Most Shanghai residents know the address "600 South Wanping Road" by many names. Although it is the only top tier mental health hospital in Shanghai, only a few people really know the important role it plays in people’s lives.

However, during the COVID-19 pandemic last year, as mental health gained more and more attention, many residents contacted “the Shanghai Mental Health Center, hereinafter referred to as Jingwei Center, at 600 South Wanping Road” by calling its hotline and using its mobile app. Only then did they realize that it was neither mysterious nor isolated - it was a place for people with mental illness.

A graduate of Shanghai Medical University in 1987, Professor Xu Yifeng, the first professional doctor to devote himself to the diagnosis and treatment of mental illness, took the initiative to pursue postgraduate study in psychiatry before graduation. In 2011, he became the president of Jingwei Center. Under his leadership, being the largest and the most comprehensive mental health institution with the most advanced disciplines, Jingwei Center has been a leading hospital in the field of mental health.

In the comprehensive ranking of the best hospitals in China published by the Institute of Hospital Management of Fudan University, Jingwei Center had ranked second among psychiatric hospitals for 9 consecutive years from 2011 to 2019.  It also ranked second in the 2019 China Hospital Science and Technology Influence Ranking (Psychiatry) issued by the Chinese Academy of Medical Sciences.

The Road to Become a Doctor

Xu Yifeng is quite considerate of others. He once desired to live his life freely at sea. In 1981, Xu Yifeng participated in the college entrance exam. His first aspiration was Qingdao Ocean University (now China Ocean University). Xu Yifeng said with a smile, “If I hadn't followed my family’s tradition to practice medicine and changed my choice, I might still be floating at sea now.”

After three years of basic study and starting his clinical practice in the fourth year, he plunged into the research and study of general surgery. For this reason, he spent 60 yuan (very expensive at that time) on a book titled “Huang Jiasi Surgery” in 1985. For Xu Yifeng, the path to psychiatry was somewhat accidental. "The first department I worked in the hospital was general surgery, but then I discovered a fatal obstacle. I had ‘Steamer Head.’  I was very prone to sweating when I was in the operating room.  My eyeglasses quickly became blurry due to their poor quality.  This problem could not be resolved since there were no nurses to wipe clean my sweat since I was just an entry-level surgeon.  At that time, my roommate lent me a set of books on psychiatry, which opened my door to another world."

At that time, psychiatry in China was lagging, and it was not a promising career. It was the sense of social responsibility that made Xu Yifeng choose psychiatry as the direction of his postgraduate study.  He studied psychiatry at the Shanghai Medical College under the guidance of Professor Xu Taoyuan, the head of the department of psychiatry. After graduation, Xu Yifeng became more aware of what he really wanted to attain in the future.

Xu Yifeng knew very well that, in addition to a good growth environment and competitive atmosphere, an important factor in the cultivation of young doctors was to have a good mentor, who must be a master in the medical field.

Professor Xu Taoyuan graduated from Zhejiang Medical University around 1949.  He had comprehensive and profound knowledge of psychiatry and a solid academic foundation. According to Xu Yifeng’s recollection, Professor Xu Taoyuan’s nickname in the hospital was "Medical Encyclopedia". Whenever you asked him about something that you could not find in the library, he could even tell you the page number of the book where you could find the answers!

Xu Yifeng was profoundly influenced by Professor Xu Taoyuan during his graduate study. He was taught that to be a good psychiatrist, he should study and practice unceasingly. In 1996, the 33-year-old Xu Yifeng went abroad for the first time and was invited to the University of Melbourne, Australia. This experience gave him a good opportunity to learn more comprehensively and systematically.  He also gained a better understanding of research methods and gradually broadened his horizons.

In 1997, Xu Yifeng went to Harvard University Medical School as a visiting scholar, sponsored by the Freeman Foundation, to study social medicine and medical anthropology for one year. What is social medicine? What is medical anthropology? Why would a psychiatrist study them? Xu Yifeng replied with a smile, “In fact, my field of study was designated by the Freeman Foundation.” He studied intensively for three months to learn social medicine and medical anthropology before going abroad.

