China is seeing a resurgence in psychiatric treatment for ‘troublemakers’

When Zhang Junji was 17 years old, he decided to protest against the laws of 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 protested or complained to the authorities.

Many of the people we spoke to had been prescribed antipsychotic drugs against their consent, and in some cases electroconvulsive therapy (ECT).

Hospitalization in China has been reported for decades as a way to detain dissident citizens without involving the courts. But the BBC has recently found that the issue it wants to tackle in law has returned.

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

His ordeal began in 2022 when he protested China’s strict lockdown policies. He said the professors saw him five minutes later and spoke to his father, who took him to the family home. His father called the police and the next day – when he was 18 – two men drove him to what was said to be a Covid testing center but was actually a hospital.

“The doctors told me that I had a very serious mental illness … then they tied me to the bed. The nurses and doctors kept telling me that I must be mentally ill because of my attitude towards the party and the government. It was very scary,” he told the BBC World Service. It was there for days.

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

A month after her release, Junji was arrested again. He made a video of himself setting off in protest of the Chinese New Year ban on fireworks (a move to combat air pollution). Someone uploaded it online and the police were able to link it to Junji.

He has been repeatedly accused of being a “belligerent and troublemaker” to silence criticism of the Chinese government. Junji said that he was forced to stay in the hospital again for more than two months.

After her release, Junji was prescribed antipsychotic drugs. We saw the prescription – it was for Aripiprazole, used to treat schizophrenia and bipolar disorder.

“Taking the medicine made me feel like my mind was messed up,” he said, adding that the police would come to the house.

Fearing a third hospitalization, Junji decides to leave China. He told his parents he was going back to university to take the class – but in fact he ran away to New Zealand.

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

Junji is one of 59 people the BBC has confirmed – either through speaking to them or their relatives or through court documents – who resisted being hospitalized for mental health reasons or defied the authorities.

The issue has been recognized by the Chinese government – ​​the country’s 2013 Mental Health Law aims to stop this abuse, making it illegal to treat someone with mental illness. It clearly states that psychiatric treatment must be voluntary unless the patient is a danger to themselves or others.

In fact, the number of people being held against their will in mental health hospitals has recently increased, a prominent Chinese legal expert told the BBC World Service. Huang Shuetao, who was involved in drafting the law, blamed the weakening of civil society and a lack of checks and balances.

“I have come across many cases like this: the police want power and are running away from accountability,” he says. “Anyone who knows the flaws of this system can abuse it.”

An activist named Ji Lijian He told us that in 2018 he had to be treated involuntarily for mental illness.

Lijian said he was arrested because he demanded better pay at a factory. Police said they examined him for three days before he was taken to a psychiatric hospital.

Like Jungji, Lijian claims to have been prescribed antipsychotics to suppress his critical thinking.

After a week in the hospital, he said he did not receive any more medication. After fighting with staff and allegedly causing trouble, Ligian was referred to ECT – a treatment that involves passing electrical currents through a patient’s brain.

“The pain was from head to toe. My whole body felt like it didn’t belong to me. It was so painful. Electric shocks came on. Then it went off. Electric shocks came on. Then it went off. I felt like I was going to shoot myself several times. I wanted to die,” he says.

He said he was released after 52 days. He now has a part-time job in Los Angeles and is applying for asylum in the US.

In the year In 2019, the year Lijian admitted to the hospital, the Chinese Medical Doctor Association updated its guidelines for ECT, which said it should only be given with consent and under general anesthesia.

We want to know more about the participation of doctors in such cases.

Speaking without permission from foreign media like the BBC could get them in trouble, so our only option was to hide behind the scenes.

We held telephone consultations with doctors working in four hospitals.

Using the story of a relative who was hospitalized for posting anti-government comments online, we asked five doctors if they had experienced patients referred by the police.

Four confirmed their presence.

“The psychiatry department has a type of admission called ‘troublemakers,'” one doctor told us.

Another doctor from the hospital where Junji was detained seems to confirm the story that the police continued to monitor patients once she was released.

“The police will check your home to make sure you take your medication. If you don’t, you could be breaking the law again,” they said.

We approached the hospital for comment but did not receive a response.

Last year, we were given access to the medical records of pro-democracy activist Song Zaimin, who was hospitalized for the fifth time, making it clear how closely political views appear to be tied to psychiatric diagnoses.

“Today he was talking a lot, talking incoherently and criticizing the Communist Party. So he was sent to our hospital for inpatient treatment by a committee of police, doctors and local residents. This was an involuntary hospitalization.” He says.

We asked Professor Thomas G. Schull, President of the World Psychiatric Association, to review these notes. He said:

“No one should be admitted or treated without his consent for what is described here. This would lead to political violence.”

In the year More than 200 people were wrongly hospitalized by authorities between 2013 and 2017, according to a group of citizen journalists in China reporting abuses of mental health laws.

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

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

In the year In 2023, the man we call Mr. Lee, who was hospitalized after defying the local police, tried to take legal action against the authorities while in prison.

According to Junji, doctors told him that Mr. Lee was not sick, but the police arranged for an outside psychiatrist to evaluate him, who diagnosed him with bipolar disorder, and he was jailed for 45 days.

After his release, he decided to resist the investigation.

“If I don’t sue the police, it’s like admitting that I’m mentally ill. This will have a big impact on my future and my freedom because the police can lock me up at any time,” he says.

In China, information on anyone diagnosed with a serious mental health disorder can even be shared with the police and local residents’ committees.

But Mr Lee was unsuccessful – the courts rejected his appeal.

“We hear our leaders talk about the rule of law,” he told us. “We never thought we’d be locked up in a mental hospital.”

The BBC found 112 people listed in Chinese court rulings between 2013 and 2024 who tried to take legal action against police, local authorities or hospitals.

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

And the site appears to have been censored – five other cases are missing from the database.

Nicola McBean, from the London-based Human Rights Watch, said the case was a “considered precaution” by the police in dealing with “troublemakers”.

“Sending someone to a psychiatric hospital, going through the process, is a very simple and very useful tool for the local authorities.”

The fate of vlogger Li Yixu, who accused a police officer of sexual assault, is at stake. Yixu is said to have been hospitalized for a second time recently after speaking about her experience on social media. It is said that she is now being monitored at a hotel.

We have submitted the results of the investigation to the Chinese Embassy in the UK. Last year, the Chinese Communist Party “reaffirmed” the need to improve the mechanisms surrounding the law, which it said “clearly prohibits illegal detention and other methods of illegally depriving or restricting the personal freedom of citizens.”

Additional reporting by Georgina Lamb and Betty Knight