The World Psychiatric Association (WPA) should actively investigate reports of systematic political abuse of psychiatry in China. The WPA's triennial World Congress meets in Yokohama, Japan from August 23-29, 2002.
In a 298-page report, "Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era," Human Rights Watch and the Geneva Initiative on Psychiatry, a Netherlands-based international foundation, compare the treatment of dissidents in mental asylums to similar abuses in the former Soviet Union. The sentencing of political dissidents to special psychiatric hospitals on the basis of false diagnoses led to the forced withdrawal of the Soviet Union from the WPA in 1983 and it was not readmitted until 1989, after the Gorbachev reforms had brought an end to systematic political abuse of psychiatry in the Soviet Union.
"The world medical community should speak out on this important issue," said Mike Jendrzejczyk, Washington director of Human Rights Watch's Asia Division. "The Chinese psychiatrists who bravely refuse to participate in state repression need to feel they have support from abroad."
It appears that only a minority of Chinese psychiatrists have actually been involved in these practices. Other psychiatrists have written extensively about "political cases" in the Chinese professional literature, perhaps with the goal of forcing a broader ethical debate both inside and outside of China.
Extensive documentary evidence makes it clear that the political use of psychiatry was much more common in China during the Cultural Revolution (1966-76) than in either the former Soviet Union or China today. During that turbulent period, the official view was that virtually all forms of mental illness were caused by politically deviant thoughts.
However, official psychiatric theory in China continues to condone the involuntary treatment in custodial mental asylums of dissidents and nonconformists including Falun Gong members, independent labor organizers, whistle blowers and individuals who complain about political persecution or official misconduct.
Wang Wanxing, a political activist whose family is still seeking his immediate release, was first arrested in the mid-1970s. He was arrested again in 1992 and held in an institution for the criminally insane based on a diagnosis by police psychiatrists that he was a "paranoid psychotic." Wang was released in 1999 but later that year was returned to the same institution when he attempted to discuss his incarceration with foreign journalists. He remains in detention and is being treated for "political monomania," according to government officials.
While it is impossible to know precisely how many such persons are currently being held in mental asylums alongside the genuinely mentally ill, numerous official documents from China included in "Dangerous Minds" state that during the 1980s, the percentage of people held in asylums who were being punished for committing political offenses was as high as 15 percent of the total criminal psychiatric caseload.
"The WPA delegates should adopt a strong resolution in Yokohama calling on China to cease these abuses and to fully cooperate with a WPA investigation," said Robert van Voren, general secretary of the Geneva Initiative on Psychiatry. "A WPA-led delegation should visit the asylums, carry out independent medical examinations, and monitor conditions and treatment, especially in the police-run asylums."
Under the WPA's Madrid Declaration, passed in 1996, all forms of psychiatric diagnosis or treatment on the basis of the political needs of governments are explicitly forbidden.
Human Rights Watch and the Geneva Initiative also urged the U.N. Special Rapporteur on Torture and Ill-Treatment to address the issue of political psychiatric abuse in China.
They called on the Chinese government to conduct a systematic review of China's legislation and administrative regulations governing forensic psychiatric assessment, the interactions between police and psychiatrists, and to remove all provisions stating or implying that dissident or nonconformist beliefs provide a justifiable basis for the diagnosis of mental illness.