"Follow soap operas and chase celebrities as you wish" and"increase the sense of ritual in life and awaken your soul" are somesayings made popular during the pandemic by Xie Bin, secretary of the partycommittee of the Shanghai Mental Health Center (hereinafter referred to as the"Shanghai Jingwei Center").
NO. 600 Wanping South Road, Shanghai, isthe location of the Shanghai Jingwei Center. Xie Bin's down-to-earth remarks atthe municipal government's press conferences brought a lot of comfort andwarmth to people. They also earned him the title of "Prince Charming ofNo. 600" on the Internet. As a big shot psychologist easing the public’sanxiety during the pandemic, he is not only an idol but also a true power.
Chief psychiatrist, graduate studentadvisor, academic leader, one of the 100 youth committee members selected fromamong the world's outstanding young psychiatrists by the World Congress ofPsychiatry, authoritative mental illness forensic expert, co-author of thefirst "Mental Health Law of the People's Republic of China”, and a popularpsychology mogul, none of these titles can encompass Xie Bin's medicalachievements.. As a "slash" doctor, he is full of boundless love andpassion for work. One breakthrough after another, he contributes to thedevelopment of mental health in China.
Journeyto being a Doctor
Xie Bin said his path to practice inmedicine was conventional except for his somewhat dramatic transition fromorthopedics to psychiatry (from external to internal). It was this"transition" that changed the course of his life forever.
Xie Bin was born in Sichuan province.Although he has worked in Shanghai for many years, Xie still spoke with astrong Chuanpu (Sichuan Mandarin) accent during the interview. During his erawhere information was lacking, there were few opportunities for choices. Afterthe College Entrance Examination in 1981, Xie Bin, with the advice of hishomeroom teacher and the support from his family, decided to attend medicalschool.
After graduating from university, being awestern medical doctor, Xie was “imported” into the local traditional Chinesemedicine hospital and worked in the orthopedics department. The hospital wasnot well-equipped then. One time, when a patient needed oxygen, he and a fewyoung doctors carried the oxygen cylinder into the ward. Accidentally, thecylinder fell to the ground and hit his right hand, causing severe damage tohis middle and ring fingers.
For an orthopedic surgeon, flexible fingersare essential to perform surgical procedures. He asked himself: “How can Iperform surgeries in the future?” Withthat doubt in mind, he switched to internal medicine. Many years has since passed, and Xie sayswith a smile that those scarred fingers are still not that flexible.
"In the 1980s, Freud's psychoanalysistheory was introduced in China and had a great influence on our generation, soI chose psychiatry for my postgraduate study. To my surprise, it turned out tobe such a profound and interesting field." During his undergraduate study,Xie Bin had already developed a strong interest in psychiatry and read a lot ofbooks about the field in his spare time.
Xie recalled that every time he followedthe senior physician during ward rounds, he was always pleasantly surprised."This is an unprecedented experience. Unlike orthopedics who go straightto the wound and fractured line, psychiatrists actually observe a person. Theyinquire about the person’s medical history, often starting from his/her familyhistory. Through casual conversations, psychiatrists slowly unfold the person’scourse of life, growth environment, family situation, and even the entiresocial environment to analyze his/her mental state."
However, despite heartfelt fondness, hisrationality came into play. He feltthat, as a modern medicine discipline, psychiatry cannot be without science orrigor. When he was a graduate student at Shanghai Second Medical University,Xie studied under Professor Zheng Zhanpei, an expert in forensic psychiatry inChina, and therefore decided to embark on the path of combining law andpsychiatry.
It was after the promulgation of China’sCriminal Law that Professor Zheng Zhanpei became a forensic evaluator. He hasaccumulated a wealth of experience in forensic psychiatry through his longcareer. He participated in manydifficult cases and was appointed as a technical expert of the Supreme People'sCourt. Zheng, along with other experts, traveled throughout the country andcontributed to maintaining the rigidness of China's laws and the safety of thesociety.
Under the careful cultivation of ZhengZhanpei, Xie Bin, his only graduate student, has become a famous scholar in thefield of forensic psychiatry in China. In Zheng's own words, "I can smilein my grave."
