Supporting compulsory admitted psychiatric patients in China

In their Letter (The Lancet, October 2, p. 1145) entitled “Compulsory admission to psychiatric hospitals in China”, Xiang, Yu and Chiu comment on the case of a 59-year-old farmer from Henan province who was helping a disabled neighbour with a land dispute and as a result of this was sent to a psychiatric institution for more than 6 years after local government officials forged documents (Editorial, July 3,
p. 2)ii.
The authors argue that in order to avoid similar cases, the national mental health legislation (which is still pending) should be finalized and implemented as soon as possible. They also call for continual monitoring by the media and improved ethical training for mental health professionals. I fully endorse these suggestions and might add the following from experiences in the Netherlands.
Since 1982 in Dutch mental hospitals so-called patient advocates (“patiëntenvertrouwenspersoon”)give advice and support to psychiatric inpatients who have complaints about their commitment, the treatment (or lack of it), or the care they receive in the mental hospital. These patient advocates are employed by an independent organization which is subsidized by the government, and they work as
guests within the walls of the mental institution. They have the legal authority to communicate with all institutionalized patients and may not be hindered to visit any part of the institutional building(s), even seclusion rooms.
Periodical evaluations of their work shows that patients are satisfied about the support they received, even if this did not lead to a solution for their complaint. At the start in 1982, the boards and professionals of the mental hospitals needed time to get familiar with this new public professional. In the meantime, the patient advocate has become for many patients a trusted figure who takes care of their legal rights.
I don’t think that examples of psychiatric human rights abuses can thus be absolutely prevented, but the risk of abuse will decrease if patients are well-informed about and have access to such independent professionals. In addition to having their rights formulated in mental health law, patients must have the opportunity to execute these rights effectively.