When Jeffrey Geller, M.D., chair of APA’s Council on International Affairs, returned to Beijing for the second annual Sino-American conference on psychiatry in April, he discovered how much the practice of medicine had changed since his last visit 20 years ago.

"I was struck that Chinese psychiatrists are engaging in efforts [similar to ours] to classify mental disorders, conduct epidemiological research, and advance psychosocial interventions," said Geller, who was a member of the conference scientific committee.

At the same time, however, concepts familiar to American psychiatrists—such as the right to refuse treatment and confidentiality—were still unfamiliar to Chinese psychiatrists, he said.

Geller attributed the difference between the two groups of psychiatrists to the high priority that psychiatrists and other physicians practicing in the United States place on individual rights.

Geller and Allan Tasman, M.D., who was APA president at the time of the meeting, planned the three-day scientific program with four CSP leaders: Zhang Mingyuan, M.D., Zhou Dongfeng, M.D., Chen Yanfang, M.D., and Zou Yizhuang, M.D. The first conference was held in the late 1980s.

The meeting topics reflected various scientific developments and specialty interests of each country. For example, Chinese psychiatrists discussed the treatment of opiate addiction and Qi-gong magic (a culture-bound disorder), and American psychiatrists discussed the right to refuse treatment and the benefits of ECT maintenance in the elderly.

Geller observed several changes in the Chinese health care system since he was there in 1980. For example, American pharmaceutical companies were represented at the APA-CSP conference, which was held in conjunction with the Chinese Medical Association annual meeting.

Chinese psychiatrists now use brand-name drugs such as Xyprexa, Prozac, and Risperdal rather than their local generic versions, said Geller. He also discovered that fee-for-service medicine is gradually beginning to replace socialized medicine in Beijing.

When the American and international attendees visited two mental hospitals, hospital officials informed them that they treat patients who have health insurance or who can pay out of pocket, said Geller. If patients lack the resources to pay for treatment, they can be treated in designated government-funded hospitals.

Tasman, who presided over the conference with CSP President Zhang Mingyuan, M.D., told Psychiatric News that he was impressed with the high caliber of the presentations. "Chinese psychiatrists are doing sophisticated clinical work and cutting-edge research, especially in the areas of genetics and brain imaging," said Tasman.

"The nature of treatment options and the sophisticated approach seen at the Mental Health Institute affiliated with Beijing Medical University was comparable to that seen in many hospitals in the United States."

Zou Yizhuang, M.D., a member of the conference organizing committee and CSP secretary general, told Psychiatric News that "Chinese psychiatrists treat more patients than U.S. psychiatrists because there are only 12,000 of us for a population of 1.3 billion Chinese people."

In contrast, there are about 50,000 psychiatrists for the U.S. population of 260 million, according to Tasman.

An estimated 1.5 million Chinese suffer from mental illness, according to an article in the April 17 China Daily.

"Chinese psychiatry faces many challenges and opportunities in the 21st century" said Zou. "There is an increased need for our services partly due to an increase in drug and alcohol abuse. Our goals include reforming the mental health system, developing a forensic psychiatry system, and learning more about biological psychiatry and the human brain through neuroimaging. We also want to improve our diagnosis and treatment of mental disorders."

CSP psychiatrists would like to continue having scientific exchanges with APA members. "We want to learn how American psychiatrists have dealt with issues we will be facing," said Zou. "Because China has the largest population in the world, improving the practice of psychiatry can benefit a large number of people with mental illness."

Area 2 Trustee Herbert Peyser, M.D., told Psychiatric News that he, Tasman, Geller, and other psychiatrists met with CSP leaders informally to convey their concerns about Falun Gong practitioners being allegedly detained involuntarily in psychiatric hospitals and injected with harmful medications for political reasons chinese.html.

Peyser also referred to the April 17 article in the China Daily about a new mental health law being drafted.

Yin Dakui, China’s vice minister of health, said the law would protect the rights of the mentally ill and that the government would launch a public awareness campaign to reduce the discrimination and marginalization they face, according to the article.

Yin announced the new initiatives at an auction of artwork by mentally ill Chinese persons to raise money for their treatment, according to the article.

The Chinese government will set up special counseling services for mentally ill patients and their families, said Yin. "Because of tradition, Chinese people are often unwilling to admit that they or their relatives have mental disorders until suicides are committed."

The law would also protect employees from being fired because of their mental illness, said Yin.