"I found social medicine and medical anthropology very interesting after understanding these subjects." Xu Yifeng says that clinical medicine has made us accustomed to treating patients as biological beings, but social medicine teaches us to also consider patients’ growth, living environment, social culture, and socioeconomic level.

After returning from Australia and the USA, Xu Yifeng not only brought back psychiatric diagnosis and treatment techniques, innovative diagnosis and treatment ideas, and new management and service concepts, but also improved his analytic and thinking ability. For example, after studying at Harvard University with Professor Arthur Kleinman, the winner of the Boas Prize, the highest award in Anthropology, Xu Yifeng changed his understanding of psychiatry. He gradually stepped out of the relatively narrow view of psychiatry and turned it into an all-encompassing purview.  He no longer looked at everything in the world in isolation nor treated patients or disease purely from a biological point of view.

This is exactly what many young doctors lack today. As someone who has had the same experience, Xu Yifeng reminds young doctors that they should not limit themselves to a very narrow field too early.  Instead, they should read books in addition to textbooks and interact with patients more often.

In hospital management, it is a common practice to promote accomplished doctors to administrative positions.  An expert in psychiatry, Xu Yifeng has his unique charms and advantages as the president of Jingwei Center.  In the past 34 years, he has advanced from an ordinary psychiatrist, chief of the Science and Education Department, and the dean of the medical department to the president of the hospital. Xu Yifeng has worked diligently and quietly in this special medical field for more than 30 years and published more than 100 SCI papers. Further, he has been cited more than 700 times internationally and achieved an H-Index of 25. Jingwei Center has also emerged from a mysterious "organization" to the largest first-class psychiatric hospital in China.

During the battle against SARS in 2003, Xu Yifeng was the first psychiatrist in Shanghai who treated patients in an infectious disease hospital. Because of that, he was honored as the "Outstanding Worker in the Shanghai Healthcare System in the Fight Against SARS". He was also awarded the third prize for the Shanghai Municipal Science and the Technology Progress Award in 2012, the designation of “Business Manager Trusted by Shanghai Employees” in 2012 and 2013, and the title of “Top Ten Leadership Experts for Promoting Industry Development” in 2017.  He was recognized as an "Excellent Mentor for Young Physicians in Shanghai" in 2018.  He was the third prize winner of the 2019 Shanghai Medical Science and Technology Progress Award and was honored as a "People's Good Doctor" in 2020.

Xu Yifeng can still vividly remember his experience as a doctor. However, time flies and more than 30 years have passed in a flash. Xu Yifeng, who has been the president of Jingwei Center for more than 10 years, has his own "psychological methods" for the management of the hospital.

Rehabilitate Mental Patients

The history of Jingwei Center can be traced back to the Puci Sanatorium opened in 1935. It was later renamed Shanghai Psychiatric Hospital and was in the Minhang district at that time. In 1958, Shanghai Institute of Mental Disease Prevention and Control was established and headquartered on South Wanping Road. In 1985, it officially changed its name to Shanghai Mental Health Center.

"Mental hospitals and mental health centers are quite different." President Xu Yifeng said. "Decades ago, mental hospitals were focused on treating patients with serious mental disorders. Patients were forced to receive treatment because their family believed that they had problems.”

With the increased awareness of mental illness and exposure to various schools of thoughts and ideas, the understanding of mental illness has been continuously updated and expanded. In summary, the focus has changed from merely treating individuals with mental illness to being mindful of the mental health of the general population.  This also truly reflects the progress of Jingwei Center over the past few decades.

In the 1980s, it was very difficult for patients with mental disorders to be hospitalized.  It was a difficulty faced by the Chinese psychiatric community. At that time, the Shanghai Institute of Mental Disease Prevention and Control (the original name of Jingwei Center) established mental illness prevention and treatment clinics in all districts and counties in Shanghai. The clinics later evolved into district mental health hospitals. Work therapy and rehabilitation centers were also established. As such, Shanghai gradually formed a three-tier prevention and treatment network for patients with mental disorders, extending the diagnosis and treatment from Jingwei Center to the entire city of Shanghai.

