In the mid-1980s, China's leaders, perceiving the emergence of an "ideological vacuum" among the populace, caused mainly by the official downplaying of politics in national life since the Cultural Revolution, launched a campaign to build "socialist spiritual civilization"170 across the country. The purpose was to create a spiritual counterpart to China's already fairly well developed "material civilization," the national infrastructure and the economy. Since in Chinese the words for "spiritual" and "mental" are the same, the new movement was also an attempt to expand "mental civilization," and thus had important implications for the field of mental health work. In October 1986 in Shanghai, the ministries of health, civil affairs and public security convened the country's Second National Conference on Mental Hygiene Work, the first national-level meeting of this kind in almost thirty years.171 The main item on the agenda was the sharp increase in the rate of mental illness among China's population in recent years: since the 1970s, the rate was said to have risen from seven per thousand members of the population to as many as 10.54 per thousand.172 The level of violent crime in society was also rising rapidly, and China's severe lack of healthcare facilities for the mentally ill was identified as a major causal factor.
The encyclopedia then lists the following more specific and operational criteria for dealing with mentally ill people falling within the three categories:186
Finally, the police encyclopedia adds, "The taking of mentally ill people into custody is especially important during major public festivals and when foreign guests arrive for visits, and it should be appropriately reinforced at such times."189 For our present purposes, the most important categories of alleged mentally ill people listed above as being targets for Ankang-style custody and treatment are, first, "political maniacs," namely those displaying "dangerously" political dissident-like behavior, including "expressing opinions on important domestic and international affairs"; and second, those accused of disrupting "the normal work of Party and government offices," since in practice this category is often taken to include the kinds of persistent petitioners and complainants whom the police regard as suffering from "litigious mania." As mentioned earlier, most countries need to maintain institutions for the criminally insane in order to protect the public from genuinely dangerous psychotic offenders. At least in the modern era, however, few countries have ever regarded the above-mentioned types of mentally ill people as being legitimate targets for forced psychiatric custody. The former Soviet Union was the most prominent such country, and to the extent that it now follows a similar set of practices, China's recently established Ankang system appears to be performing a role much the same as that of the Soviet Interior Ministry-run "Special Psychiatric Hospitals," which were used to incarcerate, in a medically unjustifiable way, hundreds and possibly thousands of peaceful Soviet dissidents.
The most recent confirmed case of a political dissident being sent to the Shanghai Ankang facility is that of Li Da, a young worker at an electrical appliances firm in the city who had apparently been involved in the May 1989 pro-democracy movement. On three separate occasions, prior to his arrest in July 1998, he stood outside the Shanghai No. 1 Department Store handing out leaflets calling for the rehabilitation of victims of the June 4, 1989 government crackdown, for greater political democracy in China, and for the right to commemorate Taiwan National Day. Li's case was briefly reported on by Voice of America in February of the following year, on the basis of a letter he had smuggled out of the Shanghai Ankang facility. There has been no further news about him since.
As the Olympic delegation toured Beijing's sports facilities on March 7, Wang's parents waited anxiously for news about their son. Two days later, shortly after dawn,
Wang's father demanded to see the body, and he and his wife were then led down a long corridor to the hospital's morgue. Later, the couple described to the foreign journalists what they found on arrival:
The Beijing Public Security Bureau has a close organizational affiliation with only two hospitals in the capital: one is the Binhe Penal Hospital, located until recently within the grounds of the Beijing No. 1 Municipal Prison (this facility was torn down and relocated about five years ago); the other is the Beijing PSB Ankang Institute for the Custody and Treatment of the Mentally Ill, which is located in Fangshan District, a suburban area to the southwest of the city.193 Even today, very few foreigners living in China have ever heard of the name "Ankang," so it is unsurprising that the authors of the above account did not specifically identify the place of Wang Chaoru's death as being the Beijing Ankang facility. But that is undoubtedly where he died.
170 Shehuizhuyi jingshen wenming.
171 The first one had been held in 1958.
172 According to a website run by the Beijing Institute of Forensic Medicine and Science (Beijing Shi Fating Kexue Jishu Jianding Yanjiusuo), the rate of mental illness among China's population currently stands at 13.47 per thousand. See http://fmedsci.com/sfjs/sfjs09.htm.
173 "Weisheng Bu, Minzheng Bu, Gong'an Bu Guanyu Jiaqiang Jingshen Weisheng Gongzuo de Yijian (Opinion of the Ministries of Health, Civil Affairs and Public Security on the Strengthening of Mental Health Work)," April 20, 1987, in Zhonghua Renmin Gongheguo Weisheng Fagui Huibian 1986-1988 (PRC Compilation of Laws and Regulations on Health, 1986-1988), (Law Publishing House, June 1990), pp.366-369.
