A tragic incident involving the stabbing of children at a kindergarten in Beijing this month is another symptom of China’s deepening social crisis.

On the morning of August 4, Xu Heping, who was casually employed as a gatekeeper, attacked 15 children and 3 staff in the nursery of Beijing University No. 1 Hospital with a kitchen knife. A four-year-old boy was killed. Two children and one teacher were seriously injured.

According to the China Daily newspaper, a school cook noticed that Xu had locked the gate to prevent the children from escaping and then heard screaming. Teachers tried to wrestle the knife from the gatekeeper, but he was not overpowered until eight police officers arrived.

A hospital security official told the press: “It was a miserable scene. There was fresh blood everywhere—on the faces of children, on the white working clothes of the teachers and on the floor.” Another witness said: “Blood was everywhere. The kids were lying on the ground.”

Most of the victims were children aged between four and five—the sons and daughters of hospital staff members. Many employees were in tears. A doctor whose child had escaped uninjured said: “It is so scary and horrible. [The attacker] must be a maniac. A rational person would never attack young kids.”

A Beijing city government spokesman told the media that the reason for the attack was unclear. The police later confirmed that Xu suffered from schizophrenia and had been treated for five months in 1999 at the Beijing Anding Hospital—one of the country’s few specialist psychiatric institutions.

According to school staff, the gatekeeper was 51 and had been employed at the nursery on a temporary basis over the past two years. He had shown no signs of mental instability or violence. A milkman told the press that nothing appeared unusual on the morning of the attack other than that Xu seemed unhappy and the gate was locked.

The incident provoked considerable public shock. China Central Television described it as “the worst attack on children in the capital in decades”. The state bureaucracy and media immediately attempted to find a scapegoat to deflect criticism and concern. Comment has focused on whether mental patients and their guardians could be held legally liable in such cases.

The state-run Legal Daily blamed the kindergarten that hired Xu, declaring it should have followed the Kindergarten Administrative Regulation, which bans the employment of “patients with chronic communicable diseases and mental illness”. As a result, schools across Beijing have held safety meetings and demanded staff and teachers provide medical records.

Other commentators speculated that the hot summer was responsible for triggering disorientation among mentally unstable individuals.

But apart from isolated media references to the fact that Xu may have been distraught with concern over his job, nothing has been reported about his background. Nor has there been any comment on the rising social tensions in China produced by growing levels of unemployment and poverty, or the lack of psychiatric care in China.

The fact that Xu was in poorly paid casual work is not unusual for his generation. Those who grew up during the period of the Cultural Revolution often missed out on formal education as a result of the turmoil. Now middle-aged, they find themselves the target of the savage free market restructuring of the 1990s that saw the destruction of millions of jobs in state-owned industries.

Unemployment also means the loss of any economic security, as state welfare programs are virtually non-existent. Under the previous so-called “iron rice bowl”, a job in a state-owned enterprise guaranteed life-long employment, free education, public housing, health care and a pension. With the turn to foreign investment and the market, all of that has been destroyed, creating mounting uncertainty, anxiety and stress among broad layers of people. As a result, mental illness, suicide and drug abuse are all on the rise.

Those who require medical assistance have few avenues. Free health care has been restructured along the commercial lines since the early 1990s. State-owned enterprises and other public units have largely axed their medical assistance for employees. In recent months, the Beijing bureaucracy has mooted the possibility of opening up the public hospital system to foreign investment and reducing government funding even further. For low-income families, the cost of treatment, particularly for chronic diseases, is often prohibitive.

The government has largely ignored the needs of psychiatric patients. There are only 22 “Ankang” or specialist psychiatric hospitals in the entire country. Professor Liu Xiehe explained to the China Youth Daily that even though there was a legal requirement for guardians to provide care for mental patients, it was hard to do in practice. Psychiatric illness was a “high cost” affair, he said, that could easily drag a family into poverty.

According to Xie Bin, a director of the Shanghai Mental Health Centre, 80 percent of mental patients lack proper treatment. Even in Guangdong Province, the most prosperous region in China, 93 percent of the 1.22 million cases categorised as serious received no effective and systematic treatment. In China, there is only one psychiatrist for more than 10,000 mental patients.

Xie warned that conditions were far worse in other parts of the country where the lack of facilities along with poverty forced many patients to drop their treatment. He warned the situation was becoming a social “time bomb” that would lead to more tragedies like the Beijing kindergarten killings. There have been several violent incidents in recent months involving former psychiatric patients. These include:

* On April 29, a former mental patient in the northwestern province of Gansu attacked 15 students and two farmers at a primary school with a knife.

* On May 23, in Guangzhou, a psychiatric patient Wang Hanyong stabbed a man, his sixth victim in just six months.

* On July 21, Chen Hao from the southern province of Fujin used a sharp knife to attack pedestrians and vehicles, and injured a soldier who attempted to stop him.

Not only is China’s mental health system totally inadequate but it is also subject to political abuse. Thousands of political dissidents including Falun Gong followers, protesters and worker activists have been consigned to the psychiatric hospitals for “reeducation”.

After the latest incident in Beijing, a discussion has suddenly emerged in the state-owned media over the need to implement a law drafted in 1985 providing legal protection and health care for psychiatric patients. Once public reaction has died down, however, the law will almost certainly be forgotten, as it has been for the past two decades. Official neglect combined with a worsening social breakdown will only produce further such tragedies in the future.