Although psychology has a firm place in academia in China it is not accepted by the population or the social system. When a young person tells their parents in China they want to go and study psychology the first thing they are asked is what sort of job can you get and the truthful answer is none. China does not yet understand the benefits of psychology to business, hospitals, mental health, human interactions and much more. So many are refused permission to study and have to find a major that has an Iron Rice Bowl at the end – i.e. government work, teaching, business and similar topics that guarantee a job for life.
Some Western companies have tried to break into the Employee Assistance Program market but with little success except supporting Western employees from USA or similar based EAP contracts. Chinese companies have no interest in the mental welfare of employees as can be seen by the huge amount of young suicides in Chinese companies from pressure of work and alienation by the policies and system of work. Some Chinese EAP companies have had success handling US or EU requests for assistance with counselling their overseas workers – mainly for relationship problems abroad as expats find some cultural resistance and depression caused by being away from family and the usual support systems they would find in their own country.
The Chinese themselves have a long history of treating mentally ill people as shaming the family. So they hide them away in back rooms, do not seek help except psychiatric drugs to control them (much as is the use in the US). This attitude allows the situation where even the young do not seek support during a mental health crisis. Suicide is the number one cause of death, amongst young people, between 20 and 30 years old in China – mainly female – the only country in the World that has more female suicides than male.
Most companies work a family management system in China – this means the Boss acts as Father to the employees and so subservience is the order of the day – modern management techniques have all but passed China by – they simply cannot adapt to the idea of empowerment and responsibility towards younger employees. So when an employee has a mental health issue firing them is the easiest route – there is very little legal protection here in China – although the laws themselves exist, the cost of enforcement is beyond any employee’s pocket.
Hospitals in China are by and by primitive in their facilities and the standard of health care. Most doctors here would never be allowed to practice in the West as they study by rote learning and buying their way through the system. Corruption in the education system is everywhere – if your father has money – you can pass anything. This is one reason Chinese degrees are not recognized by the West and insist on a retraining package if they try to practice outside China.
Psychology in hospitals hardly exists as the authorities do not recognize psychology doctors as real doctors, which is ironic, as medical doctors are an honoury title and the psychologists all have PhD’s. If a psychologist is found working in a hospital the inspectors fine the hospital and give it negative points much the same as your driving license – so many points closes the hospital. So many have to work under a medical doctor as an advisor or consultant rather than in their own right. This is about fifty years behind in modern thinking but even in the West psychologists are often treated as second class citizens by the medical profession, who in the main actually fear a non-medical professional in their midst.
Counselling training in China is even worse. You can take a paid for course part-time over nine months, fake your supervised hours (supposed to be 500 – impossible for a new counselor in a nine month period) and pass a very easy government licensing test. Then you can go into business as a professional unsupervised counselor treating patients. In any Western country the training period is over years and is often rigorous in its testing and supervision and although I have contentions over the way we do the training in the West – as opposed to China which allows a situation where people are being treated by counselors with very little real experience, training or psychological knowledge. Most use the technique of Tea & Sympathy and have no knowledge of how empathy works in practice. Most counselors are also judgmental here – they tell the client what they should be doing according to social conventions and not what is in the best interest of the client. A little like Western psychiatry in peddling drugs rather than offering treatments.
The reader may find this over-view a little negative in presentation and is anything good happening in China for mental health. Well some places like Shanghai where there is a more Western influence and life style are accepting psychology more – but most want to be treated by a Western psychologist and not a Chinese one. They trust the Westerner to not be judgmental and have more modern ways of treating them. However Shanghai is not representative of China as a whole. Most of the population live and work in the countryside and small traditional industrialized towns. They still think and work as they have for 100 years and despite the Cultural Revolution in China many still have traditional attitudes to the mentally ill as shameful situations to be hidden and not talked about. The mad aunty is just locked in the backroom and fed; no one discusses her or talks about her outside the family. Hard to believe in this year of 2011 in a modern world but this is the situation that modern psychology in China has to overcome. Remember the average political leader in China is in his 70’s or older – they are the ones dictating policy often with little care or understanding of the mentally ill – another irony amongst the dementia in high places.
Psychology in China is 50 years behind the West in practice despite its popularity with the young as a major at Universities. On the surface the government talks about mental health but just like Western governments and spend the least amount of their annual budget on mental health support programmes. Another difficulty is the lack of senior experienced psychologist to lead the programmes anyway. Most professors in psychology departments did not even do a psychology degree themselves and teach out of Western textbooks with Chinese translations with very little depth to understanding the material and so set rote exams based on memory of the text rather than questions that test the application of the theories that the student studied. As in all education in China – you have well read students, know all the answers but cannot actually use this information in real life.
Professor Stephen F. Myler PhD (Psych) – February 2011
St. Michaels Hospital – Psychology Department – Shanghai
NOTE:This paper was a background document to support Bloomberg Publishing NY USA in its review of psychology in China. Copywrite: Dr. Stephen F. Myler – Shanghai