China orders depression screenings for college students and pregnant women

Society & Culture

A positive step toward combating stigma around mental health in China.

In a major step to combat stigma around mental health and raise public awareness around the issue, China has announced a new set of policies aimed at enhancing early interventions to prevent depression and providing better treatment for people with depressive thoughts.

The guidelines (in Chinese), issued by China’s National Health Commission on September 14, specifically orders a wider implementation of depression screenings for people susceptible to high stress and anxiety, including teenagers, pregnant and postpartum women, and people with high-pressure jobs.

According to the document, Chinese high schools and universities are required to make depression screenings part of their regular medical check-ups for students. The directive also instructs educational institutions to give “special attention” to students who appear to have depressive symptoms during their checks.

The document also encourages hospitals and medical examination centers to use the Patient Health Questionnaire-9 (PHQ-9), a self-administered test for major depressive disorder, as a preventive tool to screen possible patients of depression. Maternity Hospitals, in particular, are asked to conduct prenatal and postpartum screening for depression, as well as collaborate with psychiatrists from other medical facilities to provide professional help for patients.

Also included in the document are a string of objectives set by the Commission in the realm of mental health promotion. The government department said that by 2022, it hopes to have 80 percent of the population educated about measures they can take to prevent depression. It also expects half of the people with depressive disorder to visit doctors, and 30 percent of them to receive proper treatment.

Given the rising rates of depression among Chinese people, the recent directive to expand screening has been sorely needed for some time. Based on data from the China Mental Health Survey, 16.6 percent of Chinese adults have suffered from mental illness at some point in their lives, and depression was among the most common disorders cited by the respondents. According to a 2001-2005 survey from the Shanghai Mental Health Center, 6 percent of the population in six major Chinese cities experienced lifelong symptoms of depression. The same survey found that rural residents were more likely to have depressive disorders, especially seniors and “left behind” children, mostly the offspring of migrant workers who have moved to big cities in search of work.

In a stark contrast to the prevalence of depression in China, there are only about 23,000 psychiatrists in the country, or just 1.7 per 100,000 people, compared with 12 per 100,000 people in the United States. Meanwhile, there’s still a significant stigma associated with mental health conditions, which further prevents people from seeking treatment.