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Chinese perspectives on primary care for common mental disorders: Barriers and policy implications

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  • Kai Sing Sun
  • Tai Pong Lam
  • Dan Wu

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.

Suggested Citation

  • Kai Sing Sun & Tai Pong Lam & Dan Wu, 2018. "Chinese perspectives on primary care for common mental disorders: Barriers and policy implications," International Journal of Social Psychiatry, , vol. 64(5), pages 417-426, August.
    • Handle: RePEc:sae:socpsy:v:64:y:2018:i:5:p:417-426
    DOI: 10.1177/0020764018776347
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    References listed on IDEAS

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    2. Yang, Lawrence Hsin & Kleinman, Arthur & Link, Bruce G. & Phelan, Jo C. & Lee, Sing & Good, Byron, 2007. "Culture and stigma: Adding moral experience to stigma theory," Social Science & Medicine, Elsevier, vol. 64(7), pages 1524-1535, April.
    3. Gavin Andrews & Pim Cuijpers & Michelle G Craske & Peter McEvoy & Nickolai Titov, 2010. "Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-6, October.
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