Responding to a double stabbing that resulted in the deaths of two women at a Hong Kong shopping mall on June 2, 2023, Chief Executive John Lee Ka-chiu (李家超) has promised improvements to mental health care in the city. Without scrutiny from the outside world, what happens next may serve as yet another repressive tool.
To be “mentally illed,” an awkward and illogical-sounding phrase in English, makes perfect sense in the Mandarin of mainland China, where the boundary between policing, security and psychiatric hospitals has a history of porosity stretching back decades. It refers to the practice of detaining healthy people in treatment facilities, often coincidental to their having exercised the right to freedom of expression or otherwise displeased the Chinese Communist Party.
Dong Yaoqiong (董瑤瓊), aka Ink Girl, is a case in point: She was committed to a psychiatric hospital after defacing a portrait of Xi Jinping in Shanghai and live-streaming her protest in July 2018, an act that was mimicked across the world. Her sectioning catalyzed a chain of hurt, culminating in the death of her father in prison and the jailing of activist Ou Biaofeng (歐彪峰).
Then there is Li Tiantian (李田田), a primary school teacher in Hunan, who found herself institutionalized in a mental health facility in December 2021 after expressing support for former Shanghai Aurora College lecturer Song Gengyi (宋庚一), herself the victim of political persecution. To some degree, Li may have been shielded from worse consequences by a national and international outcry.
More recently, towards the end of 2023, another lecturer, Wu Yanan (吳亞楠), was detained at Tianjin Sheng’an Hospital in the wake of her outspoken social media posts in relation to Nankai University’s treatment of students participating in White Paper protests against China’s COVID-19 policies. Reports describe her hiding in the hospital toilets, begging for help to evade being drugged.
Other examples in China are numerous, including among supporters of the Hong Kong pro-democracy movement, which suggests that Lee’s promised mental health reforms of increased policing and an unspecified “more comprehensive” approach could easily be targeted towards political opponents. Indeed, programs to “de-radicalize” imprisoned protesters in Hong Kong are currently taking a distinctly psychological turn. In March 2021, a link was established between application of the infamous National Security Law and mental health institutions in the city when high-profile activist Andy Li (李宇軒) disappeared into the maximum security Siu Lam Psychiatric Centre.
It would be naive to believe this trend will not continue. The convenience of psychiatric care as a facade for political repression is likely to prove tempting to those who rule Hong Kong: People can be held indefinitely without trial. Contact with the outside world is strictly controlled. Dissenters are stigmatized; the act of dissent itself is framed as a sickness. Discharge can be accompanied with conditions on place of residence, curfews and the forfeit of financial independence. Forced administration of medicine — another commonly alleged abuse of human rights in China — comes with the package. And, as a deterrent to protest, it can arguably be more effective than a prison sentence. Misdiagnosing a person as mentally ill may even become a self-fulfilling prophecy due to the stress and humiliation in some cases as well, constituting a full-circle crime that covers its own tracks.
Tapping into the repressive latency may not be difficult: Lee has the right under Hong Kong’s Mental Health Ordinance to appoint both the superintendents of mental hospitals and the supervisory visitors who report on patients and conditions. He can transform any Hong Kong property into a hospital for the purposes of detention, custody, treatment and care of mentally disordered persons, too.
What is more, concerns have been previously raised in the legal profession about the ease with which a person can be compulsorily admitted for psychiatric treatment and administered mind-altering drugs. Only the opinion of a registered medical practitioner is required, countersigned by a judge or magistrate, whose role is apparently confined to examining whether procedure has been followed, rather than analyzing the details of why a person is being detained. In any case, judicial independence is no longer universal in Hong Kong, and several media outlets, which once upon a time may have reported on any politicized diagnoses, are either shuttered or facing an unsafe operating environment.
While this is not to say that Lee’s reforms will certainly result in new forms of persecution and an important discussion on community care for people with mental health conditions has been ignited, the potential for misuse of the medical system cannot be denied. Moreover, Hong Kong displays a pattern of exploiting justified public concerns to advance state apparatus for the restriction of human rights.
The attempts to bring in the extradition law that sparked huge demonstrations in 2019 emerged from the murder of a pregnant woman by her boyfriend in Taiwan. COVID-19 offered a seemingly reasonable excuse to prevent mass gatherings in 2020 and a timely opportunity to pass new, draconian legislation without vast backlash on the streets. Now, a tragic double killing could present a fresh moment in which systems can be reconfigured to insulate Hong Kong rulers from the voices of citizens even further.
Pushback against policies that respond improperly to proper issues is inherently complex, further raising the danger in a city where any comment on the decisions of authorities can be misconstrued. What do you do with people who ask awkward questions about the design and implementation of mental health care? You might place them in a medical facility themselves.
Image: Dean Hochman, CC BY 2.0
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