Nationwide registration system will keep track of patients better

More than 3 million Chinese patients with serious mental disorders have been registered under a nationwide network of hospitals and heath administrations so that they can get better care, according to a senior official at the National Health and Family Planning Commission.

The network, launched two years ago, is still being developed to cover as many mentally ill people on the mainland as possible, said Yan Jun, director of the mental health division at the commission's Disease Prevention and Control Department.

"Such a system can help mental health providers better keep track of the patients and take care of them, which serves not only public health, but also social stability and public safety," she told China Daily in an exclusive interview.

In 2009, more than 100 million Chinese had some form of mental disorder, and 16 million of them were severely mentally ill, according to the Chinese Center for Disease Control and Prevention.

To speed the registration of such patients, the commission issued a circular requiring that people with any of six types of serious mental illness were to be recorded in the national database.

The six categories include schizophrenia, schizoaffective disorder, persistent delusional disorder and paranoid schizophrenia.

Doctors were required after making the diagnosis to report to the hospital any patients with the serious mental illnesses.

The hospital would then record the patient in the national system or submit a report to a county-level mental illness prevention and treatment agency no later than 10 days after the patient was discharged from the hospital.

Collecting such information helps improve cooperation between hospitals, civil affairs departments, disabled persons' federations and public security bureaus, to reduce any harm to others and society, Yan said.

The network records such information as personal background; medical treatment and follow-up services; said Ma Hong, deputy director of the Center for Disease Control and Prevention's National Center of Mental Health.

Ma helped design the network and the training of doctors at the grassroots level who use it.

Zhang Mingyuan, vice-chairman of the China Disabled Persons' Federation and a veteran psychiatrist trained in the US, urged health authorities to fine-tune the network and improve mental health services on the mainland.

Before 2010, only about 10 percent of seriously mentally ill people received psychiatric treatment, he said.

In cities, about half of the patients who needed hospitalization could not afford it, and the situation was even worse in the countryside, he said.

In a recent, widely reported case, a mentally ill man in Shangban, a village in Jiangxi province, was found to have been "kept in a locked cage" by his family for about 11 years.

The plight of such patients has to be addressed, Zhang said, adding that taking proper care of them is also important to public safety.

"Without good care, such patients might physically attack other people," he said.

According to media reports, China has on average 10,000 cases a year of mentally ill people threatening public safety. In about a third of those cases, people are killed.

The cost of treatment in an inpatient unit can be partially covered by health insurance policies. However, there is little coverage for outpatient care or the long-term rehabilitation at communities, Yan Jun said.

But some places have done a good job addressing the coverage gaps.

Shanghai has introduced a policy to provide free outpatient care to needy patients.

Last year, Jiangxi province began to subsidize community rehabilitation of the seriously mentally ill, she said.

Community mental health clinics in Jiangxi now receive 100 yuan ($16.30) a year in state subsidy for each patient they take care of.

shanjuan@chinadaily.com.cn