Zanonia Chiu lives far south of Shenzhen, though she meets streams of Chinese patients every day, trekking across the border to seek a kind of help not offered in their own land.
Chiu is a psychologist at the Wellness Psychological Consultancy Services in Hong Kong. Her first encounter with China’s mental health-care system was in 2008, when she trained psychiatrists and counselors in Sichuan province assigned to aid victims of the earthquake.
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“The psychiatrists we met there were trying their best to counsel parents who had lost children,” she recalls. “Yet some weren't very familiar with psychotherapy.”
According to Chiu, Chinese tend to focus more on physical health than mental well-being. Even in Hong Kong, a region long exposed to Western medical practices, the public remains hesitant to address the topic. There are many taboos surrounding the problem that must be addressed before the country can begin to assist the mentally unwell more effectively. Chiu is involved with groups of psychologists that strive to increase awareness of the issue through the media, public seminars, patient education and family guidance. "We help family members learn how to better interact with loved ones suffering from mental illness," Chiu explains.
Chiu begins each case by assessing the physical, mental and familial background of a patient. The first consultation generally lasts about two hours, where she identifies the symptoms of the illness and how they are affecting a patient’s daily life. For children under 18, Chiu invites parents to join in the discussion and sends questionnaires to teachers in order to collect information about the child’s performance.
“We seldom follow a specific protocol,” Chiu adds. “Each individual case is completely different.”
Chiu can’t prescribe medicine as a psychologist in Hong Kong – none can. But she does refer patients with severe imbalances, such as depression or bipolar disorder, to local psychiatrists who offer prescriptions. Most patients need both medication and psychotherapy.
"The effectiveness of psychotherapy depends on many factors, including patient's compliance to treatment," Chiu explains. "Evidence based treatments usually require weekly follow-ups but some patients can't comply to it."
Family and social support is crucial to the recovery of mental illness. However, most of the patients struggle to disclose the details of their illness to family and friends. This causes extra stress for patients. Raised in a culture that demands 'bao xi bu bao you' – or 'only report good news' – admitting imperfections can generate intense feelings of guilt, betrayal and defeat. And on the mainland help, even for those willing to take it, may not come so easily.
// Click here to view more stories from our mental health series.
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