Advertisement

Recognition and beliefs about treatment for mental disorders in mainland China: a systematic review and meta-analysis

  • Wenjing LiEmail author
  • Nicola Reavley
Review

Abstract

Purpose

This review aimed to systematically investigate the Chinese public’s ability to recognize specific mental disorders and their knowledge and beliefs about available treatments.

Methods

Eight electronic databases were searched to identify quantitative studies examining recognition of depression, anxiety and/or schizophrenia, knowledge and beliefs about treatments, and/or correlates of each of the three constructs among the general population in China. Prevalence estimates were calculated for themes under each construct. Effect size r was computed for each relationship between an independent variable and one of the three constructs.

Results

A total of 65 studies (N = 174,253) were included in this review. Depression (25.4%), anxiety (18.2%) and schizophrenia (18.4%) had low recognition rates. More than 80% of people agreed that one should seek professional help for mental illnesses, but fewer than 40% were likely to use professional services for their own mental health issues. Regarding psychiatric medications, 57% of the respondents agreed that medications should be taken regularly, but more than 60% believed that they would be harmful. Gender, income, residential area, occupation, education and marital status were significantly associated with level of mental health knowledge.

Conclusions

The public’s level of mental health literacy related to recognition of specific mental disorders, and knowledge and beliefs about treatments is still relatively low. The government should consider public education campaigns to improve this.

Keywords

Mental health literacy Mainland China Mental health knowledge Beliefs about mental health services 

Supplementary material

127_2019_1799_MOESM1_ESM.doc (202 kb)
Supplementary material 1 (DOC 201 kb)

References

References marked with an asterisk (*) indicates studies included in the systematic review

