Mental Health Care In China Research Articles

Adoption of Digital Healthcare Interventions and Innovations in Reducing Mental Health Stigma: A Perspective on (COVID)-19

Objectives: During the COVID-19 pandemic, Chinese people with mental health difficulties faced a major issue of mental health stigma. The pandemic's constant stress and social isolation intensified the stigma attached to people suffering from mental illnesses. To address this issue, a study was done in China to investigate mental health stigma in the context of digital media arts. Methods: The study involves randomly distributing 1300 questionnaires on a 5-point Likert scale. Only 500 questionnaires, however, were found adequate for data analysis using partial least squares (PLS). Results: Digital health innovation and adoption are crucial for enhancing mental health. The study's focus was confined to the adoption of innovation in mental healthcare in China because this sector received less attention in previous research that sought to establish a link between digital health innovation and digital mental healthcare. Conclusion: The study has important theoretical and practical implications for improving people's lives by strengthening their mental health systems with digital technologies and raising awareness of digital healthcare tools. The findings are important for policymakers to make people aware of the importance of caring for their mental health by digital healthcare tools.

Formal versus informal pathways to mental health care in China

ABSTRACT The reported 20% prevalence rate of diagnosable mental illnesses in China might be underestimated due to individuals’ hesitation to report mental health problems. This study tested whether a person’s mental health diagnosis would lead to endorsement and preference for professional care. A community-based survey was conducted in Shanghai, China (n = 466). A structural model showed that 68.8% of the respondents endorsed professional help. Male respondents had a lower endorsement rate for individuals diagnosed with substance use compared to PTSD, suicide, or schizophrenia. Female respondents showed a higher endorsement rate on formal care for schizophrenia compared to PTSD or depression. In the models between health and mental health care, 34% of the respondents endorsed health care, whereas 46% of the respondents endorsed mental health care, with helping-seeking attitudes and age being significant covariates. In China, resources allocated to public education may improve acceptance of professional pathways to mental health care.

Risk factors for violent behaviors in patients with schizophrenia: 2-year follow-up study in primary mental health care in China.

The consequences and impact of violent behavior in schizophrenia are often serious, and identification of risk factors is of great importance to achieve early identification and effective management. This follow-up study sampled adult patients with schizophrenia in primary mental health care in a rural area of southern China, in which 491 participants completed a comprehensive questionnaire at baseline and the 2-year follow-up. Sociodemographic, clinical and psychological assessment data were collected from all participants. Paired sample T-Tests and the McNemar Test were performed to examine changes over the follow-up period. Generalized Estimating Equations (GEE) were used to analyze the risk factors for violent behavior. The results showed that about two in five community-dwelling patients with schizophrenia reported violent behavior in the past year. At follow-up, participants were significantly less employed, had more times of hospitalization, more psychotropic medication, and severer depressive symptoms, but had better health-related quality of life than at baseline. Use of clozapine and better insight into medication decreased the possibility of violent behavior, while more severe positive symptoms, insomnia, as well as use of second-generation antipsychotics other than clozapine, antidepressants and mood stabilizers increased the possibility of violent behavior. Risk evaluation, prevention and management of violence in patients with schizophrenia are demanded in primary mental health care.

Prevalence of and Factors Associated with Negative Psychological Symptoms among Elderly Widows Living Alone in a Chinese Remote Sample: A Cross-Sectional Study

