The use of psychiatry by China to detain and institutionalise dissidents at least equals and probably surpasses similar practices in the former Soviet Union, according a report by the New York-based Human Rights Watch.
After declining from a peak in Mao Zedong's Cultural Revolution, the report says that political psychiatric abuse has recently had a rapid revival as a result of the official crackdown on the banned spiritual sect, the Falun Gong.
The report, Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era, by Human Rights Watch (HRW), has been released in time for the World Psychiatric Association's (WPA) congress, on August 23 in Japan.
It will form the basis of a campaign to force change in China, much as what happened when the former Soviet Union withdrew from the congress between 1983-89 over similar allegations of false diagnoses against political opponents.
"The Chinese psychiatrists who bravely refuse to participate in state repression need to feel they have support from abroad," said Mike Jendrzejczyk of HRW's Asia division.
Chinese psychiatry, following reforms pushed through by senior members of the profession during the post-Mao period, generally conforms to "internationally accepted diagnostic and ethical standards", the report says.
The problem lies in forensic psychiatry, where psychiatrists co-operate with police and the judicial system to ascertain the mental state of alleged criminals.
The high tide of psychiatric abuse was under Mao during the 1960s and 1970s, when in some years, political dissidents formed nearly three-quarters of appraisals in criminal cases. "In other words, political activists sent to institutes for criminally insane . . . far exceeded the combined total of psychotic murderers, rapists, arsonists and violently mentally ill offenders dealt with under China's forensic psychiatry system," the report says.
The Mao era also set the template for a way of thinking that endures today, in which political deviancy is equated with mental illness.
The report says there is a kind of "presumption of insanity" for people who openly challenge the government on politics, a belief that "you'd have to be crazy to do that in China".
China still maintains a national system of about 20 Ankang (Peace and Health) centres, used by police to house dangerous mentally ill criminals and also "political maniacs". This category covers people "who shout reactionary slogans and write reactionary banners, make anti-government speeches in public and express opinions on important domestic and international affairs".
With dissidents dropping to about 10 to 15 per cent of all cases in the 1980s and one to several per cent in the 1990s, the report estimates an absolute minimum of 3,000 people have been subjected to psychiatric detention for political activity in the past two decades.
"By comparison, in the Soviet Union . . . the number of dissidents who were branded as mentally ill during the 1970s and 1980s was between . . . 200 and 300," the report says. The recent "surge" in new political cases involving Falun Gong followers "provides a clear indication that law and psychiatry are now working together in ever-closer professional tandem in the fast-growing judicial suppression" of banned religions.
The report speculates that the primary reason for the use of psychiatry is as a deterrent to activists who oppose the Communist party. "There are few more potent deterrents . . . than the threat of permanent or semi-permanent forced removal to an institution for the criminally insane," the report says.
The WPA is in discussion with China's Ministry of Health over arranging a mission to the country to report on its psychiatric practices. "We are not holding our breath but they are giving the appearance of co-operation," said Robin Munro, the report's author.