By Lyric Li
How do you prove your sanity, when your spouse can send you to a psychiatric ward against your will?
A report this week about a married couple, both of whom were involuntarily admitted to psychiatric wards by the other, has sparked a debate on Chinese social media about how mental health is treated in the country.
Chinese Business View, a newspaper in the central city of Xi'an, reported on Tuesday that a woman surnamed Wang said she had been "tranquilized" and "dragged" away by five men who claimed to be medical staff at a private hospital, where she was Tasered, straitjacketed, forced to take medication and undergo electroconvulsive therapy in February.
"I tried to explain to the doctors that I was not sick, again and again, but no one would listen to me," Wang told local media, adding that she had never been diagnosed with mental illness.
Wang was only released on the third night after friends tracked her down.
"What they did to me was unlawful imprisonment," she said, adding that the experience was "traumatising."
Her husband, who was not named in media reports, admitted to having her committed.
He also accused her of having him involuntarily committed him in October 2022, when he was left in a ward for 80 days and had no visitors due to Covid restrictions.
The husband had received various diagnoses - including depression, anxiety, bipolar disorder and schizophrenia - at four hospitals.
Both husband and wife had presented, as evidence, videos of what seemed to be domestic abuse or violence.
Under China's mental health law, patients must pose a risk of harm to themselves or others to be involuntarily admitted to hospital.
While local authorities confirmed that these cases happened, no action was taken.
A police investigation found no foul play, while the hospitals denied wrongdoing, according to reports.
An official said that Wang's treatment was "in compliance with regulations," and that she could file a lawsuit if she disagreed.
The Washington Post could not independently verify the story with the patients.
The case has ignited heated online discussions about mental health and toxic relationships.
"Who on earth is sick: the couple or the current system?" Huang Xuetao, a human rights lawyer who has advocated for reforming China's mental disability law, said in an interview with Chinese Business View.
"This absurd case of a couple acting as guardians and sending each other to psychiatric hospitals" should be discussed by the authorities, she wrote.
"Who's the ill one?" has become both a viral comment and news headline.
A hashtag roughly translated as "health commission confirms couple sends each other to mental hospitals" has gotten 63 million views on the Chinese microblogging platform Weibo in the two days since the news broke.
A newsreel by the Orient Today newspaper, featuring phone interviews with the couple and local health officials, was viewed more than 1.6 million times within 24 hours.
Many voiced concerns over the lack of scrutiny and protections in mental health treatment, especially since patients can be committed involuntarily, although a diagnosis is supposed to be required if a spouse wants to do so.
One user on Weibo, a woman from Liaoning province, wrote "This is a horror story: humans will never be able to convince everyone that we don't have mental illnesses."
Chen Bin, a current affairs commentator, wrote in the Southern Weekend newspaper that psychiatric treatment could become "weaponised" and "get messy" when hospitals put profits over ethics.
He added that the case was getting attention "not only because it is dramatic, but also because it has triggered people's greatest fear."
It is "not that rare" for patients to be forced to undergo treatment in China, said Zhao Liangshan, a partner at the Xi'an-based Shaanxi Hengda Law Firm who specializes in marital and business disputes.
Zhao said by telephone that "neither party has the right to forcibly commit" their spouse to a psychiatric hospital without an official diagnosis.
However, "there is a risk that some people take advantage of systemic loopholes in psychiatric treatment and use their guardianship privileges to infringe on the rights of their closest family members."
Some Chinese institutions can grant "guardianship" to family members even before the patient is formally diagnosed with severe mental disorder.
This is similar to conservatorship in the United States, a status that allowed Britney Spears's father almost total control over the pop star's personal life and finances for 13 years as she publicly struggled with her mental health.
China's 2013 mental health law had "a limited effect" in reducing the use of coercive practices, scholars noted.
More than 70% of hospital psychiatric admissions are involuntary, the researchers estimated based on a small study of 10 818 patients, a number that has not declined in a decade.
An estimated 243 million adults in China have mental health disorders, with 12 million of them severely impaired, according to 2017 figures from the National Health Commission.
Nearly a third of counties and districts have no psychiatric inpatient capacity, and over a tenth have no psychiatric institutions at all, according to a study published in the Chinese Journal of Psychiatry.
Psychiatrists worry that a high-profile case like this will do more harm than good in destigmatizing mental disorders.
Chen Minjie, who manages the outpatient psychiatry department at the private Psybene Clinic in Shenzhen, said by telephone that the sensationalizing of such an "absurd" case could bring added social stigma to patients with mental health issues.
"There are many people out there who have been hesitating whether to get medical help, but when the 'psycho asylum' image of psychiatric hospitals is amplified by social media, they may most probably decide against going," he said.