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    Mental Health Used to Be a Taboo in China. That’s Changing Fast.

    The COVID-19 pandemic has sparked unprecedented discussion of mental health issues in China. In 2021, those conversations started driving real changes.

    SHANGHAI — In 2021, China’s most talked-about new gallery wasn’t based in Beijing’s trendy 798 Art District or in the laid-back southwestern city of Chengdu. It was inside a Shanghai mental hospital.

    The No. 600 Gallery — a small space in the Shanghai Mental Health Center’s (SMHC) downtown facility — opened its doors to the public in August. It began with a tiny budget; its first exhibition showcased a collection of abstract works produced by the hospital’s inpatients.

    But the project unexpectedly became a viral sensation. The COVID-19 pandemic has triggered a profound shift in China’s attitude toward mental health issues, as millions struggle to process a massive collective trauma. 

    Though the virus has killed relatively few people in China thanks to the country’s “COVID-zero” strategy, the initial outbreak in early 2020 caused deep public anxiety. A nationwide survey conducted at the height of the crisis found that nearly 35% of respondents were experiencing psychological distress.

    Anxiety and depression, long considered taboo subjects in China, suddenly became topics of frequent discussion on social media. And that has been a game-changer for Chinese professionals, campaigners, and policymakers involved with mental health-related projects.

    The launch of the No. 600 Gallery showed how dramatic this change has been. Several national media outlets, including the state-run Xinhua News Agency, covered the event, and it generated a massive online response. A related hashtag received over 73 million views on China’s Twitter-like social platform Weibo. 

    It was just one of many landmarks for mental health in China this year, as society’s greater openness started to have dramatic, real-world effects. Once all-but-invisible on stage and screen, 2021 saw the release of a spate of productions exploring mental illness. 

    The Chinese TV drama “Psychologist” enjoyed breakout success after proudly advertising itself as the country’s first show focusing on psychological counseling. “Next to Normal,” the Broadway musical about a mother struggling with bipolar disorder, was staged at major venues in Shanghai, Beijing, and Guangzhou for the first time. And the documentary “Rollercoaster Riders” shone a light on the lives of the estimated 7 million people living with bipolar disorder in China.

    The project that made the biggest splash, however, was another art exhibition. In May, an event titled “Anti-Body Shaming” opened at a gallery in Shanghai, displaying a range of artworks by young people affected by eating disorders.

    There has been an alarming rise in the prevalence of eating disorders in China — especially among girls and young women — in recent years, but public awareness of the disease remains low. Parents often dismiss children with eating disorders as “abnormal” or lacking “self-discipline,” experts say, and the vast majority of patients are unable to access specialist treatment.

    “Anti-Body Shaming,” however, brought the issue unprecedented attention. Hailed as the first event of its kind in China, the exhibition caused a sensation on social media, with a related Weibo hashtag being viewed nearly 100 million times. It proved to be so popular, the organizers doubled its initial run time to two months. 

    “As a medium for raising awareness of social and psychological problems, I think the exhibition has exceeded my expectations,” Zhang Qinwen, curator of “Anti-Body Shaming,” tells Sixth Tone.

    In June, Zhang held a press conference with staff from the SMHC, where they announced the creation of China’s first toll-free hotline for people with eating disorders. The project has now been in operation for nearly six months.

    “It means that people in second- and third-tier cities and those without access to medical services can get help and advice free of charge,” says Zhang.

    The Chinese government had already started to focus on mental health policy before the pandemic, adding promoting the nation’s mental health to its “Healthy China 2030” strategy in 2019. But these efforts appeared to intensify in 2021, amid rising concerns over the psychological toll caused by the pandemic and the country’s social “involution,” or intensifying, cut-throat competition.

    Chinese authorities introduced several sweeping measures aiming to improve children's mental health in particular, after a report by an institute under the Chinese Academy of Sciences estimated that nearly 25% of the country’s teenagers are living with some form of depression.

    In July, the Ministry of Education issued a notice stressing the need to “vigorously cultivate students’ positive psychological condition” and improve schools’ provision of psychological counseling services. Last month, the government released new school curriculum guidelines that require schools to ensure that students can “proactively deal with mental health problems during adolescence” and “identify and prevent psychological problems such as anxiety and depression.”

