Psychiatric Quarterly

, Volume 89, Issue 3, pp 757–763 | Cite as

Long-Term Outcomes of Unlocking Chinese Patients with Severe Mental Illness

  • Yun-Shu Zhang
  • Ke-Qing Li
  • Jian-Hua Sun
  • Wei Li
  • Zhi-Hua Tong
  • Bao-Ping Yan
  • Gabor S. Ungvari
  • Chee H. Ng
  • Yu-Tao Xiang
Original Paper


In 2006, the “unlocking program” was implemented in Hebei province, China to promote the human rights for people with severe mental illness who were physically restrained at home. We assessed the long term outcomes of the “unlocking program” following the provision of hospital and community psychiatric care over 10 years and explored their associated factors. A total of 107 patients with severe mental illness who were “unlocked” in the program were included. Outcome measures were collected with standardized rating scales at 2 separate time points in August 2012 and November 2016. Poor outcome was defined either as being relocked, or missing to follow up or death. In 2012, 36 patients (33.6%) had poor outcomes. Poor outcome was positively associated with follow-up length and less caregiver burden at baseline. By 2016, 53 patients (49.5%) were found to have poor outcomes. There was only a trend of positive association between poor outcome and less caregiver burden at baseline. Poor long-term outcomes were common in patients with severe mental illness following the “unlocking program”. Evidence-based treatment strategies and mental health services to improve the outcomes and protect the human rights of patients subjected to being locked in the community are urgently needed.


China Outcome Severe mental illness Unlocking 



This study was funded by the Health and Family Planning Commission Hebei Province, in China.

Compliance with Ethical Standards

Conflict of Interest

All authors have no conflicts of interest to declare.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Sleep MedicineHebei Psychiatric HospitalBaodingChina
  2. 2.University of Notre Dame Australia / Marian Centre & Graylands HospitalPerthAustralia
  3. 3.Department of PsychiatryUniversity of MelbourneMelbourneAustralia
  4. 4.Unit of Psychiatry, Faculty of Health SciencesUniversity of MacauMacauChina

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