A series of fatal attacks by the mentally ill have revealed flaws in China's social security system, especially its failure to provide adequate aid and care for the mentally ill.

A knife-wielding man broke into a local family planning office in Dongxing City in south China's Guangxi Zhuang Autonomous Region on Tuesday. He killed two government workers and injured four others.

Investigators found that the man had a history of mental illness.

The attack came just after a 50-year-old man stabbed four people with a kitchen knife at a Carrefour outlet in downtown Beijing, killing one of them, on Monday.

Police said the attacker had a history of mental illness and had been institutionalized for the four months leading up to January.

In a similar tragedy on July 17, two people, including a woman from the United States, were stabbed to death outside a shopping mall in Beijing's Chaoyang District. The killer, a 27-year-old man from east China's Shandong Province, was reportedly mentally ill, too.

The chain of assaults has sent the public into a panic about their own safety and prompted an outcry for adequate medication, help and care for the mentally ill.

Lack of medical resources

China had more than 100 million people with some form of mental disorder in 2009, including 16 million people with severe mental illnesses, according to the latest available figures from the Chinese Center for Disease Control and Prevention.

"If not treated properly, 20 percent of these patients with severe conditions are prone to attacking others or harming themselves," said Sun Jian, the head of a psychiatric hospital in Jinan, capital of Shandong Province.

Of the 16 million severe cases, 70 percent were never institutionalized for proper treatment, he said, citing shortages of medical resources as the major cause.

"Shandong Province, for example, has less than 2,000 registered psychiatrists, far too few compared with the number of severe cases, which is estimated at about 1 million," he said.

Li Yingcun, one of six recent graduates from Shandong University's psychiatric department, works at Sun's hospital. "Few medical students readily choose to be a psychiatrist, as the job is tiring, risky but poorly paid."

In addition to a shortage of doctors, the province also lacks medical facilities for people with mental illnesses.

Altogether, 144 hospitals in Shandong Province can treat the mentally ill, and they have a total of 15,000 beds for those patients, said Wang Yanhu, chief of prevention and treatment at Shandong Mental Health Center.

It is far from enough to ensure adequate in-patient treatment for all mentally ill patients in the province, he said. "The resources are also unevenly distributed, with more hospitals in cities and very few in rural areas."

Even China's capital, Beijing, is home to about 150,000 people with mental problems and only about 6,000 hospital beds for them.

Seeking aid

China's mental health law, which took effect in May, requires custodians and institutions to take responsibility for mentally ill patients in their charge. "But it didn't say what consequences they have to face if they fail to do so," said Wang.

The law says that people with mental problems, except those with severe mental illnesses and those who have the potential to cause harm to themselves or others, should receive inpatient treatment on a purely voluntary basis.

It also requires medical institutions to respect a patient's right to be discharged.

"But in some cases, patients with severe mental illnesses are not institutionalized in time and can potentially harm themselves and others," said Wang.

Lu Chuanhua, head of Shandong Provincial Mental Health Center, cited high medical costs as another factor hindering many patients from receiving adequate treatment. "A national survey showed that 57 percent of people with mental illnesses live below the poverty line and their families often cannot afford to pay their medical bills."

Lu said the government should allocate special funds to cover their medical expenses during institutionalization, as well as their rehabilitation at home.

"Local governments, in particular, should provide aid to ensure that patients with severe conditions are properly treated and taken care of," he said.

In the wake of the fatal assaults, Beijing's health bureau is working with other city government agencies on a community-based rehabilitation scheme that covers long-term medication and nursing care for patients who are not institutionalized.

"The new scheme will hopefully be announced before the end of this year," a Beijing health official said on condition of anonymity.

It is unclear how much Beijing will spend on the new scheme.