After completing his graduate study, XieBin started working at the Jingwei Center to practice psychiatry. In the maleward, female ward, geriatric ward, special needs ward, and forensic evaluationsuite of the Jingwei Center, Xie Bin has gradually flourished from a residentto a chief physician, specializing in the diagnosis and treatment ofdepressions, sleep disorders, mental disorders in the elderly, and personalitydisorders (including adolescent conduct problems and violent and aggressivebehaviors).
Due to his outstanding professional abilityand skills, Xie Bin was identified by the hospital as a candidate for leadingkey disciplines in 1999. In 2000, he was among the initial list of 50 "NewStars of Medical Garden" named by Shanghai Municipal Health Bureau.Further, in 2004, he was named the "Shanghai Excellent Medical Garden NewStar”.
Meanwhile, Xie Bin began to engage inforensic psychiatry. At that time, it was not mainstream. The public hadsubjective views and mysterious prejudices against it. The discipline itself was not supported dueto its lack of objective scrutiny and standards. Therefore, it was considered by the societyto be quite different. It was a lonesomeoccupation. Results from forensics were often questioned, leading to frequentrepeated work.
Since he had chosen the path of forensicscience, Xie Bin was determined to march on. He started as an observer andparticipant and later became the chief evaluator. Eventually, he became thedirector of the forensic division of the Shanghai Mental Health Center,managing and leading the entire team. Under his leadership, forensic sciencebecame a key discipline of the Shanghai health system. His division wasrecognized as a model unit for innovation as well as the principle forensicpsychiatric unit of Shanghai Association of Forensic Science.
"Seeing" the Truth of Cases bySolid Professional Knowledge
In Sherlock,Sherlock said to Watson: "You only see but don’t see through.” The same is true for Xie Bin, a master forensic psychiatrist. He can always uncoverinformation that is not “seen through” in things by people who can only “see”.
Eight years ago, there was a violent crimeagainst a doctor. The police commissioned a forensic psychiatric evaluation.The result suggested that the attacker suffered from paranoid schizophrenia andtherefore bore no responsibility for the crime. However, the victim refused toaccept this. The local judicial department requested Xie Bin to conduct a newevaluation.
Xie Bin and his team spent up to 2 monthsporing over all the case files from the crime scene, case filing, arrest, toprosecution as well as all the relevant materials used in the previousevaluation. They also went to the local area to interview relatives and friendswho had been in close contact with the attacker as well as the medical staff ofthe hospital where the incident occurred, to learn about the attacker’s truestmental state before and after the incident.
Through this effort, Xie Bin determinedthat the attacker suffered from paranoid mental disorder. He explains that although paranoid mentaldisorder has the same symptoms of delusion as schizophrenia, the delusionalcontent of the former is close to real life. It is its core or only symptom.Mental activities and behavior other than delusions remain relatively normal.On the other hand, delusions associated with schizophrenia are absurd andbizarre. At the same time, they come with psychotic symptoms, such as confusionin logical thinking and hallucinations. Mental activities of those who haveschizophrenia are generally abnormal.
In the end, Xie Bin determined thatalthough the attacker was affected by the disorder and his/her motivation forcommitting the crime deviated from the reality, the attacker didn’t completelylose the ability to identify and control his/her behavior. Therefore, theattacker should bear certain responsibilities for the crime. On the day of thetrial, Xie Bin testified in court as an expert witness. His well-foundedevaluation was accepted by both the prosecution and defense.
Xie Bin explains that forensic psychiatry is aninterdisciplinary field of psychiatry and law. Based on the standards prescribed by the state and the necessaryassessment tools and equipment, a forensicpsychiatrist performs mentalevaluations to comprehensively assess the mental state and legal capacity ofthe person being evaluated. The assessment is to be used as evidence in legalproceedings.
Since the judicial sentencing of mentalpatients is very different from that of normal people, psychiatric evaluations must be done scientifically and with caution so as not to wrong amentally ill person who cannot control his/her own behavior or allow criminalsto escape legal sanctions.
Forensic psychiatry is perceived in manyways by today’s society. Some people feel that it is a "golden pass"for criminals to evade legal consequences. Others believe that it is quitesubjective and unscientific, causing many criminals “to become mentallyill."
In the face of these negative sentiments insociety, Xie Bin believes that the main reason is the unbalanced development ofthe discipline itself as well as the lack of understanding of the professionaland scientific nature of forensic psychiatry. Xie Bin has his own standards andmission for forensic psychiatry.
