Forum：China's draft mental health law Hope for China's national mental health law

Xie He LIU

Mental Health Center，West China Hospital of Sichuan University.Chengdu，Sichuan 610041

Forum：China's draft mental health law Hope for China's national mental health law

Xie He LIU

Mental Health Center，West China Hospital of Sichuan University.Chengdu，Sichuan 610041

China's Mental Health Law is finally close to becoming legislation.The recent formal release of the draft and request for suggestions by the Legislative Affairs Office of the State Council(on 10 June 2011)［1］will be followed by consideration and revision by the Standing Committee of the National People's Congress，formal adoption，promulgation，and implementation.

This has been a long and convoluted process. First drafted by a consortium of the Sichuan Provincial Health Department and the Hunan Provincial Health Department Health on the direction of the Ministry of Health in 1985，the proposed law went through 10 rounds of revision，seeking comments，and re-revision from 1985 to 1999.International and national experts discussed revisions to the proposed legislation at three collaborative conferences on mental health law coordinated by the WHO and the Ministry of Health in 1987，1990 and 1999.After 1999 the Centers for Disease Control of the Ministry of Health took responsibility for developing the legislation and organized new groups of experts that again revised the draft law multiple times and submitted a draft to the Legislative Affairs Office of the State Council in 2006.After three years of evaluation and debate they then distributed an internal draft to national experts for recommendations in 2009.The version recently distributed on the web for public opinion is the result of this very long，very careful process.

The draft released for public opinion is significantly improved in comparison to previous drafts. The major areas of change are more detailed provisions for the prevention，treatment and rehabilitation of mental illnesses：stating that"hospitalization in psychiatric hospitals should be the voluntary decision of the patient";clearly defining and restricting the situations that merit involuntary admission; and including several clauses about the protection of the legal rights of psychiatric patients and about preventing the abuse of psychiatry.When"the person involved or their guardian does not agree with the decision to involuntarily hospitalize the patient" there are two methods of recourse specified in the regulations：the individual can select a medical institution to conduct an independent evaluation or request the court to arrange a formal evaluation by experts.This is similar to the formal review process of decisions to involuntarily treat patients employed in other countries;it is a reasonable process suitable for the situation in China that safeguards the individual's legal rights，prevents the abuse of psychiatry，and is acceptable to both sides of the dispute.

There are，however，some shortcomings in the current draft.1)The early detection，diagnosis and treatments of mental disorders are important steps for preventing the chronic deterioration，disability and violent outbursts associated with mental illnesses;but thesemeasures have not been given enough emphasis in the section of the law dealing with prevention.2)The focus of the law is on services provided by institutions under the Ministry of Health;thelegalstatus，responsibilities，service population and sources of operating expenses for the more than 200 psychiatric hospitals managed by the Ministry of Civil Affairs(the ministry responsible for all social welfare services)and the more than 20 forensic hospitals managed by the Ministry of Public Security are not specified.Originally limited to serving patients without any family support (civil affairs hospitals)or criminals with serious mental illnesses(public security hospitals)，in many locations of the country these hospitals now also provide mental health services to all community members.These hospitals play an important part in the overall provision of mental health services in the country so the services they provide should be included under the umbrella of the national mental health law and should satisfy the regulations specified in the law.3)The language of several of the provisions in the law still needs to be revised.

It is hoped that after such a long history this draft that has been released for public comment can be rapidly revised and submitted to the Standing Committee of the National People's Congress for deliberation.The community-based mental health service and rehabilitation centers discussed in the draft will require substantial funds to build，staff and manage;the funding to do this has not been fully specified in the legislation so once the act is issued and sufficient time has passed to gain experience in the implementation of the law revisions and supplements will be needed to resolve this funding issue and other issues that arise.

1. Legal Office of the State Council.Draft version of Mental Health Law.http：//yijian.chinalaw.gov.cn/lisms/action/ guestLoginAction.do(accessed 21 August 2011)

doi(combining all the papers in the Forum Section)：10.3969/j.issn.1002-0829.2011.04.010