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.

China Daily (USA) - - CHINA - Con­tact the writer at tangyue@ chi­nadaily.com.cn

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.

Com­mu­nal ac­tiv­i­ties

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.

In­ad­e­quate pro­vi­sions

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.

Re­cov­ery, rein­te­gra­tion

“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

LIU QIAN / FOR CHINA DAILY

A mu­sic ther­a­pist guides pa­tients in a sin­ga­long at Kangn­ing Hos­pi­tal in Shen­zhen, Guang­dong prov­ince.

JIN YUZE / FOR CHINA DAILY

Nurses dis­pense med­i­ca­tion to pa­tients at Kangn­ing Hos­pi­tal, Shen­zhen’s only fa­cil­ity ded­i­cated to the treat­ment of men­tal health is­sues.

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