174 This latter meeting was held at the Tianjin Public Security Bureau's Custody and Treatment Center for the Mentally Ill, which was shortly thereafter renamed as the Tianjin Ankang institute. Since that time, "national academic conferences on the custody and treatment of the mentally ill," attended mainly by practicing forensic psychiatrists, have been convened in various Chinese cities approximately every two years; the first, for example, was in Wuhan in May 1988 (see Renmin Gong'an Bao [People's Public Security News], May 20, 1988), and the third was in Hangzhou in October 1990 (see Hangzhou Ribao [Hangzhou Daily], October 24, 1990.)
175 Renmin Gong'an Bao, May 24, 1988, p.1. A report two years later in the same newspaper confirmed the independent observer's account, cited above, of the establishment of a high-technology lobotomy unit at the Tianjin Ankang facility ("Gong'an Xitong Jingshenbing Guan-Zhi Gongzuo Chengxiao Xianzhu [Public Security System's Work of Custody and Treatment of the Mentally Ill Achieves Conspicuous Results]," Renmin Gong'an Bao, May 18, 1990, p.1).
176 These regulations are mentioned in Renmin Gong'an Bao, May 18, 1990; however, no actual copies of the documents have as yet come to light.
177 Long Qingchun, ed., Sifa Jingshen Yixue Jianding Zixun Jieda, p.152. The twenty places having Ankang facilities as of 1992 were the cities of Tianjin, Beijing, Shanghai, Shenyang, Dalian, Tangshan, Wuhan, Xi'an, Suzhou, Chengdu, Hangzhou, Hefei, Fuzhou, Ningbo, Jinhua and Shaoxing; and also Heilongjiang Province, Jilin Province, Ningxia Autonomous Region, and Inner Mongolia Autonomous Region (city locations for the latter four are unknown). As of late 1999, the total number of Ankang facilities was reportedly still twenty (Zheng Zhanpei et al., "Woguo Sifa Jingshenbingxue Jianding Gongzuo de Xianzhuang ji Zhanwang [Present Situation and Future Prospects of China's Judicial Psychiatric Appraisals Work]," Chinese Journal of Psychiatry, vol.32, no.4 , p.201).
178 Lin Huai, Jingshen Jibing Huanzhe Xingshi Zeren Nengli He Yiliao Jianhu Cuoshi, pp. 54-55.
179 Gu Xiangdong et al., "Shehui Jineng Xunlian Dui 32 Li Zhuyuan Manxing Jingshenfenliezheng Huanzhe de Liaoxiao Guancha (An Examination of the Efficacy of Social Skills Training for 32 Chronic Schizophrenic Patients)," Chinese Journal of Nervous and Mental Diseases, vol. 20, no. 2, pp.85-87.
180 Renmin Gong'an Bao, May 24, 1988, p.1.
181 The Chinese name for this institute was "Shanghai Shi Jingshenbing Guan-Zhi Yiyuan." In 1987, it was renamed "Shanghai Shi Gong'an Ju Ankang Jingshenbing Guan-Zhi Yuan" (Shanghai Municipal Public Security Bureau Ankang Institute for the Custody and Treatment of the Mentally Ill). The same wording is now used (after substitution of the specific city or province name in question) as a uniform designation for all the various Ankang centers in China.
182 "Shanghai Shi Jianhu Zhiliao Guanli Zhaoshi Zhaohuo Jingshenbingren Tiaoli (Shanghai Municipal Regulations on the Guardianship, Treatment and Management of Mentally Ill People Who Create Incidents or Disasters)," promulgated on August 29, 1986, in Shanghai Gong'an Nianjian, 1988 (Shanghai Public Security Yearbook, 1988), (Shanghai Social Sciences Publishing House [volume marked: "for internal distribution only"], December 1988), pp.343-346. The regulations came into force on October 1 the same year.
183 An argument that the courts should be given a leading role in this process is made in Lin Huai, Jingshen Jibing Huanzhe Xingshi Zeren Nengli He Yiliao Jianhu Cuoshi, pp.53-54.
184 See "Tianjin Shi Shouzhi Guanli Weihai Shehui Zhi'an Jingshenbingren Banfa (Tianjin Municipal Methods for the Shelter and Management of Mentally Ill People Who Endanger Public Order)," undated and unpublished document on file with the author; and "Guangdong Sheng Shourong Anzhi Zhaohuo Zhaoshi Jingshenbingren Zanxing Banfa (Guangdong Provincial Temporary Methods for the Shelter and Settlement of Mentally Ill People Who Create Disasters or Incidents)," issued by the Guangdong Provincial People's Government on January 17, 1990, in Guangdong Sheng Fagui Guizhang Huibian (A Compilation of Guangdong Provincial Laws, Regulations and Rules [January 1989-December 1990]), edited and published by the Office of the Guangdong Provincial People's Government, pp.275-276.
185 The term "hua fengzi" (literally: "flower crazies") is a euphemistic one whose broad meaning encompasses aspects of the English terms "hippy," "nutcase," and "sex maniac"; however, it does not have the often violent or non-consensual overtones of the latter term.