He believes that a very importantprerequisite for forensic evaluation is that the forensic psychiatrist musthave very rich clinical experience "because forensic psychiatry is basedon clinical psychiatry. To be a good forensic psychiatrist, a solid clinicalfoundation is a must." However, it is not enough to just have richclinical experience. Forensic psychiatry, compared to clinical diagnosis andtreatment of mental illness, has different methodologies, thinking styles, andapproaches.
"Different from clinical practiceswhere it is assumed that a patient is sick, a forensic psychiatrist assumesthat the person being evaluated is normal. This presumption is to be overturnedthrough professional assessments. Xie Bin states: "We not only look at theprogression of a case. More importantly, we should look at history. We combthrough the relationship spider web emitting from the person being evaluated atthe center and study his/her behaviors before and after the incident involvedand the interconnection and confirmation of these clues to restore his/hermental state at the time of an incident.”
Since Xie Bin became the director of theForensic Institute of Shanghai Mental Health Center, the institute handles 300to 400 cases each year. So far there have not been any mistakes orcontroversies. He strives to follow standards and be pragmatic and professionalin all the cases involved. Because of this, Xie Bin and his team of expertshave a clear conscience. They can always calmly face unimaginable difficulties,doubts, setbacks, and criticisms.
As the head of the Shanghai Association ofForensic Science and the Forensic Psychiatric Professional Committee, he alsopromotes the standardization of procedures and techniques of the profession. Hesays: “Only by continuously improving the quality can we ensure the fairness,accuracy, and authority of forensic psychiatry."
Thanks to his solid working style and professionalacademic knowledge, Xie Bin has become a leader in the field of forensicpsychiatry in Shanghai. He has presided over forensic psychiatric evaluationsof several major criminal and civil cases across the country. He has also beenappointed as an expert member of the Ministry of Justice and forensic expert ofthe Supreme People's Court.
In 2012, due to his high-quality forensicpsychiatric work related to major cases assigned by the state, Xie Bin wasselected as one of the “Top Ten Model Workers of the Shanghai JudicialAdministration System” and awarded a third-class medal. In 2013, he wasidentified as an “Exceptional Individual of Shanghai Forensic Science.”
To improve the scientific nature offorensic psychiatry, Xie Bin tirelessly engages in the research and developmentof forensic psychiatry. He led the research group to study "Violence Riskand Legal Responsibility Assessment of Mental Patients", a project of thenational “Twelfth Five-Year" scientific and technological support plan,etc. They conducted research and development of a series of forensicquantitative tools and won the second and third prizes of the Shanghai Scienceand Technology Progress Award. His "Sexual Self-Defense Ability" and"Criminal Responsibility for Violent Crimes" assessments have beenwidely used across the country.
In 2014, Xie Bin's research, “A System andMethod for Assessing Criminal Responsibilities,” won the Excellence inInvention Gold Medal in Shanghai. His Forensic Psychiatric division was alsonamed "Shanghai Health System Innovation Model Work Unit".
Legislation and Amendment – Always“Work-in-Progress”
Xie Bin frankly said that at present, thepublic still discriminates against people with mental disorders and regardsthem as "marginalized people" or "ticking time bombs insociety". Mentally distressed people often feel ashamed of their illness.As a doctor, Xie Bin has always cared about the rights and protections of thisspecial group of people.
"According to research data at homeand abroad, the ratio of violent crimes among people with mental disorders isnot higher than that of the general population. Further, most mental illnessescan be cured." Xie Bin believes that as members of society, they should betreated equally.
Due to his rich clinical and forensicexperience, since 1999, Xie Bin has been actively involved in mental healthrelated legislations in Mainland China. He strives to fully protect the rightsand interests of people with mental disorders through legislations.
From preventing false proclamations ofmental disorder to developing mental health services to protect the legalrights of people with mental disorders, and from mental illness prevention andrehabilitation to public safety and compulsory treatment, the Chinese mental healthlaw, bearing attention and expectations, strives to solve many difficultproblems.
Xie knows only too well the unimaginabledifficulties and obstacles in drafting and introducing a national law. However,he has not retreated. Xie firmly believes that only by persisting and notgiving up can he bring light to the "marginalized people of society".