(1) Background: Research indicates that most elderly widows are at a high risk of experiencing negative psychological symptoms. It is common for elderly women in rural and remote areas to live alone without family support to cope with stress due to the mass rural-to-urban migration of China’s youth labor force. Such a situation further worsens their psychological health and well-being. However, the prevalence of and risk factors associated with negative psychological symptoms (loneliness, depression, and anxiety) among remote elderly widows living alone in China are currently unclear; (2) Methods: A cross-sectional study was conducted in Hunan Province, China. The loneliness was assessed through the University of California at Los Angeles Loneliness Scale (ULS-8). The depression and anxiety were assessed with the Short Form Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7), respectively. The Chi-square test and correlation analysis were conducted to identify factors associated with negative psychological symptoms. Logistic regression was performed to predict risk and protective factors contributing to loneliness, depression, and anxiety symptoms. The significance level was set as p < 0.05; (3) Results: A total of 271 remote elderly widows living alone were enrolled in the present study. Additionally, 234 valid questionnaires were returned (valid response rate = 86.3%). The prevalence of loneliness, depression and anxiety was 8.1%, 44.0%, and 16.7%, respectively. Acute or chronic medical conditions, marital happiness, being the primary caregiver before widowhood and anticipating the death of the spouse differed significantly in the distribution of negative psychological symptoms. Logistic regression analysis predicted that participants who were satisfied with their marriage had a lower likelihood to experience loneliness, depression, and anxiety (p < 0.05). Being the spouse’s primary caregiver before widowhood was more likely to have symptoms of loneliness (p < 0.01). Those with various acute or chronic medical conditions were more likely to suffer from depression (p < 0.01); (4) Conclusions: Remote elderly widows living alone in China are prone to loneliness, depression, and anxiety symptoms. Being the primary caregiver before widowhood and having many acute or chronic medical conditions are risk factors for loneliness and depression, respectively. Marital happiness is the protective factor against negative psychological symptoms. To accomplish the goal of equitable access to mental health care in China, evidence-based policy and resource development to support psycho-social interventions that prevent and manage negative psychological symptoms for remote elderly widows living alone are urgently needed.

Mobile Health Applications for Depression in China: A Systematic Review.

Mobile health (mHealth) applications (apps) have the potential to increase access to mental health care. In China, there is growing interest in mHealth apps for depression. Our objective was to systematically review research on mHealth for depression in China to identify benefits and challenges.A systematic literature search was conducted using Chinese and English databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized and nonrandomized clinical studies on mHealth apps and depression in China were included. Study quality was assessed using the Cochrane Risk of Bias tool.Seven studies met the inclusion criteria with three randomized trials, two quasi-randomized trials, one clinical trial with an uncertain grouping method, and one study with a single-group design. All studies used the WeChat platform and included activities such as psychoeducation, self-management, supervised group chats, and/or remote contact with a healthcare team, in comparison to usual care. All studies reported significant and large benefits for outcomes, but the risk of bias was high.There are few rigorous evaluations of mHealth apps for depression in China, with all included studies involving WeChat programs and most using WeChat to extend nursing discharge care for inpatients with depression. While these studies showed significant improvement in health outcomes as compared to usual care, the results remain inconclusive because of the high risk of bias. mHealth holds promise for increasing access to mental health care in China, but issues such as efficacy, scalability, patient and clinician acceptability, and data privacy must be addressed.

The state of mental health care in China.

Over the past few years there have been considerable changes in China's mental health service system. This review provides an overview of the development of mental health services in China, including epidemiological data on psychiatric disorders, utilisation of mental health services, models of mental health service delivery, mental health resources and workforce, mental health policy framework and financial issues. We consider cultural and social factors including the involvement of family members in patient care, urbanisation and internal migration as well as the application of traditional Chinese medicine, which provides implications for mental health research and practice. Additionally, we also discuss major challenges and conclude by providing some specific recommendations on improving mental health services in China.

Mobile Mental Health Apps in China: Systematic App Store Search.

BackgroundSmartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health.ObjectiveThe purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018.MethodsA systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated.ResultsOf the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps.ConclusionsMany apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

Coronavirus epidemic and geriatric mental healthcare in China: how a coordinated response by professional organizations helped older adults during an unprecedented crisis.

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Changing of Chinese psychiatrists' attitudes toward consent process to treatment and its association with the China's National Mental Health Law.

Few studies have addressed informed consent in Chinese psychiatric practice. We wished to explore psychiatrists' attitudes toward informed consent in Shanghai after promulgation of the first national law for mental health care in China: the National Mental Health Law. A total of 398 psychiatrists were recruited from seven psychiatric hospitals in Shanghai. Their anthropometric data were collected. A confidential, self-report questionnaire addressing attitudes toward the informed consent process was completed by all participants. Most respondents would like to inform patients/guardians of the diagnosis (95.2%), treatment plan (93.5%), treatment goals and potential adverse effects of prescribed medications (94.7%), and alternative treatment plans (71.9%). In addition, 58.4% of psychiatrists thought that the informed consent process for physical restraint was difficult to follow. According to logistic regression, psychiatrists not trained to use the National Mental Health Law were more likely to have a negative attitude toward the informed consent process compared with those trained (adjusted odds ratio = 0.21; 95% confidence interval: 0.07-0.59; p = 0.003). Psychiatrists trained to use the National Mental Health Law had more positive attitudes toward the informed consent process. Lack of such training could affect the attitudes of psychiatrists toward the informed consent process in China.

