Family-Based Mental Health Care in Rural China

Family-Based Mental Health Care in Rural China

Mao-Sheng Ran
Meng-Ze Xiang
Peggy Simpson
Cecilia Lai-Wan Chan
Copyright Date: 2005
Pages: 204
  • Cite this Item
  • Book Info
    Family-Based Mental Health Care in Rural China
    Book Description:

    Without a comprehensive system of mental health care, the Chinese government and mental health care professionals are being confronted with two crucial issues. The first issue is how China will provide mental health services for those who need it in China, the world’s most populous country. Many individuals with a severe mental disorder in China go untreated or receive psychiatric treatment long after the first onset of illness, especially in the rural areas. In contemporary China, providing appropriate medication for managing mental disorders is a key factor. The second issue is how China will improve the quality of the mental health service with scarce resources and at the same time ensure a basic quality of life for people with mental disorders. The development of mental health services in China has certain characteristics. The mental hospitals play a dominant role in delivering mental health services. Families also play an important role, since more than 90% of people with mental illness are cared for at home with their immediate family members as primary caregivers. Recently, the government has mandated the development of community care, implying that the burden of care be shifted from the country to the family. However, families need help from the professionals to take care of their ill relatives. Based on a study in Chengdu in China for families with persons suffering from schizophrenia, this book examines how psychoeducational family intervention can be developed in rural areas. Detailed guidelines for effective family interventions, community mental health services, and social welfare and mental health policy are described. It is hoped that these suggestions may be incorporated into existing mental health care systems for the benefit of people with mental disorders in developing countries.

    eISBN: 978-988-220-127-9
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
    (pp. vii-viii)
    (pp. ix-xii)
    Mao-Sheng Ran, Meng-Ze Xiang, Peggy Simpson and Cecilia Lai-Wan Chan
  5. ACKNOWLEDGMENTS The Chengdu Study
    (pp. xiii-xiv)
    Mao-Sheng Ran, Meng-Ze Xiang, Peggy Simpson and Cecilia Lai-Wan Chan
  6. Part 1: Mental Health in China
      (pp. 3-24)

      Protecting and improving the mental health of a population is a complex task that can be accomplished within the context of the community. Ideally, community mental health services should provide comprehensive and locally based treatment and care that is readily accessible to individuals suffering from mental illness and their families. Effective surveillance of the numbers and conditions of people with the mental illness and using appropriate individual care plans are essential components to a successful community care program. Treatment or intervention for mental illness includes using a combination of pharmacological, psychological, and psychosocial interventions wisely, and early treatment can result...

      (pp. 25-34)

      In Chinese society, people with mental health problems, such as schizophrenia, are recognized by the rapid mood changes or very obvious behavior problems. Traditionally, mental disorders are differentiated by seven kinds of emotions. Emotional disorders may be described in somatic terms of having a physical discomfort. In Western society, a mental illness, such as schizophrenia, is termed a primary thought disorder. However, a thought disorder is difficult for people to accept in Chinese society (Xiang, Ran, & Li, 1994; Chiu, 1987). Even health care professionals refer to the Chinese medical classic Huang-Ti-Nei-Ching Su-Wen (皇帝內經素問), where functional psychoses (Tien-Kuang, (癲狂) are described...

  7. Part 2: Psychoeducational Family Intervention in China
      (pp. 37-48)

      Psychoeducational family intervention is one of the major psychosocial family intervention approaches to schizophrenia. Other major psychosocial family interventions include behavioral family therapy, social skills training, support in coping with residual psychotic symptoms, and cognitive rehabilitation (Penn & Mueser, 1996). Psychoeducation refers to “the use of educational techniques, methods and approaches to aid in the recovery from the disabling effects of mental illness. It is frequently used as an adjunct treatment for mental illness, usually within the framework of another ongoing treatment approach or as part of a research programme” (Barter, 1984). This definition is broadly applied to the family education...

      (pp. 49-102)

      Clinical practitioners and researchers are often impressed by the role of the family in relation to mentally ill family members in China. The role of the family in Chinese traditional culture is unique compared to the family in Western culture. In China, the government does not provide mental health services for each individual with mental illness. Traditionally, family members play a vital role both in caring for their family member suffering from mental illness and influencing the illness prognosis. With these characteristics in mind, an interactive psychoeducational family intervention model was developed in this study. The intervention model integrated such...

  8. Part 3: Implications and Suggestions for Mental Health
      (pp. 105-116)

      Psychoeducational family intervention is one of the most commonly used modalities of psychosocial intervention in helping families cope with mental illness. The development of interventions for families with people suffering from schizophrenia in China reflects the growing, worldwide recognition of the importance of the family in understanding and managing schizophrenia. While the international experience of family intervention influenced the development of similar services in China, certain unique historical, political, and geographical factors shaped the development of the Chinese model.

      The Chengdu experience provided basic information on major constructs, including treatment compliance, relapse, family beliefs about mental illness, attitude toward people...

      (pp. 117-120)

      Based on the findings and experiences of the Chengdu Study, common principles or guidelines for effective family intervention have been developed.

      1. A comprehensive individualized assessment of client’s needs should be done. The assessment should include: a) the main concern of the ill person and family members; b) the extent and quality of family relationships; c) the mutually agreed goals or outcomes among clinicians, the ill person, and family members; and d) choice of optional treatment modalities available to achieve desired outcomes (Dixon, Adams, & Lucksted, 2000). After a comprehensive intervention plan is implemented, a thorough evaluation should be completed of the...

      (pp. 121-130)

      There are significant challenges in developing comprehensive mental health services in contemporary China. Finding the means to face these challenges is crucial for the further development of mental health services and psychiatry in China.

      Should China take a similar path in the development of mental health services as the Western countries have done? This is a vital question that needs to be answered as China changes from a developing to a developed country. The lack of acute care psychiatric facilities in current China may reflect the situation in Western countries before the 1940s. Many developed countries, such as the UK,...

      (pp. 131-138)

      A number of challenges in social welfare and health policy are related to the development of mental health services in contemporary China. Developing strategies to face these challenges is crucial for the future direction of mental health services in China.

      As a developing country, China needs to be concerned about the threat of emerging and re-emerging infectious disease more than the impact of chronic diseases, such as mental disorders. Many effective strategies, including public health measures, mass educational campaigns, etc. were conducted to control endemic and epidemic diseases. These strategies increased the Chinese life expectancy from 32 years in 1950...

  9. Appendix
    (pp. 157-176)
  11. INDEX
    (pp. 177-182)