A migrant worker with a history of mental illness stabbed four neighbors to death and left five others injured during a bloody rampage in a remote village in Hubei province.

Police confiscated a 2-m long farm tool from a man who killed four and injured five with the weapon on Monday in Xinzhou district, Wuhan, Hubei province. Police say the man has a long history of mental illness.

The 27-year-old man, Li Zhongquan, from Qiligang village, Xinzhou district of Wuhan city, is in police custody after Monday morning's attack, police said.

Li is accused of beginning his killing spree at about 11:45 am, when he took a farm tool, a two-meter carrying pole with sharp iron blades on both ends, and rushed out of the house shouting "I want revenge", local newspaper Wuhan Evening News reported.

Cao Zhenjiao, a 76-year-old woman, was washing vegetables at a pond when she was stabbed in the neck. She fell into the pond and drowned.

Li then allegedly stabbed two seven-year-old boys, Mei Jie and Mei Lang. The two children died after arriving at hospital.

Xiao Guifeng, a 59-year-old woman having lunch at home, was the next one killed.

Li then stabbed 60-year-old women Wang Hezhen and Bao Jiao'e, and 59-year-old woman Wang Xiongying.

The next two victims were a mother and son. The mother, Li Xianying, was standing at the door of the house. He stabbed her in the neck and then found her son, Li Xiaotao, having lunch in the house and stabbed him, the report said.

Police then arrived and controlled Li. He is believed to be mentally ill and will undergo a health assessment.

Li, a migrant worker who had returned to the village on Sunday, had a history of "intermittent insanity" but had been acting normally in the months leading up to attack, the report said.

His mother left home when he was a child and he had been living with his father.

A woman from Xinzhou hospital told China Daily: "We received the patients yesterday and some of them have been transferred to other bigger hospitals in Wuhan."

"It is a big case and a lot of officials of the district came here yesterday."

When contacted, local police said: "We are trying to investigate and there is not much to say about it yet ."

Without commenting specifically on this incident, a Ministry of Health official said more than 56 million patients with varied mental illnesses in China have not received any treatment. Only a quarter of patients with serious mental disorders are hospitalized.

Low awareness of the disease and economic strain are the major causes for the situation, said Wang Gaohua of the mental illness research center of the People's Hospital affiliated with Wuhan University.

A lot of patients' family members simply deny someone in the family is suffering from an ailment as that makes them feel ashamed, he said.

"And patients seldom stick to the treatment, which usually lasts a long time," he said.

Mental illness covers a wide range of conditions, from depression to schizophrenia. Mental illness accounts for 20 percent of all diseases in the country and has become a serious threat to public health and stability, with the rate expected to rise to 25 percent by 2020, according to the Ministry of Health.

Many experts have called for national legislation on mental diseases to assure timely, appropriate and affordable medical intervention.

Latest figures show there are 11 hospital beds and less than two psychiatrists for every 100,000 patients, far below the world's average of more than 43 beds and nearly four doctors for the same number of patients.

The country's health budget last year was 5.5 percent of gross domestic product, while the investment in mental health services took up 2.3 percent of the health budget in 2008.

(China Daily July 1, 2009)