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Toil and Turmoil

Problems faced by mental health workers in China

11·26·2015

Toil and Turmoil

Problems faced by mental health workers in China

11·26·2015

Social stigma, difficulty finding a husband, the risk of being beaten, and a paltry salary; these are the ingredients that make up life for nurses on the front lines dealing with the mentally ill.

China may have rapidly developed over the last few decades, but often it seems like some areas have scarcely progressed at all. Headlines occasionally tell horror stories of the mentally ill in the countryside. At best they tend to have caring but uneducated family members looking after them, at worst they can be abused, chained, or locked up for years, or sometimes enslaved to work in brick kilns.

Sadly, these harrowing tales do not translate into widespread public respect for mental health care workers. A 2014 report in the Nanfang Metropolis Daily profiled Wang Juming, a mental health worker from the People’s Fourth Hospital. She told the newspaper that “the first thing we should learn is how to protect ourselves”. She carries a scar on her arm from an attack in which a male nurse was stabbed in the face with a fork.

Having been a nurse for over 20 years, she is one of the most highly-paid nurses in her ward. Her reward? A salary of just over 3,000 RMB per month.

The risk of violence is so pervasive that the Peking University Sixth Hospital has recently been trying to increase their proportion of male nurses, currently standing at about 30 out of 300. Not for gender-diversity reasons mind you, simply because, as Dong Tianwen, deputy director of the hospital puts it, “They have more strength to stop a patient killing himself/herself or halt physical confrontations between patients.”

In September the Guizhou Metropolis Daily ran a series of reports on various careers in the Anshun area. When profiling psychiatric nurse Wang Wanlu, it chose “fear” as the keyword for her working life. “Lighters, glasses, rope, and other items all become dangerous items. To these patients, anything can be a weapon,” the report said, citing Wang as saying that the nurses have often become desensitized to the suffering of the patients because if they care too much, they are sure to suffer themselves. “If we know he’s ill and we still care, isn’t it like giving yourself a hard time?”

It’s not just the risk of physical violence that troubles workers in the mental health care sector. The stress is often pervasive and ongoing, making the profession unattractive to new recruits, creating a vicious cycle where staff tend to be overworked and unappreciated.

According to a report by the World Psychiatric Association (WPA) in 2011, which outlined many of the problems with China’s mental health system, most of China’s mental health professionals are psychiatrists or psychiatric nurses, with few clinical psychologists and social workers. Licensing is carried out by the Ministry of Health and the Ministry of Human Resources and Social Security. It is difficult to come by concrete statistics for the number of professionals throughout the country, but in 2004, they stood at 16,103 licensed psychiatrists or registrars, and 24,793 licensed psychiatric nurses according to the WPA report, and ten years later it’s believed there are only about 20,000 licensed psychiatrists—an alarming figure for the country with the world’s largest population. Media reports of extensive violence wracking the sector are likely to have helped keep growth fairly stagnant.

The problem is compounded by the many con artists that operate substandard mental health clinics, with a representative from the Division of Clinical Psychology under the Hong Kong Psychological Society telling CNN in 2014 that many of the complaints they receive are due to unprofessional therapists with dubious credentials who often break confidentiality or worse.

Shi Wei, director at the student mental health counseling center at the Beijing University of Foreign Studies, told TWOC that working as a counselor or psychiatrist involves many risks, of both the physical and mental varieties. He said that while he hasn’t been physically hurt himself, he has seen people break down under the intense pressure of the job and that during counseling sessions, “you have to monitor the student’s emotional state at all times. I have at times felt very nervous”.

In addition, mental health workers have to deal with worries from broader society as well. Wang Wanlu, for example, may be past the “leftover woman” age of 25 in China, but she is still relatively young and attractive in a society with a surplus of men. Despite this fact, she has trouble dating. “People run away as soon as they know you work in a mental hospital,” Wang Wanlu told the paper. “All seven nurses in the hospital are women. All are around 28, but only three of them have found boyfriends.”

Such tales are far from rare. In 2013, Wang Di, a psychiatrist with Beijing’s Anding Hospital, told the Beijing News that she felt there was a stigma about her job and that people had pulled out of blind dates as soon as they learned her profession.


“Toil and Turmoil” is a story from our newest issue, “Mental Health”, coming out soon. To read the whole piece, become a subscriber and receive the full magazine. Alternatively, you can purchase the digital version from the iTunes Store.