“At that time, due to their economic situation, many psychiatric patients were confined at home without timely treatment. Most of the neighbors were fearful of them and even discriminated against their family members,” said Xu Yifeng. “In the past, most patients were treated with medications. However, in fact, some disorders could not be alleviated with medicines since psychological and social factors could also cause mental illness. Therefore, the biological-psychological-social model for treating mental disorders began to replace the traditional biomedical model. In the 1990s, Jingwei Center established the Shanghai Psychological Counseling Center, which offered outpatient psychological counseling services and treatment. The counseling center also trained psychotherapists to care for the mental health of the public and established a mental health counseling hotline as a medical service brand."

With the acceleration of the pace of life and work, disorders such as psychological imbalances, emotional disorders, and neurasthenia have gradually become "social diseases." Data show that more than 100 million people in China suffer from mental disorders, of which over 16 million are severe.

Xu Yifeng says that from confinement, supervision, prevention, and treatment to humanized care, we have made efforts to rehabilitate mental patients to give them strength and confidence. We also spread this concept to the entire society.

Nowadays, people in the outpatient hall of Jingwei Center are greeted with a clean and tidy environment. Patients seek treatment in an orderly manner while pre-triage nurses interact with visitors with smiles and guide new patients to fill out their registration cards.  Patients and their family members who come for follow-ups and prescriptions are instructed to use their WeChat app to check their appointment number and skillfully operate the self-service machines. Usually, it only takes about 20 minutes for follow-up visits and to fill prescriptions, greatly reducing the time for medical treatment.

More and more people have realized the convenience of self-service medical care due to active and effective personnel management and successful publicity of online registration and appointment systems. Therefore, the climate for patients seeking medical treatment has been improved greatly. Xu Yifeng says that Jingwei Center always puts patients first, centers its services around them, and regards people's rights and interests as the focus of its work. Jingwei Center wants to provide the best service to patients, and it must think and do more for them.

Throughout his years as the president, Xu Yifeng has been well aware of the hardships of his career. "People with mental disorders are vulnerable.  Some of them are even abandoned by their families." He reveals that many mentally ill patients do not have relatives, jobs, or savings. Nurses not only shoulder the responsibility to observe and evaluate their illnesses, provide psychological care, perform “three examinations and eight verifications (verification不可数，是否可改为checkups）”, prevent accidents, rehabilitate, and train, but also take care of their daily living needs from head to toe. They understand the weaknesses of human nature, see joys and sorrows, and treat patients with more empathy.

Although there are more than 300 types of mental illness diagnostic codes, the percentage of patients with severe mental disorders remains stable at about 1%. However, the number of people suffering from mental illness in the broad sense is indeed increasing. Xu Yifeng says that this is obviously related to the faster pace of modern society, increased pressure, and social alienation. The number of outpatient visits at Jingwei Center is also increasing. In 2019, it became the first psychiatric hospital in the country to have received more than one million outpatient visits for the first time in history. After the pandemic, the number of visits during the month of March 2021 reached a record high of more than 98,000.

Analysis reveals that, in addition to natural growth, the increase can also be attributed to the dissemination of mental health knowledge and the public’s increasing tolerance and understanding of mental health issues. Of course, it is also related to the increasingly standardized international diagnostic standards.

The heritability of schizophrenia and bipolar disorder can be as high as about 80%. In other words, they can be passed on regardless of if there are environmental factors.  The treatment is mainly medication-based. On the other hand, the heritability of depression is only 40% as one’s environment has more impact than biological factors. Therefore, according to the "social-psychological-biological" model, social support and psychological intervention are more helpful for the functional recovery of mental patients. Due to this model, new occupations, such as psychotherapists, social workers, and occupational therapists, have emerged in the field of psychiatry. This provides comprehensive help for patients so that they can not only resume their previous social roles, such as leaders, teachers, husbands, and parents, but also truly return to society.

