The World Health Organization (WHO) reports that about 54 million people in the People’s Republic of China have depression and about 41 million have anxiety disorders. The psychiatrist-population ratio is at 1.49 to 100,000. This article discusses the obstacles and the plans to improve mental health in China.

COVID-19’s Impact

During the COVID-19 outbreak, China’s National Health Commission mobilized mental health workers and increased the volume of services. The Commission produced guidelines on mental health care protocols to curb psychosocial effects arising from the pandemic. The interventions included outreach programs by psychiatrists and other professionals. Additionally, hotline services offer psychological support to patients and survivors as well as affected families and health care workers alike. The most commonly reported psychiatric conditions associated with the outbreak are depression, PTSD and anxiety disorders.

A nationwide survey of people during the COVID-19 lockdown found that 16.5% had depressive symptoms, 28.8% had anxiety symptoms and 8.1% had stress symptoms. Nevertheless, 71.5% of respondents reported satisfaction with the health information provided during the outbreak. The highest psychological impact was felt by women, students and those facing physical symptoms. During the lockdowns, psychiatric patients experienced more intense symptoms such as anger outbursts, insomnia and suicidal ideation.

Alcohol and Tobacco Use Disorders

In China, people traditionally consume alcohol during social functions and holidays. Over time, however, the WHO noted a rise in regular alcohol consumption and a subsequent impact on mental health, including alcohol dependence and alcohol use disorders (AUDs). A Beijing study showed that 2.4% of people with alcohol dependence were treated overall with only 1.4% receiving treatment from mental health professionals. Further research in China pointed to the need for early intervention in treating alcohol disorders. The WHO recommended educating both the public and health care workers on the importance of seeking mental health treatment for such issues.

Tobacco smoking also negatively impacts mental health in China. With more than 300 million cigarette smokers, China has the highest number of tobacco users in the world. The WHO partnered with the Chinese Government to control tobacco consumption and thereby reduce diseases and premature deaths arising from exposure to the harmful chemicals in cigarettes. The WHO also launched an initiative to curb tobacco dependence by training health care workers and providing informational guidelines to tobacco users.

Promoting Mental Health in China

China needs reforms in its health care delivery system. The 2016 Policy on Building High-Quality and Value-Based Service Delivery details such reforms, aiming to move from a hospital-centered approach to a people-centered one that canvases both rural and urban areas. These changes call for a multi-tiered health care delivery system that strengthens primary care. China’s new delivery system aims to better monitor such quality of care, specifically by improving integrative management practices, building a strong health care workforce and investing in community health. Additionally, the nation has made progress in attaining universal health coverage according to the U.N. 2030 Agenda for Sustainable Development.

At the Global Conference on Health in 2016 in Shanghai, China, stakeholders emphasized the need for the global community to improve mental health in China and across the world. Because the majority of Chinese people live in urban areas, many would benefit from interventions such as people-centered urban design, “greening” and recreational spaces. To further promote mental health, China also aims to treat 30% of people with depression by 2022 and 80% by 2030.

To prevent AUDs, the WHO recommends that China strengthen policies that regulate alcohol commerce and increase education about safe alcohol consumption. In line with the WHO’s Framework Convention on Tobacco Control, China enacted a law that banned tobacco smoking in indoor public spaces and the mass media advertising of cigarettes. In a social media campaign dubbed #RUFREE, China supported smoke-free spaces while altogether decreasing tobacco use and curbing associated disorders.  Hopefully, China will continue to take steps to improve the mental and physical health of its citizens.

– Beth Warūgūrū Hinga
Photo: Flickr