Australia has played a significant role in assisting China to develop its mental health strategy, writes David Paroissien.
Australia –China trade and investment and their implications both positive and negative grab daily media headlines. But as Australia continues to find its place in the Asia Century, the lens is being pulled back to reveal a much broader, more complex web of relationships between our two countries.
A long-standing collaboration in mental health is perhaps the most surprising of these relationships, yet there are few more pressing issues confronting both countries.
One in five people in Australia suffer from a mental illness, and as China undergoes a drastic transformation, rates of diagnosis have continued to climb. Estimates suggest that in China, 91 percent of all individuals with any diagnosis of mental disorders never seek help. For psychotic disorders, 27 percent never sought help and 12 percent saw non-mental health professionals only.
The enormity of the problem triggered the PRC to undertake the largest mental health reform project ever undertaken and Australia has been privileged to be its partner, playing a small yet significant role in the process.
Through imaginative partnerships, relationship building – and some inspired government support – Australia and China are learning important lessons from each other about how to deliver appropriate mental health services for our communities.
Since the 1990s Victoria has been undergoing a long period of mental health reform moving from largely custodial care in huge psychiatric institutions to treatment based in community settings.
The now Director of the National Institute of Mental Health, Peking University, Prof. Yu Xin experienced first hand Victoria’s mental health system reform. A young trainee completing psychiatric specialization studies in 1996, supervised by the University of Melbourne’s Professor Ed Chiu, Yu Xin witnessed the huge shift in the treatment of people suffering from mental illness and the positive effects on their recovery. His time spent studying in Melbourne left a lasting impression.
When the time was right and after a worldwide search for a model of mental health service for China, Prof Yu led a delegation of Health leaders from China to Melbourne to meet with the newly formed Asia Australia
Mental Health (AAMH), a consortium of The University of Melbourne’s (Department of Psychiatry and Asialink) and St Vincent’s Mental Health.
The delegation visited key Victorian government, academic and NGO mental health leaders to hear the story of Victoria’s mental health reform, our successes and most importantly our ongoing challenges to deliver a service to people who suffer with mental illness and their families.
*Pictured right: Australian Health Minister Nicola Roxon & Chinese Health Minister Chen Zhu, 2011.
In September 2004, the program for mental health reform became the only non-communicable disease program included in China’s national public health program. The event became a milestone for China’s welfare development. Mental health has become officially integrated into public health.
Named the 686 Program after its initial funding of 6.86 million yuan, China’s mental health program is similar to the Victorian model, which has at its core a patient-centred community-based approach
China’s mental health program was managed by The National Centre for Mental Health (co-located with the Peking University Institute of Mental Health), overseen by a national working group and an international advisory group with experts drawn from Asia Australia Mental Health and its associated faculty.
By early 2005, 60 demonstration sites were established, with one urban and one rural area in each of the 30 provinces of China, covering a population of 43 million. The first three years of the programme proved that people could be effectively treated in the community, given adequate resources.
The China-Australia collaboration now covers 766 counties and is co-funded by both central and provincial governments.
From the start, the China Australia collaboration in mental health needed to create a working philosophy that could accommodate the inevitable setbacks. The partnership model was based on a strong bond of mutual respect.
Professor Ma Hong, CEO, Institute of Mental Health, Peking University, explains the partnership as such: “We work now as one team, not Chinese, not Australian but a team that understands each other’s strengths and needs and is focused on improving the lives of the most neglected in all populations – people with mental illness.” ■
*David Paroissien is a program manager at Asia Australia Mental Health. Find out more about the organisation at www.aamh.edu.au