186 Another important category of persons liable to be sent to Ankang facilities is those who develop "prison psychoses" of various kinds (as discussed above) during their confinement in regular prisons. The incidence of this type of mental illness has apparently risen sharply in China in recent years. One significant subgroup of such sufferers is reportedly those sentenced to death and awaiting execution; if the stress and anxiety of impending execution leads them to become mentally ill, they are regarded as "incompetent to undergo punishment" and are then placed in Ankang custody for treatment until they become sane enough to be executed. Moreover, prisoners who stage hunger strikes in jail are often regarded as suffering from a subtype of this particular illness and are therefore also sent to Ankang centers for secure psychiatric treatment.
187 "Huhan fandong kouhao, zhangtie sanfa fandong biaoyu, chuandan, zaocheng buliang zhengzhi yingxiangde."
188 Zhongguo Gong'an Baike Quanshu (China Encyclopedia of Public Security), (Jilin People's Publishing House, February 1990), p.1964. A similar set of criteria for enforcing police custody of the mentally ill is listed in Zeng Wenyou et al., ed., Jing Guan Bi Du (Essential Reading for Police Officials), (Police Officials Publishing House, Beijing, October 1992), (volume marked "for internal circulation only"), p.163. A more readily accessible source, giving roughly the same kinds of guidelines and discussing the role and purposes of the Ankang system more generally, is Liu Dechao, "Dui Weihai Shehui Zhi'an de Jingshenbingren de Chuli (On the Handling of Mentally Ill People Who Endanger the Public Order of Society)," Xiandai Faxue (Modern Jurisprudence), no. 2 (1990), pp.69-71. Finally, a 1996 book states that the various criteria for compulsory Ankang admissions were first formulated at the First National Public Security Conference on Custody and Treatment of the Mentally Ill, held in Tianjin in December 1987. See Lin Huai, Jingshen Jibing Huanzhe Xingshi Zeren Nengli He Yiliao Jianhu Cuoshi, p.111.
189 The rounding-up by police of mentally ill citizens in advance of important public events and visits by foreign dignitaries was also a highly characteristic feature of political psychiatry in the former Soviet Union.
190 The treatment method of electric acupuncture, which is in widespread use in China (and is found also as an "alternative" therapy in many other countries nowadays) is to be differentiated from the use of ECT. When properly administered, electric acupuncture has no ethically abusive connotations. Like many other legitimate medical treatments, however, electric acupuncture can, as the above account indicates, be misused for purposes of inflicting pain and punishment.
191 Handwritten account circulated to various human rights groups in 1995; the writer cannot presently be identified for reasons of personal safety. According to the account, the ward in which she was placed held twenty women, three of whom were political dissidents of various kinds. Moreover, "[inmates] convicted of murder were allowed to talk freely together, but political prisoners were not permitted to do the same." The reason why one of the three dissidents had been admitted was, according to the same account, as follows: "She had gone onto the streets to make a speech protesting about the high increase in the cost of living. She said that skyrocketing prices had made people's lives worse, and that political corruption nowadays meant officials made a fortune through their official posts, something that could not have happened in Mao Zedong's day."
192 Nicholas D. Kristof and Sheryl WuDunn, China Wakes: The Struggle for the Soul of a Rising Power (Random House, 1994), p.98. The authorities' version of Wang's death was as follows: "`The police said that my son had died on the night of the sixth,' [said the father.] That was just hours before the Olympic delegation arrived. `They said he went mad and died on the streets. That's impossible! When they said that, I yelled at the policemen. They were just too inhumane. How could they hate my son so much?'"
193 A detailed official description of the organization and functions of the Beijing Ankang facility can be found in Lin Huai, Jingshen Jibing Huanzhe Xingshi Zeren Nengli He Yiliao Jianhu Cuoshi, pp.111-116; the account was written by Zhang Hu, a leading forensic psychiatrist who formerly worked at the Harbin No. 1 Special Hospital (Ha'erbin Shi Diyi Zhuanke Yiyuan) and for the past ten years or so has been based at the Beijing Ankang institute. In his article, Zhang said that the Beijing Ankang is divided into three parts: a closed and highly secure zone (fengbi qu), where all new admissions are placed; a semi-open zone, holding around half of the inmates; and an open zone, mainly devoted to work-therapy activities, where inmates scheduled for release are held. According to Zhang, the facility is run "fully in accordance with humanitarian principles," although he also acknowledges that "many problems remain to be solved." In his view, Ankang centers should primarily be places of treatment, rather than detention or punishment: "If the reverse were true, so that the medical objectives became secondary, and the principal purpose was simply to lock up the patients and keep them in custody, then it would be wrong, and the nature and aims of Ankang hospitals would no longer be the same" (Ibid., p.113). Another description of the Ankang regime can be found in Li Congpei, Sifa Jingshenbingxue, pp.385-386.