Neither solitary nor social: surviving Chinese psychiatry

This is a first-person account of my study visit to a Chinese mental hospital. What I write is based on an interview with the Chinese medical director as well as on what I witnessed in one of the inpatient wards. My observations are Informed by my own experience with psychotic illness and hospitalizations in America. I characterize the Chinese inpatients as neither solitary nor social. There is a mass of patients sitting stagnant in close physical proximity all day long, but there isn’t any social interaction amongst the patients or any psychosocial group activity in place. The prevalence of second-generation antipsychotics paralleling Western countries lies in startling juxtaposition with the absence of any other form of rehabilitation or socialization. I argue it is ultimately misleading to understand the lack of therapy in terms of overcrowding. Instead staff neglect and the lack of care other than mere custodial containment stems from the professional perception of chronically psychotic individuals as uninvolved with this world. This “carefree schizophrenic” paradigm from a third-person only perspective eclipses the human, personal and interpersonal dimensions. First-person inputs from the patients themselves are critically needed for better re-conceptualizing and re-envisioning care for the psychotically ill.