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

When Zhang Junjie was 17 years old, he decided to protest outside his university about rules set by the Chinese government. Within days he was admitted to a psychiatric hospital and treated for schizophrenia.

Junjie is one of dozens of people identified by the BBC who were hospitalized after protesting or filing complaints with authorities.

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

There have been reports for decades that hospitalization is being used in China as a way to detain dissident citizens outside of courts. But the BBC has discovered that the problem the law was intended to solve has recently come back to life.

Junjie said he was restrained and beaten by hospital staff before being forced to take drugs.

His ordeal began in 2022 when he protested against China’s strict lockdown policies. Professors found him just five minutes later, contacted his father, and he was taken back to his parents’ home. He said his father called the police and the next day, on his 18th birthday, two men drove him to what they said was a coronavirus testing center, but was actually a hospital. It is said that it was.

“The doctors said that I had a very serious mental illness… and they tied me to the bed. The nurses and doctors said that given my views on the party and the government, I kept saying I must be mentally ill,’ he told the BBC World Service. He stayed there for 12 days.

Junjie believes he felt he had to hand him over to the authorities because his father worked for the local government.

Just over a month after being discharged from the hospital, Junji was arrested again. In defiance of the Lunar New Year fireworks ban – a measure introduced to combat air pollution – he made a video of himself setting off fireworks. Someone uploaded it online and the police were able to link it to Junjie.

He was accused of “picking fights and causing trouble,” an accusation often used to silence criticism of the Chinese government. Junjie was forced to be hospitalized again for more than two months.

After being discharged from the hospital, Junjie was prescribed antipsychotic medication. We saw the prescription. It was about aripiprazole, which is used to treat schizophrenia and bipolar disorder.

“When I took that drug, I felt like my brain was going pretty crazy,” he said, adding that police sometimes came to his home to check if he had taken the drug.

Fearing being hospitalized for a third time, Junjie decided to leave China. He told his parents he was going back to university to clean up his room, but in reality he fled to New Zealand.

He did not say goodbye to his family and friends.

Junji is one of 59 people confirmed by the BBC to have been admitted to hospital for mental health reasons after protesting or challenging authorities.

The problem is acknowledged by the Chinese government, whose 2013 Mental Health Act aims to stop this abuse, making it illegal to treat people without mental health problems. It also clearly states that psychiatric admission must be voluntary, unless the patient poses a danger to themselves or others.

Indeed, the number of people being held against their will in psychiatric hospitals has increased sharply in recent days, a leading Chinese lawyer told the BBC World Service. Huang Xuetao, who helped draft the bill, blames a weakened civil society and a lack of checks and balances.

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

An activist named Jie Lijian said in 2018 that he had been treated for mental illness without his consent.

Lisian said he was arrested for taking part in a protest demanding better wages at the factory. He said police interrogated him for three days before taking him to a psychiatric hospital.

Like Junjie, Lijiang was prescribed antipsychotic medication, which he said impaired his critical thinking.

After a week in the hospital, he says he refused further medication. After getting into an argument with a staff member who told her she was causing trouble, Lisian was given ECT (a treatment that involves sending electrical current through the patient’s brain).

“I had pain from head to toe. My whole body felt like it didn’t belong to me. It really hurt. The electric shocks went in and then went away. The electric shocks went in and then went away. I passed out several times. It felt like I was dying,” he says.

He was discharged from the hospital 52 days later. He currently works part-time in Los Angeles and is seeking asylum in the United States.

In 2019, the year after Lijiang announced her hospitalization, the Chinese Medical Association updated its ECT guidelines to state that CT should only be administered with consent and under general anesthesia.

We wanted to know more about doctors’ involvement in such cases.

Speaking to foreign media such as the BBC without permission could get you into trouble, so they had no choice but to go undercover.

We scheduled a telephone consultation with doctors at four hospitals that evidence suggests are involved in forced admissions.

We asked five doctors if they had ever come across a case where a patient was referred to the police after posting anti-government comments online and using a fabricated story about a hospitalized relative.

Four people confirmed that this was the case.

“There is a type of admission in psychiatry called a ‘troublemaker,'” one doctor told us.

Another doctor at the hospital where Junjie was being held appears to corroborate his story that police continued to monitor the patient even after he was discharged.

“Police will search your home to check if you have taken your medication. If you do not, you may break the law again,” they said.

The hospital in question did not respond to a request for comment.

We were granted access to the medical records of pro-democracy activist Song Zaimin, who was hospitalized for the fifth time last year, revealing how closely political views appear to be tied to psychiatric diagnoses. has become clear.

“Today, he…talked a lot, made incoherent statements, and criticized the Communist Party.Therefore, he was sent to our hospital for inpatient treatment by the police, doctors, and local resident committee. “It was an involuntary hospitalization,” it says.

We asked Professor Thomas G. Schulz, President-elect of the World Psychiatric Association, to review these notes. He replied:

“What is being said here reeks of political abuse. No one should be involuntarily hospitalized and treated against their will.”

More than 200 people were reported to have been wrongfully hospitalized by authorities between 2013 and 2017, according to a group of Chinese citizen journalists who have documented abuses of the mental health law.

Their reporting ended in 2017 when the group’s founder was arrested and subsequently imprisoned.

For victims seeking justice, the legal system appears stacked against them.

This man, whom we will call Mr. Lee, was hospitalized in 2023 after protesting against local police, but he also tried to take legal action against the authorities for being imprisoned.

Unlike Junjie, doctors told Li that he had no illness, but when police later arranged for an outside psychiatrist to evaluate him, he was diagnosed with bipolar disorder, and Li was diagnosed with bipolar disorder. He was detained for 45 days.

Upon his release, he decided to contest the diagnosis.

“For me not to sue the police is like accepting that I am mentally ill. This is a threat to my future and my freedom because the police can always use it as a reason to lock me up. “It will have a huge impact,” he says.

In China, records of people diagnosed with severe mental disorders can be shared with police and even local residents’ committees.

However, Mr. Lee did not prevail and the court dismissed his appeal.

“I hear our leaders talking about the rule of law,” he told us. “We never dreamed that we would one day be locked up in a mental hospital.”

The BBC reports that between 2013 and 2024, 112 people tried to take legal action against police, local authorities and hospitals for such treatment, published on the official website about Chinese court decisions. I discovered that it was done.

Approximately 40% of these complainants involved complaints against authorities. Only two people won their cases.

And the site appears to have been censored, with five other cases we investigated missing from the database.

The problem, said Nicola McBean of London-based human rights group The Rights Practice, is that police have “considerable discretion” when dealing with “troublemakers”.

“It’s too easy and too convenient for local authorities to circumvent the process and send someone to a mental hospital.”

Attention is currently focused on the fate of video blogger Li Yixue, who accused a police officer of sexual assault. Yixue is said to have recently been hospitalized for a second time after a social media post talking about the experience went viral. She is reportedly currently under surveillance at a hotel.

We submitted our findings to the Chinese Embassy in the UK. Last year, the Chinese Communist Party said it had “reaffirmed” the need to “improve the mechanisms” surrounding the law, adding that the law does not include “illegal detention or other forms of illegal deprivation or restriction of citizens’ personal freedom.” “This method is explicitly prohibited.”

Additional reporting by Georgina Lam and Betty Knight