Continuous Innovation to Benefit More Patients

In recent years, the number of outpatient visits at Jingwei Center continues to rise. In 2019, the awareness of mental health disorders reached 76.7% in Shanghai, far higher than the national number of 50%. In 2014, Jingwei Center also completed the revision of the "Shanghai Mental Health Regulations" in cooperation with the local People's Congress. It is the spirit of innovative courage and continuous breakthrough that drives all the staff at Jingwei Center to accomplish all this.

Xu Yifeng explained that to optimize the layout of clinical departments and the functional positioning of the two hospital districts, Jingwei Center conducted an in-depth analysis and perfected, based on its location, size advantages, and its needs, the top-level design to create a psychiatric research hospital and a high-quality international hospital that is superior to other hospitals in all aspects. By building research-enabled wards and promoting comprehensive strategic cooperation with the Institute of Neurology, the Institute of Medicine at the Chinese Academy of Sciences, and the Zhangjiang Institute of Brain Intelligence Research, Jingwei Center further improved the development of the Shanghai Clinical Medical Research Center of Psychopathology and the Shanghai Engineering Technology Research Center of Intelligent Psychological Assessment and Intervention. It also further strengthened the development of subspecialties, the research of specialized diseases, clinical pathway management, and multi-disciplinary team services to improve its ability to diagnose and treat difficult and severe mental illnesses and to provide high-end services.

Since 2015, Jingwei Center has established three databases to store PACS images, clinical diagnosis and treatment records, and scientific research data.  It has cooperated with the Aridamo Academy to continuously develop the clinical diagnosis and treatment system to form a workflow-oriented hospital clinical work model.  It has also established physical rehabilitation and cognitive rehabilitation facilities in the geriatric department and then to the entire hospital. In 2017, the online service platform for safe medication and discharge follow-up was launched, further meeting the needs of discharged patients and their families to receive continued services.  Therefore, Jingwei Center has formed a preliminary integrated diagnosis and treatment model, providing patients with detailed, differentiated, and individualized diagnosis, treatment, rehabilitation, consulting services, and management.

As the leader of the hospital, Xu Yifeng stands on a broader stage and is driven by a sense of mission to fully capitalize his unique advantage of being a domain expert and serving as the chief operating officer.  He can fully play his role by integrating many aspects of his knowledge to reach a comprehensive and thorough understanding of the operations of the hospital. Along the way, he has formed his own unique ideas for the innovation of mental health.

“Establishing a strong hospital via research and teaching is a prerequisite for the comprehensive development of Jingwei Center, which is the country's largest first-class psychiatric hospital.” Xu Yifeng values scientific research and innovation. "With respect to the emerging technology of artificial intelligence, we have successfully applied our research in virtual reality to treat children with autism and have achieved positive results.  At the same time, we have also helped the development of the China Brain Program and the Shanghai Science and Technology Innovation Center.  We have also built two operating rooms that will be utilized to explore the use of functional physical regulation and brain chips to intervene and change the occurrence, development, and prognosis of mental disorders.  Hospital discipline bases will also be established and laid out with long-term goals to focus on international cutting-edge scientific topics. We have reasons to believe that soon, functional psychosurgery (psychosurgical) techniques will be used in psychiatric clinics to benefit more patients."

In recent years, the funding for research projects at Jingwei Center continues to rise.  The number of projects awarded at the national level and the number of SCI articles published continue to increase as well. The platform for the national major new drug research and the new psychotropic medicine clinical evaluation research technology have been funded by the Ministry of Science and Technology during the 11th to 13th Five-Year Plan. The Shanghai Primary Laboratory of Severe Mental Disease has also been established. All the above achievements demonstrate that Jingwei Center is creating a new path for the development of disciplines conforming to its own characteristics.

