Dandelion helping to sow the seeds of stability for members
A government-sponsored facility provides psychiatric patients with opportunities to reintegrate into society. Tang Yue reports from Shenzhen, Guangdong province.
Every day, Alice, not her real name, travels 25 kilometers each way to work, changing buses twice en route. To secure a seat on the earliest bus, she rises at 4 am and leaves home an hour later.
She is employed by the Dandelion Clubhouse in Shenzhen, Guangdong province. Despite the name, it’s not a night club, but a facility where people with mental health issues learn to reintegrate with society.
Alice was diagnosed with schizophrenia in 2008, and she started coming to the club in 2010 at a time when her mental health was stable. At the club, she shares a space with about 30 other members, who cook for themselves, do paperwork and even produce a weekly TV news program about Dandelion’s activities.
“I know I have a mental illness. But in the clubhouse, I don’t feel like a useless person anymore,” said the 38-yearold, who preferred not to give her real name. She receives 1,400 yuan ($210) a month from Dandelion, which is sponsored by the local government, if she works a full schedule.
“Everyone is equal here, and I feel like talking more. Being emotionally more stable, I am also able to treat my family better,” she added.
Unlike hospitals, which focus on medical treatment, Dandelion provides stable patients with the encouragement and assistance they need to lead successful lives, so they can recover and participate fully in society.
Since 1948, when the Fountain House, the first facility of its kind, opened in New York, more than 320 others have been established worldwide — including five on the Chinese mainland — and have been accredited by Clubhouse International.
“Here, we are not doctors and patients. They don’t call me Director Chen but Brother Chen. Every time we want to accomplish a task, we ask, ‘Could you please do it with us together?’” said Chen Yuanhua, director of the Dandelion Clubhouse.
The de institutionalization movement started in the West in the 1960s, replacing longstay psychiatric hospitals with more-inclusive community services for people with mental health issues.
However, the situation is more complex in China, where 4.3 million people were registered with severe mental issues by the end of 2014. Moreover, unlike in developed countries, the basic medical resources for psychiatric patients are underfunded and inadequate.
Data from the National Health and Family Planning Commission show that China has 1,650 professional mental health institutions, with 228,000 beds, about 1.71 beds for every 10,000 people on average. However, in many county-level cities in less-developed regions, there are no major facilities.
In most Western countries, by comparison, the number is five beds or more per 10,000 patients.
As a result, community services, including the clubhouses and their variants, are less developed in terms of both quantity and quality.
Although many rehabilitation centers have been established in China’s urban areas in recent years, mainly under the auspices of local disabled persons’ federations, few were specifically designed for people with mental health issues, who have different needs from those with physical disabilities.
“Community rehabilitation is very important, but it is lagging behind other fields in mental health work,” said Wang Bin, an official with the commission.
Moreover, the scarcity of medical resources and services has taken a toll, not only on the patients and their families, but also society as a whole. In 2014, 7,250 people with severe mental issues were responsible for a series of incidents and attacks, some of which resulted in death or injury, according to China Disabled Persons’ Federation.
The incidents reinforced the existing discrimination against patients and further isolated them from the public, said Liu Tiebang, president of Kangning Hospital, Shenzhen’s only facility dedicated to mental health issues.
Citing a 2013 survey, Liu said 73.6 percent of local residents were reluctant to have people with mental health issues as neighbors, while 82.5 percent said they consider such patients “a risk”.
In one extreme incident last year, the hospital was besieged by local residents calling for it to be relocated, after a man with mental issues killed one person and injured seven others. However, the man wasn’t a patient at the hospital.
“To get treatment and go through rehabilitation is the patients’ right, no one can deprive them of that,” Liu said, adding that government funding has risen in recent years and a larger hospital is now under construction.
Last year, in an attempt to reduce the number of incidents and improve the patents’ welfare, the central government ordered a number of local departments nationwide, including those in the fields of public security, social security and civil affairs, to set up a united working group and improve coordination.
“The best way to maintain social stability is to give patients full access to treatment and rehabilitation,” said Hu Chiyi, a psychiatrist and vice-president of Kangning Hospital. “You can keep patients at home for a day, but you can’t do it forever.”
Like clubhouses elsewhere in the world, Dandelion has a long-term plan to prepare its members for a return to society and the job market.
The clubhouse has a small shop, where members take turns to work behind the counter. Those whose condition is stable and who are recovering well are also allowed to work at other facilities that have partnered with the clubhouse. They are mainly run by the local disabled persons’ federation, and members start by working half-days and gradually work up to the full schedule.
So far, 12 Dandelion members have been employed this way.
“Corporate social responsibility is a new thing in China. I hope one day more companies will provide job opportunities for our members,” said Chen, Dandelion’s director, who is currently in negotiations with a local company to arrange work placements for members.
“It doesn’t only help them rebuild their lives, but also enables the public to learn more about them.”
Alice is not yet ready for job-hunting, but like many of her friends at the club, she is looking forward to finding a full-time job one day to “contribute more to the family”.
Moreover, she has another pressing goal in the shape of her 3-year-old daughter, who is being cared for by her grandfather in her hometown in Hubei province.
“I know my condition is not good enough for me to look after my daughter at the moment. I just hope I can keep recovering and become a responsible mother soon,” she said.
Community rehabilitation is very important, but it is lagging behind other fields in mental health work.” Wang Bin, an official with the National Health and Family Planning Commission
A music therapist guides patients in a singalong at Kangning Hospital in Shenzhen, Guangdong province.
Nurses dispense medication to patients at Kangning Hospital, Shenzhen’s only facility dedicated to the treatment of mental health issues.