Mental health policies and legislations donot simply establish or lead to an ideal system. They should also provide practical,operational solutions. Around 2011, at its most critical point, China’s mentalhealth legislation drew a tremendous amount of attention with respect to itspurpose and related provisions. As such, it generated many controversies andhad given rise to a lot of opinions as well.
Therefore, Xie Bin traveled around thecountry to vigorously explain the main content of the mental health law andstandardized services to mental health professionals. On the other hand, heappealed to society through the media to pay attention to the legislative goalsof protecting the mentally ill and promoting the development of mental healthservices. At the same time, he provided amendment suggestions and referencematerials to the legislative branch via multiple channels. All of these haveplayed an important role in further perfecting the mental health law.
In October 2012, the 29th session of the 11th Standing Committee of the National People's Congress passed the Mental HealthLaw of the People's Republic of China. It was subsequently formally implementedon May 1, 2013.
The Mental Health Law has faltered alongthe way. As one of the primary drafters of this law, Xie Bin is pleased withthe result of the law since its implementation seven years ago. At the sametime, he is also concerned about the medical treatment and assistance systemfor people with mental disorders and the operation of hospitals specialized inmental health.
A gratifying change is that the protectionof the legal rights and interests of people with mental disorders is graduallybecoming a social consensus. The social trend of respecting their legal rightsand interests is forming. With increased government and social investment, themental health service system is being perfected continuously and the quality ofservice is experiencing steady improvement. The notion that services shouldfollow standards and law is taking shape.
"The implementation of the law hasmobilized society. Consequently, people have started to pay attention to thosewith mental disorders. Discrimination against them has decreased." Seeingthese results, Xie Bin finds satisfaction in his heart and feels that all hisefforts are worthy.
Of course, admittedly, it is impossible fora newly introduced law to solve all the problems accumulated over the years.Xie Bin believes that, due to the lack of necessary supporting regulations andthe unbalanced development in different regions, patients with mental illnessexperience regional differences in services and protections. In other words,the enforcement of the law needs to be more "forceful."
In addition, this very law, resulted frommore than 20 years of cultivation, basically outlines regulations surroundingthe process from diagnosis and treatment to rehabilitation of patients withmental illness. Its provisions on mental health services as well as healtheducation and promotion are relatively weak. Xie is currently working onsupplementing the law in these areas.
In addition to the mental health law, XieBin was also a main contributor of the Shanghai Municipal Mental HealthRegulations, China's first local mental health law. Since its implementation inApril 2002, Xie has been working non-stop on the publicity and training of thelaw as well as drafting its supporting standard documents.
In 2013, the Shanghai People's Congress andGovernment launched the initiative to revise mental health regulations. Xie leda team of experts and explored innovative approaches without violating higherlaws. He said: “Law is rigid and lags behind practice in which certain flexibilityis desirable to accommodate for exceptions. The work of legislations andamendments along with enacting supplementary supporting documents is a long andarduous process. We are always on this “work-in-progress” journey.
In November 2014, the revised ShanghaiMunicipal Mental Health Regulations were officially approved by the StandingCommittee of the Shanghai Municipal People's Congress. The definition of theservice system, the management of the psychological counseling industry as wellas involuntary follow-up services in the community, the refinement of theprocedures for the diagnosis, and the treatment of mental disorders are thehighlights of this law.
He led the effort to complete the followingprojects commissioned by the National Health Commission: “Research on theStaffing Standard of Mental Health Professional Organizations,” “Study on theOrganization and Efficiency of Mental Health Services,” “Study on theManagement and Operation of Mental Health Professional Organizations,”“Research on the Training of Mental Health (Psychological Therapy)Professionals,” and “Research on the Countermeasures for Resolving ProblemsDuring the Implementation of the Mental Health Law.” These projects providedtechnical foundations for the formulation of mental health policies andregulations.
Xie Bin said, “Participating in research,debate, lobbying, and strategizing of policies and regulations can be quiteexhaustive and often fruitless. It does not help one's academic career either.Sometimes I feel lonely and depressed, but as long as there is one thinggetting done at the end, I am still satisfied.” His enthusiasm towards work iswhat motivates him to participate in every step of the legislative work.
