China’s first blue book on mental health released

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China’s first blue book on mental health, the “China National Mental Health Development Report (2017-2018)”, was released by the Chinese Academy of Sciences on February 22. The report found positive trends in mental health throughout the country. However these trends were not extremely significant and Zhang Wei, a researcher at the Institute of Psychology of the Chinese Academy of Sciences, said that the overall situation for mental health has not changed much in the past four years. The mental health status of the rural population is also generally worse than that of the urban or non-rural population.

The blue book’s report is based on a collection of earlier surveys and studies. The National Mental Health Status Research Group of the Institute of Psychology of the Chinese Academy of Sciences conducted a mental health survey of urban residents aged 10-100 in 2007-08. This report found that 2-3% of residents suffered from moderate to severe mental health issues and 11-15% suffered from a mild to moderate range of issues. This 11-15% is identified as the main target group for mental health work as their social functions are not yet impaired and they can function as normal, but without counselling they may develop more serious psychological issues. The 2011-2012 National Key Psychological Characteristics Survey exemplified that citizens with an agricultural hukou had greater mental health issues than those with a non-agricultural hukou. About 2.6% of agricultural hukou citizens had severe mental health issues and 18.3% had “poor” mental health or existed with a mild to moderate range of mental health issues. For non-agricultural hukou citizens, the ratios were 2% and 13.8% respectively.

In addition to noting the rural-urban divide in mental health, the survey also analyzed the mental health status of various groups within society, namely college students, kindergarten teachers, migrant workers, and bankers. Chinese college students’ mental health, in recent decades, has remained relatively stable with slight improvements and positive trends. Most notably, the positive trends are most significant for graduate-level students. Similar to college students, kindergarten teachers’ mental health has seen a slight upward trend. Private kindergarten teachers had better mental health than public kindergarten teachers, and rural kindergarten teachers had better mental health than urban kindergarten teachers.

Research conducted in 2012 on 14 migrant workers reported that migrant workers’ mental health was lower than the national average. However, looking at broader trends and research from 1995 to 2011, the report establishes that overall migrant workers’ mental health has gradually increased. Improvements are most notable in the eastern regions of China and with those working in the manufacturing sector. Migrant workers’ mental health in the construction industry has not improved. Migrant workers who have been working in the field for more time, have a larger range of mobility, and work in “newer” first-tier cities have better mental health. Banking industry workers have the highest overall stress levels.

The report also noted mental health differences between men and women. Women have a higher incidence of depression and anxiety than men, and the overall mental health index of adult women in China is significantly lower than that of men. Yet, women’s mental health scores for emotional experience and interpersonal dimensions are higher than men‘s. Overall the report has no answer for the reasons behind the gender imbalance in mental health, but claims there are both physical and social causes. A study within the report found that from 2002 to 2011 China’s annual average suicide rate dropped by 58% to 98 cases per 100,000 people. The most dramatic decline in suicide rates was among rural women under the age of 35, with a reduction of about 90%.

The report highlights that there is still a huge need for mental health services. When asked if they thought mental health issues in today’s society were serious, 12% of respondents replied that they were not, 40% said they were unsure, and 48% replied affirmatively. In the same survey 74% of respondents said that they think it is inconvenient to seek for psychological counselling services, and only 26% said it was convenient.

The report also lists the country’s six most common mental health needs. The highest demand rate is for “self-regulation” or understanding of your own mental health, for which 53% of respondents expressed a need. The others are guidance on educating children, interpersonal communication, mental illness prevention, career and marriage. Mental health knowledge concerning marriage had the lowest demand rate at 28.9%, a figure that is still quite large, highlighting the need for greater mental health infrastructure throughout China.