Mental Health in ChinaMental Health in China

Daolong Zhang M.D.Daolong Zhang M.D.

Psychcn-Chestnut Global PartnersPsychcn-Chestnut Global Partners

OutlineOutline

History of Mental Health in ChinaHistory of Mental Health in China Current AffairsCurrent Affairs Applicability of New Programs Like Applicability of New Programs Like

EAPEAP

Brief History of PsychiatryBrief History of Psychiatry

1951 Society of Neurology and Psychiatry 1951 Society of Neurology and Psychiatry established by Chinese Medical Associationestablished by Chinese Medical Association

1955 Published first professional journal1955 Published first professional journal

1963 Organized first national meeting1963 Organized first national meeting

19661966 －－ 1978 Suspended all professional activities1978 Suspended all professional activities

1978 Resumed professional activities1978 Resumed professional activities

1979 Established the first Chinese mental illness 1979 Established the first Chinese mental illness classification systemclassification system

1980 Expanded operations internationally1980 Expanded operations internationally

1989 Established the official Chinese Mental Illness 1989 Established the official Chinese Mental Illness Classification and Diagnostic CriteriaClassification and Diagnostic Criteria

1993 Society of Psychiatry established by the CMA1993 Society of Psychiatry established by the CMA

Brief History of PsychologyBrief History of Psychology

1951 Institute of Psychology established by 1951 Institute of Psychology established by the CASthe CAS

1955 Established the Chinese Psychological 1955 Established the Chinese Psychological SocietySociety

19661966 －－ 1977 Suspended all professional ac1977 Suspended all professional activitiestivities

1977 Resumed professional activities1977 Resumed professional activities1980 Joined the IPA1980 Joined the IPA2004 Hosted the 28th ICP2004 Hosted the 28th ICP

Current AffairsCurrent Affairs

Effect of Rapid Socio-cultural Changes on the Effect of Rapid Socio-cultural Changes on the Number of People Suffering From Mental Number of People Suffering From Mental

IllnessIllness

1.1. Transition from a planned to free market economyTransition from a planned to free market economy

2.2. Reduction of job security due to reforms in the Reduction of job security due to reforms in the labor marketlabor market

3.3. Changes in traditional family structures and Changes in traditional family structures and valuesvalues

4.4. Demands of higher standards of livingDemands of higher standards of living

Increase in the Number of Individuals Increase in the Number of Individuals Suffering from Severe Mental IllnessSuffering from Severe Mental Illness

1.1. 2.7‰ of the population was afflicted with severe 2.7‰ of the population was afflicted with severe mental illness in 1950, 5.4‰ in 1970, 11.1‰ in mental illness in 1950, 5.4‰ in 1970, 11.1‰ in 1980, 13.47‰ in 1990. Now over 16 million have 1980, 13.47‰ in 1990. Now over 16 million have severe mental illnesses. There are more than 40 severe mental illnesses. There are more than 40 thousand patients diagnosed with depression thousand patients diagnosed with depression in Beijing alone.in Beijing alone.

2.2. Psychiatric disorders comprise about 20Psychiatric disorders comprise about 20 ％ ％ of of all illnesses in China.all illnesses in China.

3.3. More than 30 million mentally ill patients are More than 30 million mentally ill patients are younger than 17.younger than 17.

Inadequacies of Mental Health ServicesInadequacies of Mental Health Services

1.1. There are only about 600There are only about 600 psychiatric hospitals psychiatric hospitals with a total of 11 thousand inpatient beds.with a total of 11 thousand inpatient beds.

2.2. There is a long waiting list for much needed There is a long waiting list for much needed mental health services.mental health services.

Effects of Chinese Cultural Stigmatization of Effects of Chinese Cultural Stigmatization of Psychological InterventionsPsychological Interventions

About About 90%90% of patients who suffer from of patients who suffer from schizophrenia stay at home.schizophrenia stay at home.

The vast majority of mentally ill patients refuse The vast majority of mentally ill patients refuse any kind of psychiatric treatment.any kind of psychiatric treatment.

Lack of Health Insurance Coverage for Lack of Health Insurance Coverage for the Mentally Illthe Mentally Ill

1.1. Only 20-25% of China’s population has health Only 20-25% of China’s population has health insurance. However, insurance does not cover insurance. However, insurance does not cover mental health services.mental health services.