EscortingPublic's Mental Health
In addition to doing a lot of work inforensic psychiatry and promoting mental health legislations, Xie Bin currentlyis also the head of the Shanghai Center for Mental Disease Control andPrevention, vice chairperson of Chinese Association for Mental Health, andchairperson of the Mental Health Branch of the Chinese Preventive MedicineAssociation. He has devoted a lot of effort to educate the public on theprevention and treatment of mental illness.
Although China's mental health servicesystem has made some progress in recent years, due to China's rapid economicand social development as well as changes in family structure, it still facesmajor challenges.
For example, the increase in lifeexpectancy and the one-child policy that has been implemented for many yearsgive rise to severe challenges brought on by an aging population in China.Consequently, changes in family structures could seriously impact the mentalhealth of the elderly, teenagers, adolescent,and working professionals.
OnFebruary 22, 2019, the "Blue Book of Mental Health," jointlypublished by the Chinese Academy of SciencesInstitute of Psychology and the Social Sciences Academic Press, revealedthat 88% of those surveyed felt that mental health work was very important, andnearly 50% of them believed that people in today’s society had serious mentalproblems.
The demand for mental health services hasbeen increasing year by year. They require specialized knowledge,professionals, and a standardized service system. In recent years, Xie Bin hasbeen busy calling for more effort in filling two major “voids.” Specifically,the need to train mental health service professionals and enhance technicalstandards to meet the growing demand for health services. As of now, Shanghaihas made many exemplary achievements in public mental health promotions andestablishments.
According to Xie Bin, the Shanghai JingweiCenter has been improving its mental health service system and its talent poolin recent years. It has set up a psychological assistance hotline as a publicwelfare service to strengthen mental health services for key groups such asminors, the disabled, and the elderly. Through continuous exploration andoptimization, it has gradually built a psychological service team composed ofhospital and social volunteers.
The Shanghai Jingwei Center has created avariety of organizations and services, such as the "Mind Mirror Home"Patient Friendship Association, the "Mind Post" Advisory, the"Heart and Lung Health” Hotline, community consultation services and seminars,psychological counseling services for minors, and one-stop comprehensiveservices. The center has become known for its large-scale volunteer activities,such as Learn from Lei Feng and New Stars in Medical Garden free clinics.
Before major public emergencies occur,timely and professional psychological crisis intervention and mental healthscience are the "spiritual masks" to put on people to enhance theirmental immunity.
In response to COVID-19, the ShanghaiJingwei Center quickly launched a 24-hour pandemic assistance hotline and anAPP for self-assessment of emotions related to COVID-19. It also opened anInternet rapid consultation platform and cloud-based services on its officialWeChat account to provide mental health and psychological support for the localresidents. Medical staff and volunteers use their knowledge and love topromptly implement psychological crisis intervention. They also follow up withthe high-risk population and provide continuous psychological consultation.
Xie Bin himself was also actively involvedin the psychological counseling work and public education effort during thepandemic. He was invited to attend multiple press conferences organized by theShanghai Municipal Government and made resonating speeches, knownas "Xie’s golden phrases" and became popular instantly
In response to the special needs of thepublic with respect to psychological problems during the pandemic, Xie Bin andhis team wrote and published the book "Professor Xie Bin Helps You toOvercome COVID-19 - 70 Heartfelt Words and New Wishes." The book usesXie’s style to express profound knowledge in an easy-to-understand manner,which both cautioned and comforted people.
His down-to-earth explanation of sciencegreatly alleviated the anxiety of the public during the time of panic andisolation. He was quickly dubbed as "Prince Charming of No. 600" bynetizens. "Afterwards, I thought about the reason as to why my words werefrequently searched on the internet. It was because they concurred with theoverall emotion and concern of the public at that time." Xie said:"So when doctors try to explain science to the public, they’d better firstconsider the public’s mental state and focus on what concerns them, thenexplain in plain and simple words.”
Xie Bin feels, being an ordinarypsychiatrist, he has merely worked with his colleagues to do his best toprovide psychological counseling work during the pandemic. United we conquer,divided we fall. Although the pandemic has eased at this moment, the work of preventionand control cannot be relaxed at all. Xie and his team are still quietlyfulfilling their responsibility of “respecting life and willing to sacrifice”and “escorting” public’s mental health.
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