Recommendations

To the Chinese Government:

· The Chinese government should permit an international investigative mission led by the World Psychiatric Association (WPA) and composed of acknowledged international experts in the fields of general and forensic psychiatry, criminal law and human rights to visit China, hold workshops and seminars, carry out independent and confidential medical evaluations of a representative selection of persons, visit secure psychiatric detention and treatment facilities where political or religious dissidents are believed to be held, and publish a report on their findings and recommendations. In addition, international human rights groups and concerned medical organizations other than the WPA should be allowed freely to investigate the alleged abuses.

· The Chinese government should conduct a systematic review of the country's existing national and local-level legislation and administrative regulations governing forensic psychiatric assessment, interactions between police and prosecution agencies and the psychiatrists, and psychiatric custody of persons determined to be dangerously mentally ill. Aside from clarifying these procedures and assuring the professional independence of psychiatrists, the government should remove all provisions stating or implying that dissident or nonconformist political or religious beliefs provide a medically or legally acceptable basis for the diagnosis of severe or dangerous mental illness.

· The Chinese legislature should promptly formulate and enact the long-delayed Mental Health Law of the People's Republic of China, in such a form as to incorporate fully the minimum international provisions for safeguarding the rights and interests of involuntary mental patients, as laid down by the WPA and the U.N. and also in the World Health Organization's 1996 document, "Mental Health Care Law: Ten Basic Principles." The Mental Health Law should contain specific provisions stating unequivocally that deviation from, or inability to conform to, the country's prevailing political or religious orthodoxies as upheld by the Chinese government and Communist Party does not provide a medically or legally acceptable basis for the diagnosis of mental illness, psychiatric custody, or involuntary treatment.

· A coordinated campaign should be carried out throughout China's police and prosecutorial and court system, to inform law-enforcement and judicial officers at all levels that previous policies or practices, whether formal or ad hoc in nature, that either permitted or encouraged involuntary psychiatric examination or custody of persons holding peaceful dissident or religious views will no longer be officially tolerated or condoned. Chinese translations of both the WPA's Madrid Declaration and the U.N.'s 1991 Principles should be widely disseminated within the police and judicial systems.

· The Chinese judicial authorities should conduct a comprehensive nationwide review of all cases in which citizens have been diagnosed as severely mentally ill and then psychiatrically detained mainly or solely on account of their non-violent political or religious viewpoints or activities. All such persons should be relieved of any outstanding criminal charges or convictions and should be promptly released from psychiatric or police custody. Any such persons found, after fresh medical examination, to be suffering from genuine mental illness should be afforded humane and appropriate medical care in a non-forensic setting and (unless posing a clear and verifiable danger to themselves or others) on a voluntary basis.

· The Chinese government should extensively revise the provisions of the Criminal Law concerning offenses of "endangering state security," in such a way that they no longer provide a basis for the criminalization of political or religious freedom of expression, or can otherwise be used as a means of punishing those who engage in peaceful acts of public protest, assembly or demonstration or who attempt to form non-violent dissident groups of various kinds.

To the Chinese Psychiatric and Mental Healthcare Community:

· Acknowledging that most Chinese psychiatrists are not involved or complicit in the abuses described in this report: China's mental healthcare professionals should resist any pressure or inducement from the country's law-enforcement and judicial agencies to become personally involved in the legal handling or psychiatric assessment of persons detained by the police solely or mainly on account of their peaceful and non-violent political or religious views or activities. Chinese psychiatrists should decline to make diagnoses of severe mental illness on the above-mentioned grounds, whether asked by the authorities to do so in a formal forensic appraisals setting or in the context of a regular psychiatric treatment facility. Where direct conflicts of interest are encountered between their ethical obligations and their professional duty to examine police detainees, they should refuse to participate. They should also refrain from commenting on the specific criminal charges laid by the police, in cases where these clearly conflict with internationally agreed standards of human rights and due process.

· Those working either as fulltime police psychiatrists or as part-time forensic consultants to the police, prosecutorial and judicial agencies in China should take the lead in repudiating past abuses within their sphere of professional competence and in systematically removing the theoretical, medical-diagnostic and treatment bases for any continuance of such practices in the future. This should include an extensive revision of the country's existing training and reference literature in the field of forensic psychiatry, as well as the long-term vocational retraining of those already employed in this field.

· In the specific case of psychiatrically detained Falun Gong activists who have been "unofficially" handled by the police authorities on a non-forensic track and within the general psychiatric care domain, general psychiatrists who are called upon by the police to diagnose such cases should decline to do so on the grounds that the requisite legal process for criminal psychiatric committal has not been observed.

· Recognizing the Chinese Psychiatric Association's recent decision to remove homosexuality from the Chinese Classification of Mental Disorders (CCMD-III), we call upon the Chinese psychiatric community to further improve its diagnostic and treatment regime by supplementing CCMD-III with a specific provision stating that a person's disagreement with, deviation from, or inability to conform to the country's currently prevailing political, religious or other ideological orthodoxies should never be viewed as grounds for making a diagnosis of severe mental illness.

· The Chinese Psychiatric Association (a constituent body of the Chinese Medical Association) should invite the World Psychiatric Association, through its Review Committee and other relevant bodies, to provide professional assistance and advice aimed at furthering and enhancing its own efforts to systematically remove all elements of politically motivated psychiatric abuse from within its professional ranks. The assistance of the WHO's Mental Health Division in this process would also be useful.

To the International Psychiatric Community:

· At its forthcoming world congress in Yokohama, Japan, in August 2002, the World Psychiatric Association should seriously and systematically address the issue of political psychiatric abuse in the People's Republic of China. Its national constituent bodies should debate and vote on a formal resolution at Yokohama expressing the WPA's concern over this issue, calling upon the Chinese government to allow a WPA-led international psychiatric investigative mission to visit China, and declaring that steps will be taken, as mandated under the terms of the Madrid Declaration, to expel the Chinese Psychiatric Association from the WPA should the Chinese government fail to cooperate fully in the WPA's attempts to investigate the alleged abuses or if the authorities then fail to adopt effective remedies.

· National psychiatric associations throughout the world should continue to develop and expand their professional contacts and exchanges with Chinese psychiatrists and Chinese mental health facilities of all kinds. While expressing their firm solidarity with the ethically minded mainstream of contemporary Chinese psychiatry, national psychiatric bodies should also use all such bilateral events and exchanges as a forum for raising clearly with their Chinese counterparts their deep concern over the Chinese authorities' continued misuse of psychiatry as a means of dealing with certain categories of peaceful political or religious dissidents.

To Other Governments and International Bodies:

· In human-rights dialogues with the Chinese government, governments should discuss the issue of political psychiatric abuse in China. Where known, the names of individual Chinese political or religious dissidents currently being detained in psychiatric asylums in China should be presented to the Chinese side and requests made for clarification of their status and for their release.

· Both the U.N. Special Rapporteur on Torture and the U.N. Working Group on Arbitrary Detentions should take up the issue of political psychiatric abuse in China.

· The U.N. Sub-Commission on Prevention of Discrimination and Protection of Minorities should begin compiling and studying the available evidence of political psychiatric abuse in China, with a view to preparing a detailed report and set of practical recommendations aimed at bringing Chinese government practice into conformity with established U.N. rules and guidelines in the field of compulsory psychiatric detention and the rights of the mentally ill.