Mental health challenges raised by rapid economic and social transformations in China: a systematic review

Abstract

BackgroundWith the largest proportion of world's total population, the mental health pandemic in China and related challenges of treating mental disorders could influence the accomplishment of UN Sustainable Development Goals, which include mental health. Therefore, understanding China's current mental health status after rapid economic and social transformations, including urbanisation, industrialisation, globalisation and informatisation, could strengthen awareness of mental health, and aid the proposal of solutions to prevent and control mental disorders. MethodsWe did a systematic search of the literature using PubMed, Embase, PsycINFO, CNKI, and Wanfang databases to find relevant studies published between Jan 1, 1990, and Dec 31, 2018. Articles in English and Chinese were included. The search terms included “urbanisation”, “industrialisation”, “globalisation”, “informatisation”, “mental disorders[MeSH Term]” and “China”. FindingsDuring the past three decades, both the disease and economic burden of mental disorders have increased in China. Rapid urbanisation and industrialisation have resulted in increasing internal migration and left-behind families, who have poorer mental health status than their peers. The ageing population will lead to higher prevalence of mental and neurological disorders, such as depression and dementia. Adoption of unhealthy diets can directly affect mental health, as well as indirectly by facilitating intermediate risk factors such as obesity. Increased alcohol intake and smoking can induce increased alcohol and nicotine dependence, and even illicit drug abuse. Additionally, internet and social media use can not only increase internet or gaming addiction, but also facilitate exposure and delivery channels via the internet. The growth of urbanisation and manufactories has also increased air, light, and noise pollution that can further induce mental problems. InterpretationSocial and economic transformations have triggered increasing disease and economic burden of mental disorders. We propose three priorities to deal with these challenges: identify social and economic effects on mental health on the basis of high-quality qualitative and quantitative analysis, improve mental health awareness and literacy, and enhance the mental health-care system and promote implementation research. Lessons from China can be a great reference for low-and-middle-income countries (LMICs) and upper-middle-income countries in prevention and control mental disorders. FundingNational Natural Science Foundation of China.