    For the SMHC, one of China’s leading psychiatric hospitals, these changes are opening up new possibilities that would have been unthinkable just a few years ago. Shanghainese used to avoid the hospital at No. 600, South Wanping Road, like the plague. Qiao Ying, the center’s deputy chief psychiatrist, says her parents would conceal the fact she worked there, instead telling friends that their daughter was a “psychological consultant.”

    Now, the center’s reputation has transformed. When it released a brand of mooncakes — a traditional festive snack — bearing the SMHC logo in the fall, they quickly went viral on social media. Qiao has been slightly taken aback by the turnaround but also considers it natural given recent events.

    “In today’s fast-paced society, almost everyone will encounter mental health problems,” says Qiao. “The pandemic has made us all really see how important mental health is to us.”

    After the success of its inaugural exhibition, the SMHC partnered with a local mental health nonprofit to put on a second, more ambitious event at the No. 600 Gallery in November. The new show — titled “Blue Dreams” — is themed around bipolar disorder and depression, and includes works by 10 artists, most of whom are affected by the conditions themselves.

    Studies show that people with bipolar disorder are twice as likely to attempt to kill themselves as those with major depressive disorder, but the condition is not well-understood among the Chinese public. “Blue Dreams” aims to change that by allowing visitors to communicate directly with the artists. Each collection is fitted with two QR codes: one that allows visitors to view a video of the artist introducing their work and a second that enables them to leave a text message for the artist.

    “We hope the viewers can see through the artworks to understand the artists living with affective disorders,” says Chen Zhimin, a therapist at SMHC and the curator of the exhibition.

    Art therapy has become a well-established method for treating people with mood disorders in the West, and the approach is now beginning to gain popularity among Chinese mental health professionals. Chen admits that it’s hard for most psychiatrists to read the inner worlds of their patients.

    “We usually just observe their symptoms and give them pills that target those symptoms — like target shooting — and that’s it,” Chen tells Sixth Tone. “Art offers psychiatrists a special way to understand more about their patients.”

    Walking down a corridor inside No. 600 Gallery, Chen stops at a collection titled “My Emotions and Myself” by an artist named Kim. He remarks that, based on his clinical experience, he can infer a lot about the artist’s mental state based on the works.

    “His creations contain quite a few characteristic elements: bright colors, fluid strokes done in a rather quick fashion,” says Chen. “It indicates that he could have been experiencing emotional highs while creating the pieces.”

    However, Chen stresses that the SMHC doesn’t view art merely as a therapeutic tool; it’s also a way for people with affective disorders to express themselves as individuals.

    “In psychiatry, art shouldn’t be limited to a means of rehabilitation, but should also be a form of pure artistic expression,” he says.

    Several artists who participated in “Blue Dreams” echo this view. Manson Pan, an artist who was diagnosed with bipolar disorder two years ago, said in his video message at the exhibition that he was grateful for his manic and depressive episodes, as sometimes “sick states” can be more artistically inspiring.

    “On the other hand, if you can’t draw, there’s no outlet for your emotions in many difficult situations,” he added.

    Chen Mengyuan — another curator of “Blue Dreams” who isn’t related to Chen Zhimin — tells Sixth Tone that giving artists like Pan a public platform could have a powerful influence on perceptions of mental disorders in China. She has been trying to organize art exhibitions highlighting mental health issues for several years, but it’s only now that these events are attracting widespread attention, she says.

    “An exhibition of artists discussing and representing their emotional disorders is important as a way for the general public to know more about this group,” says Chen Mengyuan.

    Next year, the No. 600 Gallery aims to build on its success by organizing more public events, with tentative plans for exhibitions focused on eating disorders and schizophrenia. Chen Mengyuan says she’s also interested in exploring mental health issues through other media, including film, theater, literature, and participatory workshops. 

    Inside the gallery, Zeng Jiahui, a Shanghai-based psychiatry student, slowly browses the artworks. It’s not easy for someone who has never experienced a mood disorder to understand people living with conditions like depression, she says, but she feels like the art is helping her achieve a form of empathy.

    “Looking at these paintings, we can feel their worlds collapsing,” Zeng says. “They need to be understood, respected, and supported.”

    Editor: Dominic Morgan.

    (Header image: People browse the artworks at the exhibition “Blue Dreams” at the No. 600 Gallery, in Shanghai, Nov. 18, 2021. People Visual)