Rethinking progress and challenges of mental health care in China

Rethinking progress and challenges of mental health care in China

Measuring internalized stigma of mental illness among Chinese outpatients with mood disorders

Internalized stigma is a barrier to mental health care in China, and stigma reduction is expected to promote treatment utilization, especially for mood disorders and schizophrenia. We aimed to iden...

Depression as seen through the eyes of rural Chinese women: Implications for help-seeking and the future of mental health care in China

BackgroundAs part of a larger epidemiological study of depression among rural Chinese women, we sought to understand their explanatory models of depression. We explored how participants describe depression, to what cause they attribute depression, and what sources of treatment they would recommend. MethodsParticipants first were assessed with the Center for Epidemiological-Depression scale (CES-D), with a cut-point of 16 or greater indicative of depression. The Short Explanatory Model Interview (SEMI), a semi-structured questionnaire, was our primary tool for exploring participants’ explanatory models relating to a vignette describing a rural Chinese woman with depression. ResultsAmong the 416 women who consented and completed the SEMI, 277(66.6%) reported that the woman in the vignette had something wrong with her health. Among these, only 8(2.9%) women provided a specific psychiatric name for the condition, while 150(54.2%) provided non-specific psychiatric disease names or affective symptoms, and 78(28.2%)of the sample provided physical disease names. Participants attributed causes largely to internal factors (41.5%) or external factors (36.8%). In terms of help-seeking, 101(36.4%) said the woman in the vignette should see a doctor, 70(25.3%) indicated that she should solve the problem herself, and 42(15.2%) recommended seeking support from family members and friends. We did not find any differences in recognition, causal attribution, and help-seeking suggestions between women with a CES-D ≥ 16 and those with CES-D < 16. LimitationsThe use of a vignette to prompt discussion was not the same as talking about real-life personal situations. ConclusionOur results point to potential challenges and opportunities that lay ahead as China develops mental health services in its vast rural areas among women who may be at risk for developing depression. We found that our participants often attributed their symptoms to internal or external social causes, and preferred not speaking with family members and friends. Our findings suggest that rural Chinese women may be reticent to recognize or describe categorical concepts such as “depression” as a health problem, and they invite further consideration about how best to develop new health services in China's rural regions.

The first Mental Health Act in China 2013 : Anhistorical step towards human rights

In the past, the mentally ill used to be relentlessly stigmatized and their basic needs grossly neglected in China. Only the coastal cities with their Western oriented universities provided Western type mental healthcare. In general, traditional Chinese medicine (TCM) embracing medicinal herbs and acupuncture was practiced. Mental hospitals were non-existent before 1889 and care of the chronically mentally ill rested with their families and the community; however, the prevalence and spectrum of mental disorders were similar to those in Western countries. After the establishment of the People's Republic of China old-fashioned mental hospitals were founded. The "Great Leap Forward" starting in 1958 envisaged the creation of amental healthcare system based on Soviet Union standards. Psychiatry had astrong biological orientation, and psychotherapy did not exist. Psychology was rejected as not being science and was not taught at universities before 1978. With the Reform and Opening Policy in 1978 the education of psychology was stepped up. Psychology was introduced as an academic discipline in 1978 and psychotherapy and psychosomatic medicine were established in mental healthcare. The current mental healthcare in China resembles the standard in Germany before the "Psychiatrie-Enquete" (expert commission official report). With the Mental Health Act adopted in 2013 after 27years of planning, China has laid the legal foundation for planning and establishing ahumane system of mental healthcare. The Act safeguards patients' human and individual rights and increases trust in psychiatric institutions. It guarantees the right to optimal treatment and provides legal protection in cases of malpractice.

