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Executive director of the National Center for Mental Health, China Centre for Disease Control tells how African approaches to health care can overcome manpower shortages and mental health stigma in China

Hong Ma is one of just 20,000 Chinese psychiatrists serving a country of 1.4 billion. During the session New Paradigms for Behavioral and Mental Health Care, she told Salzburg Global the challenges facing mental health professionals in China and what they can learn from other countries.

Educated in the aftermath of the Cultural Revolution when access to university was reopened for all, she came to specialize in psychiatry thanks to an inventive suggestion from her parents.

“When I was close to finishing my five-year degree my parents, my mother working as a doctor and my father at the university, both strongly suggested I become a doctor that could work anywhere without equipment,” she explained.

“The idea was very simple - if there were certain days when something happened to the equipment and it could not be used, then I would still be able to serve people.”

As the first executive director of the National Center for Mental Health, China Centre for Disease Control, Ma is well aware of the difficulties of delivering quality mental health care to such a vast population. In addition to manpower shortages, Chinese health care workers must overcome the powerful stigma that still prevails in much of the country.

“Most Chinese people think that people with mental health problems are crazy or mad. If you ask people what makes someone mad, they would say people who run down the stairs without any clothes on. That is what most people think is crazy. Then I ask, do you see that kind of person on the street? The response is no, but that is what we think is crazy. So, people try to avoid to be labeled as a mentally-ill patient.”

However, Ma says she has learned valuable lessons from her fellow session participants that can help overcome these difficulties. She especially singles out her discussions with colleagues based in African countries, where in some cases medication is 100% free.

“I am thinking about the Ugandan and Rwandan people who use more community health care services. However, I worry if such people are able to provide the right services with only two years of training, with no doctors? But they tell me, 'absolutely.' This is the first level of care for these people, and this is enough.

“So, I am thinking how this idea can be applied to different provinces in China, especially in remote and rural areas where there is a lower number of doctors, nurses, and psychiatrists. China is similar to other countries, so maybe we will change this to be a more diverse model.

“In the big cities, you can use a psychiatrist and nurses to provide all levels of care, but in some places we need to choose reasonable and accessible care for those regions to provide those services. We have psychiatrists there, but even the poorest need access to all health sectors. So, we are thinking about how to develop the manpower for health services in western China.”

Hong Ma was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.