In public discourse, it is common for Western media and commentators to critique China for its treatment of people with mental illness. These critiques often portray Chinese policies as outdated, harsh, or authoritarian, citing practices such as institutionalization or lack of psychiatric reform. While some criticisms have merit, the repeated focus on China’s shortcomings in this domain serves a deeper, more uncomfortable function: deflection and projection. By highlighting another nation’s faults, Western societies avoid confronting the disturbing psychological consequences of their own cultural systems—particularly the emotional alienation, isolation, and judgment that shape the inner lives of their most vulnerable.

This dynamic is especially evident in the case of schizophrenia. A growing body of anthropological and psychiatric research reveals a stark difference in how schizophrenic individuals experience auditory hallucinations across cultures. In Western countries such as the United States, people with schizophrenia are more likely to hear negative, violent, or persecutory voices—voices that berate, insult, or threaten them. In contrast, studies conducted in countries like India and Ghana have shown that patients often hear voices that are more benign, playful, spiritual, or even helpful. These voices may come from deceased relatives, guiding spirits, or divine sources, and are often interpreted in a culturally integrated and meaningful way.

This contrast is not a trivial curiosity—it is a reflection of the emotional fabric of society. In Western cultures, especially in the United States, mental illness is heavily stigmatized. Hearing voices is medicalized as a pathological symptom, and those who experience it are quickly labeled as broken or dangerous. Western society’s deep emphasis on rationalism, productivity, and individual achievement leaves little room for vulnerability, and even less for inner chaos. When people internalize these values, the result is often a harsh internal critic that, in the context of schizophrenia, manifests as cruel and punishing hallucinations. The content of the voices becomes a mirror to the cultural psyche—lonely, anxious, hyper-critical, and unforgiving.

In many Eastern societies, by contrast, the experience of hearing voices is often interpreted through spiritual or relational frameworks. Whether it is the belief in ancestors communicating through the mind, or gods delivering moral correction, these interpretations reframe the experience as meaningful rather than pathological. While mental illness in Eastern societies is not free from stigma, the surrounding culture is generally more relational, collectivist, and spiritually integrative—qualities that may soften the intensity and content of psychotic experiences. The result is that hallucinations become less hostile, even in severe mental illness.

So when Westerners critique China—or any Eastern society—for being “harsh” on the mentally ill, what they often ignore is that Western culture is harsh within the mind. The cruelty is not just institutional; it is internalized. Western society breeds a kind of suffering that is invisible to the eye but excruciating to the psyche. And instead of reckoning with this, it becomes easier to point to other cultures and accuse them of being regressive. This is projection: attributing one’s own shadow to another.

Moreover, these criticisms are rarely rooted in a desire to understand or improve mental health across cultures. Instead, they serve to reinforce a narrative of Western moral superiority—a narrative that positions the West as the enlightened, humane force in a world of backward others. It is a story built not on truth, but on denial.

It is time to stop using China—or any other culture—as a mirror to flatter the Western ego. A society in which mentally ill individuals hear voices telling them to die, to kill, to give up, is not a society that should be boasting about its compassion. Instead, the West must turn inward and ask:

What kind of world have we built, if even our hallucinations hate us?