Chinese Communist Party had “reaffirmed” that it needed to “develop mechanisms” around the law, which it said “strictly prohibits illegal detention and other methods of illegally depriving or restricting the rights of citizens”.

Additional reporting by Georgina Lam and Betty Knight