China sees revival of psychiatric care for ‘troublemakers’

When Zhang Junjie was 17, he decided to protest outside his university against the rules set by the Chinese government. A few days later, he was admitted to a psychiatric hospital and treated for schizophrenia.

Junjie is one of dozens of people identified by the BBC who have been hospitalized after protesting or complaining to the authorities.

Many of the people we spoke to were given antipsychotic drugs and, in some cases, electroconvulsive therapy (ECT) without their consent.

For decades, there have been reports that hospitalization has been used in China as a way to detain dissenting citizens without involving the courts. However, the BBC found that the problem the legislation sought to address has recently returned.

Junji says he was restrained and beaten by hospital staff before being forced to take medication.

His trials began in 2022 after he protested China’s harsh adjustment policies. He says teachers noticed him after just five minutes and contacted his father, who took him to his family home. He says his father called the police and the next day – his 18th birthday – two men took him to what they claimed was a Covid testing center but was actually a hospital.

“The doctors told me that I have a very serious mental illness… Then they tied me to the bed. Nurses and doctors have repeatedly told me that because of my views on the party and the government, I must be mentally ill. It was terrible,” he told the BBC World Service. He was there for 12 days.

Junji believes his father was forced to hand him over to the authorities because he worked for the local government.

Just over a month after his release, Junjie was arrested again. In defiance of the Chinese New Year fireworks ban (a measure introduced to combat air pollution), he made a video of himself setting them off. Someone uploaded it to the Internet and the police were able to link it to Junjie.

He has been accused of “inciting strife and disorder” – charges often used to silence criticism of the Chinese government. Junjie says he was forcibly hospitalized again for more than two months.

After discharge, Junjie was prescribed antipsychotic drugs. We saw the prescription – it was Aripiprazole, which is used to treat schizophrenia and bipolar disorder.

“When I took the drugs, I felt like my brain was in complete disarray,” he says, adding that the police come to his house to check if he has taken them.

Fearing a third hospitalization, Junjie decided to leave China. He told his parents he was going back to university to pack a room, but in reality he had run away to New Zealand.

He did not say goodbye to his family or friends.

Junjie is one of 59 people the BBC has confirmed – either by speaking to them, their relatives or by reviewing court documents – who have been hospitalized for mental health reasons after the protests or challenges to the authorities.

The problem has been recognized by the Chinese government – the country’s 2013 Mental Health Law aimed to stop this abuse by making it illegal to treat those who are not mentally ill. It also expressly states that psychiatric hospitalization must be voluntary, unless the patient poses a danger to himself or others.

In fact, the number of people being held in psychiatric hospitals against their will has increased recently, a leading Chinese lawyer has told the BBC World Service. Huang Xuetao, who was involved in drafting the law, blames the weakening of civil society and the lack of a system of checks and balances.

“I have come across many similar cases. The police want power, avoiding responsibility,” he says. “Anyone who knows the flaws of this system can abuse it.”

An activist named Jie Lijian told us that in 2018 he was treated for mental illness without his consent.

Lijian says he was arrested for taking part in a protest demanding higher wages at the factory. He says that the police interrogated him for three days before sending him to a psychiatric hospital.

Like Junjie, Lijian says he was prescribed antipsychotic drugs that impaired his critical thinking.

After a week in the hospital, he says he refused further medication. After fighting with staff and being told he was causing trouble, Lijiang was sent for ECT, a therapy that involves passing an electrical current through a patient’s brain.

“The pain was from head to toe. My whole body felt like it wasn’t my own. It was really painful. An electric current came on. Then it went off. An electric current came on. Then it went away. I passed out several times. I felt like I was dying. , – he says.

He says he checked out after 52 days. He now works part-time in Los Angeles and is seeking asylum in the United States.

In 2019, a year after Lijian said he was hospitalized, the Chinese Medical Association updated its guidelines for ECT, saying it should only be performed with consent and under general anesthesia.

We wanted to learn more about the involvement of doctors in such cases.

Talking to foreign media like the BBC without permission could get them in trouble, so our only option was to go undercover.

We made appointments for telephone consultations with doctors working in four hospitals that, according to our data, engage in involuntary hospitalization.

We used a fictional story about a relative who was hospitalized for posting anti-government comments online, and asked five doctors if they had ever encountered patients being referred by the police.

Four confirmed that there is.

“There’s an appointment in the psych ward called ‘disturbers,'” one doctor told us.

Another doctor from the hospital where Junjie was held appeared to corroborate his account that the police continued to monitor patients after discharge.

“The police will check on you at home to make sure you are taking your medication. If you don’t accept them, you may break the law again,” they said.

We reached out to the hospital in question for comment, but it did not respond.

We obtained access to the medical records of pro-democracy activist Song Zaimin, who was hospitalized for the fifth time last year, revealing how closely political views are tied to psychiatric diagnoses.

“Today he… talked a lot, spoke incoherently, criticized the Communist Party. That’s why the police, doctors and his relatives sent him to our hospital for inpatient treatment. It was forced hospitalization,” it says.

We asked Professor Thomas Schulze, president-elect of the World Psychiatric Association, to review these notes. He replied:

“Because of what is described here, no one should be involuntarily admitted and treated against their will. It reeks of political abuse.”

Between 2013 and 2017, more than 200 people reported being wrongfully hospitalized by authorities, according to a group of citizen journalists in China that documented violations of the Mental Health Law.

Their reporting ended in 2017 because the group’s founder was arrested and subsequently imprisoned.

For victims seeking justice, the justice system seems stacked against them.

A man we call Mr. Lee, who was hospitalized in 2023 after protesting against the local police, tried to sue the authorities for his imprisonment.

Unlike Junjie, doctors told Mr. Li he was not sick, but the police then appointed an outside psychiatrist to examine him, who diagnosed him with bipolar disorder, and detained him for 45 days.

After being released, he decided to challenge the diagnosis.

“If I don’t sue the police, it’s like admitting I’m mentally ill. This will greatly affect my future and my freedom, because the police can use this as a reason to lock me up at any time,” he says.

In China, the records of anyone ever diagnosed with a serious mental health disorder can be handed over to the police and even local residents’ committees.

But Mr. Lee did not succeed – the courts rejected his appeal.

“We hear our leaders talk about the rule of law,” he told us. “We didn’t even think that one day we could be locked up in a mental hospital.”

The BBC found 112 people listed on China’s official court judgments website as trying to take legal action against the police, local authorities or hospitals for such treatment between 2013 and 2024.

About 40% of these plaintiffs were involved in complaints against the authorities. Only two won cases.

And the site appears to be censored – five other cases we investigated are missing from the database.

The fact is that the police enjoy “considerable discretion” in dealing with “disturbers”, according to Nicola McBean of The Rights Practice, a rights group in London.

“Sending someone to a mental hospital, bypassing procedures, is too easy and too useful a tool for local authorities.”

Now eyes are on the fate of video blogger Li Yixue, who accused a police officer of sexual assault. Isha is said to have recently been hospitalized for a second time after her social media posts recounting the experience went viral. She is reportedly now under surveillance at a hotel.

We have passed the results of our investigation to the British Embassy in China. Last year, it said the Chinese Communist Party had “reaffirmed” that it must “improve mechanisms” around the law, which it said “clearly prohibits illegal detention and other methods of unlawfully depriving or restricting the personal freedom of citizens”.

Additional reporting by Georgina Lam and Betty Knight