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When I first visited Beijing, China in 2007, I was confronted for the first time with the unintended byproduct of China’s rapid transition to a market economy and subsequent explosive economic growth. This byproduct was the breakdown of China’s healthcare services, which was highly conspicuous judging by the number of mentally and physically disabled persons visible on the streets of Beijing at the time. Because of this experience I became very personally invested in international social problems. In summer 2011 I found myself back on the ground in Beijing, except this time I was conducting research on a project entitled “Community Inclusion for People with Mental Disabilities” through the Penn Undergraduate Research Mentoring (PURM) program with my faculty mentor, Irene Wong.
An especially neglected area of health care in China is that of mental health. Due to the development of a “fee-for-service” system for general and mental health care and skyrocketing costs (phenomena that should sound very familiar to the American ear) only the people who can afford to pay out of pocket can receive services. Additionally, more than 85% of private insurance plans in China don’t cover psychiatric disorders. Even when individuals can pay for services there simply are no mental health services available in many areas of the country, resulting in a huge unmet need for treatment. Compounding the problem is the fact that there is no legislation in China guarding the rights of people with mental disabilities, meaning that access to services cannot be guaranteed. The nation is painstakingly realizing the extent of the problem after several high-profile crimes involving the under-served, severely mentally ill.
This summer was mostly devoted to gaining the adequate background information to design our project. This stage has involved a two-week trip to China, where we attended an International Social Work conference and visited various facilities for people with psychiatric or developmental disabilities. We additionally networked extensively with professors at Chinese universities in order to discuss the possibility of collaborating on an observational research study. Since returning to the U.S. we have been focused on reviewing the existing literature with the aim of writing the research proposal. Because mental health care is at the juncture of health care and social work, the background research has been highly interdisciplinary and has allowed me to come away with an enhanced understanding of Chinese culture, society, and politics. As a Political Science major I was encouraged to study the policymaking and service delivery processes in China. For me, it has been particularly interesting to learn how public opinion affects policymaking in a non-democratic system. This has also been a lesson in approaching research with realism: Not all research proposals receive grant funding; not all attempts to create academic partnerships, especially international academic partnerships, bear fruit; and conducting international research means facing the risk that foreign governments will not approve of your research plan and will preclude you from conducting your project.
With these challenges in mind, we created a tentative research plan by the end of the summer. Our research design will fill a literature gap on how individuals with mental illness are integrated into their communities. For example, do their social networks reflect the adequate size and diversity of roles that one might expect from a similar, non-disabled peer? Do they utilize resources or services outside of their home? Do they consider themselves to be members of the community? Given what we know about the inadequacy of services for people with mental disabilities in China, we would hypothesize that this is not true for most individuals, but assessing the specific needs of individuals will better help governmental and non-governmental organizations alike to understand what the greatest outstanding needs are and how to deliver services in a more effective way.