Most patients are unwilling to take depot medications so their

use in outpatient settings is somewhat less than in the West (the most commonly used depot medications are haloperidol decanoate and fluphenazine decanoate). Nonadherence is even more of a problem in China than in the West; very few patients remain on medication for more than 1 year after an initial Inhibitors,research,lifescience,medical admission. As part of the new reform era (that started in 1978), hospitals in China have been forced to become economically self-sufficient; the state is no longer willing to pay for services that arc not profitable. This change has decreased the willingness of hospital administrators to expend personnel and resources to provide cost-effective (but n unprofitable) community services. Prior to the mid-1980s most psychiatric hospitals provided extensive outreach (“home-bed”) services to Inhibitors,research,lifescience,medical help schizophrenic patients avert hospitalization, but the need to become economically self-sufficient has forced hospitals to cut back on services that reduce GSK-3 inhibitor hospitalization rates. Similarly, family therapy for schizophrenia47,48

and group psych oeducati on for relatives of schizophrenic patients49 Inhibitors,research,lifescience,medical are cost-effective ways of reducing rehospitalization in China, but psychiatric hospitals (the only source of the personnel who could provide these services) are reluctant to employ family therapy methods in their outpatient departments because this change would reduce overall hospital revenues. Inhibitors,research,lifescience,medical Community-based services Social welfare services for disabled persons in China experienced a renaissance during the 1980s, largely initiated and sustained

by the efforts of the All China Disabled Persons’ Federation under the direction Inhibitors,research,lifescience,medical of Deng Pufang, Deng Xiaoping’s disabled son. A comprehensive range of legislation during this period recognized the extent of the problem of the disabled in the country, established the rights of the disabled and the responsibility of the state to provide for their care and employment, and set out a plan for their rehabilitation. As part of Megestrol Acetate this movement, psychiatric rehabilitation was transformed from a low-status activity limited to “industrial therapy” for chronically institutionalized patients to a high status activity that provided mental health professionals with access to funding and support that were not previously available.50 In the absence of a culture-specific theory of psychiatric rehabilitation, the indigenous models that evolved over this period were based on vague notions about the benefits of repetitive practice and social support; they involved collective activities rather than individualized assessment and skills-training.