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Psychopaths locked in by a law

(Global Times)

09:01, May 30, 2013

Many patients in the city's psychiatric hospitals had been looking forward to the introduction of a new law this month. They believed this would be a turning point in their lives and would allow them to walk free and live in the community once again. Most still remain locked in overcrowded wards.

Although the new law, which came into effect on May 1, means that a patient should be discharged from a psychiatric hospital after recovery if he or she wants to leave, only 18 of the 70 patients that met this condition have actually been discharged from the Shanghai Mental Health Center in Pudong New Area this month.

The hospital houses twice the number of patients it should. The doctors and nurses work overtime trying to care for the patients. The big stumbling block is the patients' families who are often reluctant to accept family members back home after treatment.

The hospital has been trying to contact the families of the other 52 patients who can now leave, but the families are proving elusive - changing their phone numbers, moving addresses and remaining difficult to contact.

The situation is the same for many of the mental health institutions in Shanghai with a legal expert suggesting that the hospitals are caught between a rock and a hard place - they could be taken to court if they release the patients and they could also face legal penalties for continuing to keep patients who might be released.

Against their will

The Shanghai Mental Health Center in Pudong is packed. The high-rise center was designed to accommodate 450 patients at the most but now it cares for more than 800 patients, Sun Xirong, the vice president of the center, told the Global Times. She said that the majority of the patients had come to the hospital against their will, and 90 percent were suffering from schizophrenia.

Sun led the Global Times reporter around the wards on the fifth floor of the building. The entire floor used to be hospital management offices but is now used for patients. Access to the floor requires an elevator smart card which lets people reach the floor where they need another key to open the iron-barred gate to the actual wards.

In the wards there is no furniture - only beds closely packed next to each other so that the patients can only move around with difficulty. After lunch most of the patients were resting.

Wang, a managerial officer from the center, explained: "Many of the 70 patients that could be discharged under the new law have lived in this hospital for more than a decade and are now quite stable." She said that many families refused to take their relatives home because they were afraid they might suffer relapses. Others just left the patients in the hospital because it was inconvenient to collect and care for them.

Chen Dinghua, the center's president, told local media that patients from poor families were given an allowance from the government, and most of their medical bills were waived. "Families with financial difficulties only need to pay 12 yuan ($1.95) a day to cover their board."

Even though the cost is minimal, some families refuse to pay and abandon their relatives at the hospital.

"There is one female patient who could be discharged now. She is in her 50s. But apart from her father who is in his 80s, she has no other relatives who want to look after her. It is impossible for this father to pay the bills or care for his daughter," Sun said.

She said that the patients that have been left in the hospital for a long time have prevented the hospital from accepting many new patients in real need. Sun said the doctors and nurses at the center were taking on the responsibilities that should be taken by the patients' relatives.

"When a patient falls ill and needs surgery at a general hospital, we have to arrange a nurse to accompany the patient for the entire procedure if the patient's relatives refuse to show up. We have to sign the surgery agreement contracts on behalf of the relatives," Sun said.

There are about 30 doctors working in the center at present, meaning each doctor takes care of about 25 inpatients. Because of the case loads, the doctors and nurses work six days a week.

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