Quota for mental patients is by no means mandatory

Zhengzhou health centers do have a quota to fill for registering people with severe mental health problems, but it is not compulsory, authorities said on Thursday. Communities are required to register 0.2 percent of the population as mentally ill and add them to a national monitoring network, as stipulated by the city health bureau last year. But doctors throughout the Henan provincial capital complained this week of being unable to meet the quota. "We have 35,398 residents, which means, according to the quota, we should have found at least 71 with severe mental health problems. So far, we've got 12," said Huang Linlin, a doctor at Linke Community Health Center. His team communicates with nearby hospitals to register discharged mental health patients if family members agree. However, he said many people are not willing to voluntarily disclose their health information or that of a relative, and also suggested it is possible that his area does not have that many mentally ill people. "Maybe the quota was designed based on the situation in cities such as Beijing and Shenzhen, where more people may have problems due to great pressure," he said. "I know many centers (in Zhengzhou) are having the same problem as us." Song Yuzhong, director of another center in the Linke community, agreed and added, "Many people here are migrants who tend to move frequently. It's hard to find mental health patients among them." A notice issued by the city health bureau last year said failure to meet the quota could lead to administrative penalties. But in a statement on Wednesday the authority said the quota is not compulsory and is only aimed at improving the rate of detection and management of mentally ill people and to lower the risk of accidents. Only those who make up numbers or records face serious punishment, the statement said. Huang confirmed that grassroots carers such as himself do not face any consequences if they fail to meet the target. "Our performance, including the management of mental health patients, is assessed every October," he said. "The performance doesn't affect my salary, but I don't know if, or how, it will affect people above me, such as government officials." The quota in Zhengzhou came after a 2012 document issued by the Ministry of Health — now the National Health and Family Planning Commission — that required provinces on the Chinese mainland, except the Tibet autonomous region, to reach a detection rate of 0.25 percent. The Zhengzhou health bureau readjusted its target to 0.2 percent, based on local conditions. Deng Haihua, spokesman for the national commission, said the city is no exception to the national picture. "According to a national epidemiological survey in 1993, 13.47 in every 1,000 people aged 15 or over have mental health problems," he said. "Studies in China and abroad show the rate of people with schizophrenia is about 5 in every 1,000, and the number doesn't differ much depending on area, race or economic level." People in China with six types of illness, including schizophrenia and bipolar disorder, are considered to have severe mental health problems, and should be registered with a national monitoring network so their conditions can be managed outside hospitals, and so they pose no risk to themselves or others. Deng said that as of March the national monitoring network included 3.5 million people with severe mental health conditions.