The Current Situations and Needs of Mental Health in China.

Abstract

correspondence: Norman Sartorius, M.D., M.A., D.P.M., Ph.D., FRC. Psych. Mailing address: President Association for the Improvement of Mental Health Programmes, 14 chemin Colladon Geneva, Switzerland. Email: sartorius@normansartorius.com It was good news to hear that the National Health and Family Planning Commission produced China’s National Mental Health Plan 2015-2020 having developed it in collaboration with ten other departments. Progress in the field of mental health requires a broad and lasting involvement of a variety of health and other social sectors which are unlikely to contribute to the program if they are not involved in making plans for it. It was also good to hear that the developers of the Plan had taken into account the mental health action plan produced by the World Health Organization (and discussed in its global and regional governing bodies). Professor Wang tells us that the plan stressed (i) that the coordination and management of mental health services at all levels needs further improvement, (ii) that it is necessary to train more mental health workers – to reach the number 40,000 psychiatrists set as a target by the plan means that it will be necessary to more than double the current numbers of specialists in mental health and (iii) that the plan includes sections on the prevention and management of common mental disorders such as depression which were previously not considered a priority although they are, by their frequency and consequences a major public health problem. Professor Wang also draws attention to the fact that while China’s Plan is in harmony with the lines of action described in the WHO global and regional plans it does differ from those reflecting the specific situation and mental health needs of China. The description of targets that Professor Wang provides is of particular interest. In line with WHO action plans, China’s Plan focuses on six severe mental disorders schizophrenia, schizoaffective disorders, persistent delusional disorder, bipolar disorders, mental disorders due to epilepsy and mental retardation. It is somewhat surprising to see the inclusion of “mental disorders due to epilepsy” which do not figure in the international classification of diseases and the exclusion of severe depression which WHO included in its plans as a priority condition. What is astonishing, however, is that dementia and related cognitive disorders, alcohol and other substance use disorders and psychological consequences of brain trauma did not find a place among serious mental disorders although these three groups of disorders are making a major contribution to the total burden of disability caused by mental and other diseases.