"Through hard work, continuous innovation, and trials of new treatment, the doctors at Jingwei Center are able to cure some patients with difficult and complex mental disorders. For doctors, this is their greatest joy and accomplishment," Xu Yifeng said with emotion. In addition, technology innovation helps improve the management of the hospital. In 2020, Jingwei Center’s electronic medical record system successfully passed the fifth level review, becoming the only psychiatric hospital in China to have received this recognition. The electronic medical record system can standardize doctors' work management and data transformation.

In addition, Jingwei Center has also developed a clinical pathway system and a prescription verification system to regulate doctors' diagnosis and treatment behavior and encourage reasonable use of medication. Further, it has also developed a quality control management system to perform real-time operational analysis and predict the number of outpatient visits and hospitalization so appropriate arrangements can be made in advance.

Striving to Establish a High-Quality Mental Health Platform（Field）with High Standards and Be a Pioneer

In June 2017, the State Council formally released the "Development Plan for Cities in the Yangtze River Delta". According to the plan, initiatives, such as promoting the cooperation of medical establishments in the Yangtze River Delta region, following medical reform policies by implementing a multi-tier diagnosis and treatment system, developing regional medical consortia, and expanding telemedicine cooperation platforms, present important opportunities and challenges for hospitals to seek innovative development in the future. Early planning will inevitably have a much bigger impact.

Mental health is a major public health and social problem which hinders economic and social development.  Improving mental health is an important part of furthering medical and health system reforms and maintaining and enhancing the physical and mental health of the public. In the new era, the main problem in the field of mental health lies in the imbalance and inadequacy between the needs of patients and the availability of medical resources. The establishment of Medical Consortia is an effective way to solve this problem.

Jingwei Center is a top-tier psychiatric hospital in Shanghai. It is responsible for mental health related medical treatment, teaching, rehabilitation, prevention, counseling, and academic exchanges in the city. It is obligated to establish a high-quality mental hospital with high standards. Since 1997, Jingwei Center has explored and established an alliance of various specialties to designate responsibilities of each hospital at different levels. The alliance has also perfected the multi-tier diagnosis and treatment system to optimally direct patients to the appropriate hospitals.  Jingwei Center has also made improvements in both service quality and efficiency by instituting professional service standards and optimizing discipline development strategies and differential development. Over the past 20 years, 12 psychiatric hospitals and 54 general hospital psychiatric departments from Shanghai and 13 provinces and autonomous regions in China have joined the alliance, benefiting millions of people.

Through an in-depth research on the current policy, development status, issues, and future development trends of the current medical consortia, especially the mental health consortium, on November 10, 2017, Xu Yifeng edited and published the first "China Mental Health Consortium Development Blueprint (2017 Edition).” It summarized the experience related to the development of medical consortia in the field of mental health and provided guidelines for its future. In 2019, "Guidelines for the Establishment and Development of Modern Psychiatric Hospital Management System," edited by Xu Yifeng, was published by the People's Medical Press. The book contained 580,000 words, and it was the first guideline published in China after the release of the "Guidelines of the General Office of the State Council on Establishing Modern Hospital Management Policies" in 2017.

Currently, Jingwei Center is actively applying to become a National Psychiatric Center. At the same time, in the first year of the 14th Five-Year plan, with the support of the Shanghai Municipal Government, 900 million yuan will be invested to build a comprehensive facility hosting the Shanghai Mental Health Severe Mental Disease Clinical Diagnosis and Treatment Center in the Minhang district. It will occupy more than 74,000 square meters and break ground in October. Jingwei Center has unprecedented development opportunities. Xu Yifeng says that in the future, Jingwei Center will continue to promote resource sharing with vision, high standards, and high self-disciplines. It will complement one another to improve medical care capability, teaching, research, and prevention in the region. Jingwei Center will take full advantage of being a top-tier hospital to lead the advancement of mental health.

"In this era of instant gratification, people may not have time for others. However, the people at Jingwei Center are born with the mission to help people. There is always a force pushing us to move forward!" Xu Yifeng frankly said that “Medical workers have to bear unacceptable burdens, but all our medical staff adhere to their original aspirations, inspired by truth and acceptance, and fight for the health of the people.”