China sees resurgence of psychiatric care for ‘troublemakers’

When Zhang Junzhi was 17 years old, he decided to protest in front of his university against the rules created by the Chinese government. Within days, he was admitted to a psychiatric hospital and treated for schizophrenia.

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

Many 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 the courts getting involved. However, the BBC found that a problem the legislation was meant to address has recently returned.

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

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

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

Junji believes his father felt compelled to turn him in to the authorities because he worked for the local government.

Just over a month after being discharged, Junji was arrested again. Opposing the ban on fireworks during Chinese New Year (a measure introduced to combat air pollution), he had made a video of himself lighting them. Someone uploaded it online and the police were able to link it to Junjie.

He was accused of “starting quarrels and causing trouble” – a charge often used to silence criticism of the Chinese government. Junji says he was again forcibly hospitalized for more than two months.

After discharge, Junjie was prescribed antipsychotic medication. We saw the prescription – it was for aripiprazole, used to treat schizophrenia and bipolar disorder.

“Taking the drug made me feel like my brain was in a big mess,” he says, adding that the police would come to his house to check if he had taken it.

Fearing a third hospitalization, Junji decided to leave China. He told his parents he was going back to university to clean up his room, but he actually fled to New Zealand.

He doesn’t say goodbye to his family or friends.

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

The problem was recognized by the Chinese government in the country’s 2013 Mental Health Law. was intended to stop this abuse by making it illegal to treat people who were not mentally ill. In addition, it is expressly stated that admission to psychiatry must be voluntary, unless the patient poses a danger to himself or others.

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

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

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

Lijian says he was arrested for taking part in a protest demanding better pay at a factory. He says the police questioned him for three days before taking 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 more medication. After arguing with staff and being told he was causing trouble, Lijian was sent for ECT, a therapy that involves passing an electrical current through the patient’s brain.

“The pain was from head to toe. My whole body felt like it wasn’t mine. It was really painful. Electric shock included. Then turned off. Electric shock on. Then disappeared. I passed out several times. dying,” he says.

He says he was discharged after 52 days. He now works part-time in Los Angeles and is seeking asylum in the US.

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

We wanted to know 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 retained telephone consultations with doctors working in four hospitals that, according to our data, deal with involuntary hospitalizations.

We used a fictional story about a relative who had been hospitalized for posting anti-government comments online, and asked five doctors if they had ever come across cases of patients referred by the police.

Four confirmed that they had.

“The psychiatric ward has a type of admission called ‘troublers,'” one doctor told us.

Another doctor at the hospital where Junji was held appeared to corroborate his story that police continued to monitor patients after they were discharged.

“The police will check on you at home to make sure you take your medicine. If you don’t, you could be breaking 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, hospitalized for the fifth time last year, which clearly shows how closely political views appear to be linked to a psychiatric diagnosis.

“Today, he … talked a lot, talked incoherently and criticized the Communist Party. He was therefore sent to our hospital for inpatient treatment by the police, doctors and the local residents’ committee. It was involuntary hospitalization,” it said.

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 admitted involuntarily and treated against their will. It smacks 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 who have documented abuses of the Mental Health Law.

Their accountability ended in 2017 as the group’s founder was arrested and subsequently jailed.

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

A person we call Mr. Li who was hospitalized in 2023. after a protest against the local police, tried to take legal action against the authorities for his detention.

Unlike Junji, doctors told Mr. Li he was not sick, but the police then arranged for an outside psychiatrist to examine him, who diagnosed him with bipolar disorder, and he was detained 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. It will have a big impact on my future and my freedom because the police can use it as a reason to lock me up at any time,” he says.

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

But Mr Li failed – the courts rejected his appeal.

“We hear our leaders talk about the rule of law,” he told us. “We never dreamed that one day we might be locked up in a mental hospital.”

The BBC found 112 people listed on the official website for Chinese court decisions who between 2013 and 2024 have tried to take legal action against the police, local authorities or hospitals for such treatment.

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

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

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

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

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

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

Additional reporting by Georgina Lam and Betty Knight