Chinese perspectives on primary care for common mental disorders: Barriers and policy implications
Abstract
Background: The World Health Organization (WHO) has called for integration of mental health into primary care for a decade. In Western countries, around 15% to 25% of patients with common mental disorders including mood and anxiety disorders seek help from primary care physicians (PCPs). The rate is only about 5% in China. Aims: This article reviews the Chinese findings on the barriers to primary care for common mental disorders and how they compared with Western findings. Methods: A narrative literature review was conducted, focusing on literature published from mid-1990s in English or Chinese. Patient, PCP and health system factors were reviewed. Results: Although Chinese and Western findings show similar themes of barriers, the Chinese have stronger barriers in most aspects, including under-recognition of the need for treatment, stigma on mental illness, somatization, worries about taking psychiatric drugs, uncertainties in the role, competency and legitimacy of PCPs in mental health care and short consultation time. Conclusion: Current policies in China emphasize enhancement of mental health facilities and workforce in the community. Our review suggests that patients’ intention to seek help and PCPs’ competency in mental health care are other fundamental factors to be addressed.
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Nearly 92% of individuals diagnosed with mental disorders in China never sought mental health care.
“Evidence shows that nearly 92% of the individuals diagnosed with mental disorders in China never sought mental health care [8-11].”
From Promoting the mental health of university students in China: Protocol for contextual assessment to inform intervention design and adaptation (2021) · cites this paper as [9]
The Introduction reports an 8% overall help-seeking rate in a study of mood disorders in four Chinese provinces, which supports the approximate 92% figure by subtraction. It does not establish that this rate applies to all people diagnosed with mental disorders across China, or that those who did not seek help had never done so. (LLM, conf=0.86)
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Sun, K. S., Lam, T. P., Lam, K. F., & Lo, T. L. (2015) · Family Practice · doi:10.1093/fampra/cmv044 · Cited by 6 · see citing works
Self-citationDemand of General Practitioner in Beijing for Training on Depression and the Strategy
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Flagged first, then by citations
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Cited by
Sorted by citations
Zhang, Z., Sun, K., Jatchavala, C., Koh, J., Chia, Y., Bose, J., Li, Z., Tan, W., Wang, S., Chu, W., et al. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010280 · Cited by 263 · see citing works
Barriers to Professional Mental Health Help-Seeking Among Chinese Adults: A Systematic Review
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Wong, J. P.-H., Jia, C.-X., Vahabi, M., Liu, J. J. W., Li, A. T.-W., Cong, X., Poon, M. K.-L., Yamada, J., Ning, X., Gao, J., et al. (2021) · JMIR Research Protocols · doi:10.2196/25009 · Cited by 11 · see citing works
“Evidence shows that nearly 92% of the individuals diagnosed with mental disorders in China never sought mental health care [8-11].”
Background
- Authors
- Sun, K. S., Lam, T. P., & Wu, D.
- Affiliations
- University of Hong Kong (HK)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Lam, Tai Pong
- Venue
- International Journal of Social Psychiatry
- Publisher
- SAGE Publications
- Published
- 2018-05-20
- Volume
- 64
- Issue
- 5
- Pages
- 417-426
- ISSN
- 0020-7640 (ISSN-L)
- 1741-2854
- OpenAlex
- W2803391931
- Cited by
- 35
- References
- 107
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 6 · 2020: 2 · 2019: 8
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Social Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- common mental disorders, primary care, mental health integration, barriers to care, help-seeking intentions, mental health stigma, somatization, consultation time, mental health policy, China, Western comparison
- MeSH terms
- Mental Disorders, China, Humans, Health Knowledge, Attitudes, Practice, Mental Health Services, Patient Acceptance of Health Care, Primary Health Care, Organizational Policy, Social Stigma, Physicians, Primary Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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