The Trend in Mental Disability in Individuals Aged 60 and Older in China: National Sample Survey on Disability From 1987 to 2006

The Trend in Mental Disability in Individuals Aged 60 and Older in China: National Sample Survey on Disability From 1987 to 2006

Mental health care in China: review on the delivery and policy issues in 1949–2009 and the outlook for the next decade – Corrigendum

Mental health care in China: review on the delivery and policy issues in 1949–2009 and the outlook for the next decade – Corrigendum

Social Realities in China Today: In Reply

Back to table of contents Previous article Next article LettersFull AccessSocial Realities in China Today: In ReplySamson Tse, M.Sc., Ph.D.Samson TseSearch for more papers by this author, M.Sc., Ph.D.Published Online:1 Oct 2013https://doi.org/10.1176/appi.ps.6401007AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail In Reply: We were pleased to read Law’s letter. It is exactly the kind of response we seek to achieve—opening many forums for discussion among practitioners, service users, caregivers, researchers, and policy planners in China and beyond. We agree unreservedly that substantially reforming safety-net creation and dealing with issues of social inequity are paramount in order to make real progress in community-based mental health care in China. Although the Internet by itself is not going to lessen the stigma associated with mental disorders in Chinese society, it remains a very useful platform or instrument (especially when used together with “evidence-based, culturally meaningful, and government- and citizen-driven efforts at many levels”) for individuals who are computer literate and troubled by mental health problems and who wish to access credible information about various conditions in the hope of healing and recovery (1,2).We never pretend to have the answers nor do we underestimate the challenges involved in transforming community-based mental health care in China. On the contrary, we write with the conviction that we are witnessing small pockets of meaningful and novel solutions to lasting social and mental health problems in local communities, although, admittedly, in a scattered fashion (3,4). We are not naïve optimists who expect quick results to be realized in the near future, nor pessimists who think that there is nothing new under the sun. To accomplish this goal, we are challenged to be passionate, contemplative, and scientific (5).References1 Quinn N, Knifton L, Goldie I, et al.: Nature and impact of European anti-stigma depression programmes. Health Promotion International (ePub ahead of print, Jan 24, 2013; doi 10.1093/heapro/das076)Google Scholar2 Corrigan PW, Morris SB, Michaels PJ, et al.: Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatric Services 63:963–973, 2012Link, Google Scholar3 Ran M-S, Xiang M-Z, Chan CL, et al.: Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia—a randomised controlled trial. Social Psychiatry and Psychiatric Epidemiology 38:69–75, 2003Crossref, Medline, Google Scholar4 Pearson V: Psychiatric services in China: Guangzhou; in Culture and Mental Health: A Comprehensive Textbook. Edited by Bhui KBhugra D. London, Arnold, 2007Google Scholar5 Torrey WC, Bond GR, McHugo GJ, et al.: Evidence-based practice implementation in community mental health settings: the relative importance of key domains of implementation activity. Administration and Policy in Mental Health and Mental Health Services Research 39:353–364, 2012Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 64Issue 10 October 2013Pages 1065-1066 Metrics PDF download History Published online 1 October 2013 Published in print 1 October 2013

Mental health care in China: review on the delivery and policy issues in 1949–2009 and the outlook for the next decade.

Using qualitative and quantitative methodologies, delivery models and policies on mental health care in China during the period of 1949–2009 were reviewed and characteristics of different stages of the mental health-care development were also analysed in this period. Recent studies demonstrate that mental health-care services in China are being transformed from large mental hospital-based pattern to community-based pattern in the past six decades. Combining the international experiences with current strategies and situations of Chinese health care, we provided the outlook for mental health-care services in the next decade in China. In addition, we proposed relevant policy recommendations that mainly focus on the equity and availability of mental health-care services with the purpose of promoting community-based health services.

Mental Health Care in China: State Policies, Professional Services and Family Responsibilities.

The development of psychiatric services in China mental illness, law and rights health and social policy the patient in the community the municipal hospital the patients the patients' voices.

Book Reviews : Mental Health Care in China. State Policies, Professional Services and Family Responsibilities

Book Reviews : Mental Health Care in China. State Policies, Professional Services and Family Responsibilities

Mental Health Care in China: State Policies, Professional Services, and Family Responsibilities.Veronica Pearson

<i>Mental Health Care in China: State Policies, Professional Services, and Family Responsibilities.</i>Veronica Pearson