2.2. Roughly 800 million citizens remain uninsured. Roughly 800 million citizens remain uninsured. Most must bear the full burden of paying for Most must bear the full burden of paying for mental health services alone.mental health services alone.

3.3. Payment for mental health services come mostly Payment for mental health services come mostly from out-of-pocket spending. from out-of-pocket spending.

Traditional psychological therapy is simple and Traditional psychological therapy is simple and inflexible. inflexible.

Treatments are often limited to only in-hospital Treatments are often limited to only in-hospital care and prescription drugs. care and prescription drugs.

There is a lack of comprehensive psychological There is a lack of comprehensive psychological care in China.care in China.

Rapid Progress in Chinese Mental Health Rapid Progress in Chinese Mental Health ServicesServices

1.1. 1991 Beginning of comprehensive mental health 1991 Beginning of comprehensive mental health services strategy implementationservices strategy implementation

2.2. 2000 Psychology became a core collegiate 2000 Psychology became a core collegiate science majorscience major

3.3. 2001 Psychotherapy or psychological 2001 Psychotherapy or psychological counseling became a legalized professioncounseling became a legalized profession

4.4. 2002 Chinese central government published the 2002 Chinese central government published the 2002-2010 mental health services development 2002-2010 mental health services development planplan

Professionals’ BackgroundProfessionals’ Background

1.1. Medical professionals (e.g. Psychiatrist)Medical professionals (e.g. Psychiatrist)

2.2. PsychologistsPsychologists

3.3. Social Workers and Human Resource ManagersSocial Workers and Human Resource Managers

4.4. Current Diversification and Specialization of Professionals Current Diversification and Specialization of Professionals into:into:

• Clinical PsychologistsClinical Psychologists• Counseling PsychologistsCounseling Psychologists• PsychotherapistsPsychotherapists• PsychiatristsPsychiatrists

Education Backgrounds of Mental Education Backgrounds of Mental Health ProfessionalsHealth Professionals

学校和医院从业人员的学历

32. 60%

11. 70%1. 80%

42. 20%

11. 70%博士硕士本科专科其他

Mental Health Experience of Mental Health Experience of ProfessionalsProfessionals

从业人员从事心理服务的时间

14. 30%18. 40%

24. 50%2. 00%

40. 80%<1年 1- 2年2- 5年>5 年其他

Survey of Professionals’ Preferences for Survey of Professionals’ Preferences for Short-term and Long-term CounselingShort-term and Long-term Counseling

咨询人员对疗程的评估

46. 90%

46. 90%

2. 10%4. 10%

短程好 长程好

两者无差别其他

Frequency of Counseling SessionsFrequency of Counseling Sessions

咨询和治疗次数

10. 20%

6. 10%1. 80%

3. 50%

78. 40%

1次2次3次4次>5次

Applicability of New Programs Applicability of New Programs Like EAPLike EAP

11. . About 30% of the working population has some type About 30% of the working population has some type of a mental health problem. of a mental health problem. 95%95% of people with of people with depression does not receive treatment.depression does not receive treatment.

2. 20% of employees attribute mental illnesses to job rela2. 20% of employees attribute mental illnesses to job related stress.ted stress.

3. After the ICP, mental health awareness has increased.3. After the ICP, mental health awareness has increased.

4. Multinational companies have introduced the EAP con4. Multinational companies have introduced the EAP concept to China. Now, Chinese companies are beginning cept to China. Now, Chinese companies are beginning to consider adopting EAP services.to consider adopting EAP services.

5. Employees also mention changes in family structur5. Employees also mention changes in family structure along with other rapid socio-cultural changes as fe along with other rapid socio-cultural changes as factors contributing to mental illnesses.actors contributing to mental illnesses.

6. Web-based and telephone counseling make EAP se6. Web-based and telephone counseling make EAP services a reality.rvices a reality.

7. The EAP concept is gradually gaining acceptance b7. The EAP concept is gradually gaining acceptance by the general public.y the general public.

8. EAP is supported by the Chinese government as w8. EAP is supported by the Chinese government as well as professional organizations:ell as professional organizations:• Chinese Psychological SocietyChinese Psychological Society• Chinese Association for Mental HealthChinese Association for Mental Health• Society of Psychiatry, CMASociety of Psychiatry, CMA• www.psychcn.comwww.psychcn.com

Thank You for Your Thank You for Your Attention!Attention!