Monday, August 26, 2002

Abuse of psychiatry

YOKOHAMA, Japan --The World Psychiatric Association is scheduled to make a major decision this Monday. Gathered in Yokohama for their triennial congress, the national member societies will consider the widespread misuse of psychiatry in China for political repression.

The members should vote for a full investigative mission capable of establishing the true facts in the cases of individual victims. In doing so they would send a message of hope to many Chinese citizens who now find themselves confined indefinitely for the 'crime' of peaceful expression of their political or religious beliefs.

For 50 years, Chinese authorities have resorted to false psychiatric diagnosis to stigmatize all kinds of people: political dissidents, religious nonconformists, independent trade unionists, local whistle-blowers, rural dwellers who dare to complain about official corruption and malfeasance, and those seeking legal redress for their past experiences of political persecution at the hands of the government. They are labeled as 'dangerously mentally ill criminals' who need to be locked away in secure mental hospitals 'for the protection of society.' Since the start of the government's [persecution] in July 1999, more than 300 detained members of Falun Gong, the officially banned spiritual group, have reportedly received the same treatment. A new report from Human Rights Watch and the international mental health foundation Geneva Initiative on Psychiatry presents a wealth of evidence, drawn from China's own psychiatric archives, to chart the previously unknown history of political psychiatric abuse stretching back to the earliest years of the People's Republic. In 1971, among all the criminal offenders diagnosed and committed as
'dangerously mentally ill' at the foremost mental health center in Shanghai, no fewer than 73 percent were labeled 'political cases.' Similarly astonishing figures for the period recur in the psychiatric archives of other major cities.

By the 1980s, political dissidents committed to police-run mental asylums in China were 10 to 15 percent of the total criminal psychiatric caseload. Only in the early 1990s, when the officially recorded figure stood at a few percentage points, did the overall scale of politically abusive psychiatry in China fall to roughly the same level found in the Soviet Union at the height of psychiatric abuse there. But incidents of similar abuse in China once again appear to be on the rise.

Most psychiatrists prefer international congresses to be agreeable academic and social occasions. But at Yokohama, China will be a specter at the feast. The situation is eerily reminiscent of the former Soviet Union. There will be no shortage of psychiatrists in attendance who will recall that the response of the World Psychiatric Association in the 1970s to the evidence of politically abusive psychiatry in the Soviet Union was distinctly less than robust.

By 1983, however, pressure from concerned national bodies such as Britain's Royal College of Psychiatrists and the American Psychiatric Association became so great that the Soviet member society, facing almost certain expulsion, voluntarily withdrew from the association. It was readmitted in 1989 after the Gorbachev reforms led to the release of most psychiatrically
detained critics of the regime. Since then, both the World Psychiatric Association and the United Nations have passed clear ethical codes, notably the Madrid declaration of 1996, prohibiting any diagnosis of mental illness on the basis of political or religious belief. The crucial question now is whether the WPA, having trodden the path before, will choose to act decisively in the case of China. Recognizing that most Chinese psychiatrists today are not directly involved or complicit in these abuses and that the problem lies mainly within the shadowy domain of police-related or forensic psychiatry, the British delegation to Yokohama is tabling a resolution calling on the WPA leadership to send an investigative mission to China. The aim would be to conduct independent medical evaluations of a representative number of alleged mentally ill dissident and religious inmates in China's secure mental hospitals.

The proposal falls far short of the stern measures eventually adopted by the WPA in the Soviet case. The association's national member societies will have the opportunity to vote this Monday on the China resolution proposed by the British delegation. By supporting it unequivocally they would safeguard the reputation of the psychiatric profession worldwide. Robin Jacoby is
professor of psychiatry at Oxford University and chair of the Geneva Initiative on Psychiatry. Robin Munro, a London-based human rights researcher, is the principal author of 'Dangerous Minds: Political Psychiatry in China Today and Its Origins in the Mao Era,' a report recently published by Human Rights Watch and the Geneva Initiative on Psychiatry. They contributed this comment to the International Herald Tribune.


http://www.iht.com/articles/68717.html

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