  1. 1.
    National Health Commission of the People’s Republic of China (2002) National Mental Health Work Plan of the People’s Republic of China: 2002–2010, N.H.C.o.t.P.s.R.o. China, Editor, BeijingGoogle Scholar
  2. 2.
    Ma H (2012) Integration of hospital and community services—the ‘686 Project’—is a crucial component in the reform of China’s mental health services. Shanghai Arch Psychiatry 24:172–174PubMedPubMedCentralGoogle Scholar
  3. 3.
    Good BJ, Good MD (2012) Significance of the 686 program for China and for global mental health. Shanghai Arch Psychiatry 24:175–177PubMedPubMedCentralGoogle Scholar
  4. 4.
    Liu J et al (2011) Mental health system in China: history, recent service reform and future challenges. World Psychiatry 10(3):210–216PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Li N et al (2013) Mental health service use among Chinese adults with mental disabilities: a national survey. Psychiatr Serv 64:638–644PubMedCrossRefGoogle Scholar
  6. 6.
    Wong DFK et al (2017) Comparing the mental health literacy of Chinese people in Australia, China, Hong Kong and Taiwan: implications for mental health promotion. Psychiatry Res 256:258–266PubMedCrossRefGoogle Scholar
  7. 7.
    Jorm AF et al (1997) “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust 166:182–186CrossRefPubMedGoogle Scholar
  8. 8.
    Jorm AF (2012) Mental health literacy: empowering the community to take action for better mental health. Am Psychol 67:231–243PubMedCrossRefGoogle Scholar
  9. 9.
    Chen J (2018) Some people may need it, but not me, not now: seeking professional help for mental health problems in Urban China. Transcult Psychiatry 55:754–774PubMedCrossRefGoogle Scholar
  10. 10.
    Bonabi H et al (2016) Mental health literacy, attitudes to help seeking, and perceived need as predictors of mental health service use: a longitudinal study. J Nerv Ment Dis 204:321–324PubMedCrossRefGoogle Scholar
  11. 11.
    Reavley NJ, Jorm AF (2011) Recognition of mental disorders and beliefs about treatment and outcome: findings from an Australian National Survey of Mental Health Literacy and Stigma. Aust N Z J Psychiatry 45(11):947–956PubMedCrossRefGoogle Scholar
  12. *12.
    Huang D, Yang LH, Pescosolido BA (2019) Understanding the public’s profile of mental health literacy in China: a nationwide study. BMC Psychiatry 19(1):20PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Fisher LJ, Goldney RD (2003) Differences in community mental health literacy in older and younger Australians. Int J Geriatr Psychiatry 18(1):33–40PubMedCrossRefGoogle Scholar
  14. 14.
    Farrer L et al (2008) Age differences in mental health literacy. BMC Public Health 8(1):125PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Dahlberg KM, Waern M, Runeson B (2008) Mental health literacy and attitudes in a Swedish community sample—Investigating the role of personal experience of mental health care. BMC Public Health 8(1):8PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Chiang JCS et al (2005) Pathway to care for patients with first-episode psychosis in Hong Kong. Hong Kong J Pyschiatry 15:18–23Google Scholar
  17. 17.
    Loo PW, Wong S, Furnham A (2012) Mental health literacy: a cross-cultural study from Britain, Hong Kong and Malaysia. Asia-Pacific Psychiatry 4(2):113–125PubMedCrossRefGoogle Scholar
  18. 18.
    Furnham A, Chan E (2004) Lay theories of schizophrenia. A cross-cultural comparison of British and Hong Kong Chinese attitudes, attributions and beliefs. Soc Psychiatry Psychiatr Epidemiol 39(7):543–552PubMedCrossRefGoogle Scholar
  19. 19.
    Wei Y et al (2015) Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review. BMC Psychiatry 15(1):291PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Wei Y et al (2016) Measurement properties of tools measuring mental health knowledge: a systematic review. BMC Psychiatry 16(1):297PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Xu Z et al (2017) Challenging mental health related stigma in China: systematic review and meta-analysis. II. Interventions among people with mental illness. Psychiatry Res 255:457–464PubMedCrossRefGoogle Scholar
  22. 22.
    Xu Z et al (2017) Challenging mental health related stigma in China: systematic review and meta-analysis. I. Interventions among the general public. Psychiatry Res 255:449–456PubMedCrossRefGoogle Scholar
  23. *23.
    Yu Y et al (2015) Assessment of mental health literacy using a multifaceted measure among a Chinese rural population. BMJ Open 5(10):e009054PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Tian M et al (2011) Survey and analysis on mental health knowledge of urban and rural residents. Chin J Health Psychol 19:144–146Google Scholar
  25. *25.
    Yan B et al (2014) Investigation of the awareness rate for mental health knowledge and attitude about mental illness in urban and rural general population. Mod Prev Med 41:1636–1639Google Scholar
  26. *26.
    Wong DFK, Li JCM (2014) Cultural influence on shanghai Chinese people’s help-seeking for mental health problems: implications for social work practice. Br J Soc Work 44(4):868–885CrossRefGoogle Scholar
  27. *27.
    Han H et al (2008) Investigation of the awareness rate for mental health knowledge in Kunming residents. Chin J Health Psychol 16:1274–1277Google Scholar
  28. *28.
    Qiu J, Xie B (2005) Investigation of literacy and need for mental health services in Shanghai residents. Chin J Health Psychol 13:81–85Google Scholar
  29. 29.
    Moher D et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Vandenbroucke JP et al (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS ONE 4:1628–1654Google Scholar
  31. 31.
    Biostat (2005) Comprehensive meta-analysis (version 2). Englewood, BiostatGoogle Scholar
  32. 32.
    Abbey G et al (2015) A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder. Psycho-Oncology 24(4):371–381PubMedCrossRefGoogle Scholar
  33. 33.
    Lipsey MW, Wilson DB (2001) Practical meta-analysis. Sage Publications, Thousand OaksGoogle Scholar
  34. *34.
    Huang Y et al (2015) The awareness of mental health and its associates: a cross-sectional survey in Tianjin community inhabitants. J Int Psychiatry 42:23–26Google Scholar
  35. *35.
    Li Q et al (2014) Cross-sectional survey on awareness of mental health knowledge among the rural communities of Mianyang City. China Med Herald 11:91–95Google Scholar
  36. *36.
    Gao Q et al (2014) Awareness of residents’ mental health status in Guancheng district of Zhengzhou. J Zhengzhou Univ 49:829–832Google Scholar
  37. 37.
    Lenhard W, Lenhard A (2016) Calculation of effect sizes. https://www.psychometrica.de/effect_size.html#transform. Accessed 6 May 2019
  38. 38.
    Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Erlbaum, HillsdaleGoogle Scholar
  39. 39.
    National Health Commission of the People’s Republic of China (2010) Survey evaluation protocol of mental health work from the General Office of the Ministry of Health, N.H.C.o.t.P.s.R.o. China, Editor, BeijingGoogle Scholar
  40. 40.
    Valentine JC, Pigott TD, Rothstein HR (2010) How many studies do you need?: a primer on statistical power for meta-analysis. J Educ Behav Statist 35:215–247CrossRefGoogle Scholar
  41. 41.
    Angermeyer MC et al (2017) Public attitudes towards psychiatry and psychiatric treatment at the beginning of the 21st century: a systematic review and meta-analysis of population surveys. World Psychiatry 16(1):50–61PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Mo PK, Mak WW (2009) Help-seeking for mental health problems among Chinese: the application and extension of the theory of planned behavior. Soc Psychiatry Psychiatr Epidemiol 44(8):675–684PubMedCrossRefGoogle Scholar
  43. 43.
    Mak HW, Davis JM (2014) The application of the theory of planned behavior to help-seeking intention in a Chinese society. Soc Psychiatry Psychiatr Epidemiol 49(9):1501–1515PubMedCrossRefGoogle Scholar
  44. 44.
    Mak WWS, Chong ESK, Wong CCY (2014) Beyond attributions: understanding public stigma of mental illness with the common sense model. Am J Orthopsychiatry 84(2):173–181PubMedCrossRefGoogle Scholar
  45. 45.
    Corrigan PW, Watson AC (2002) Understanding the impact of stigma on people with mental illness. World Psychiatry 1(1):16–20PubMedPubMedCentralGoogle Scholar
  46. 46.
    Gulliver A et al (2012) A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry 12(1):81PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    National Health Commission of the People’s Republic of China (2015) National Mental Health Work Plan of the People’s Republic of China: 2015–2020, N.H.C.o.t.P.s.R.o. China, Editor, BeijingGoogle Scholar
  48. 48.
    National Health Commission of the People’s Republic of China (2008) Directives for development of the National Mental Health Work System (2008–2015), N.H.C.o.t.P.s.R.o. China, BeijingGoogle Scholar
  49. 49.
    Kohls E et al (2017) Public attitudes toward depression and help-seeking: impact of the OSPI-Europe depression awareness campaign in four European regions. J Affect Disord 217:252–259CrossRefPubMedGoogle Scholar
  50. 50.
    Brijnath B et al (2016) Do web-based mental health literacy interventions improve the mental health literacy of adult consumers? Results from a systematic review. J Med Internet Res 18(6):e165PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Zhang M, Yan H, Phillips MR (1994) Community-based psychiatric rehabilitation in shanghai: facilities, services, outcome, and culture-specific characteristics. Br J Psychiatry 165(S24):70–79CrossRefGoogle Scholar
  52. 52.
    O’Connor M, Casey L, Clough B (2014) Measuring mental health literacy–a review of scale-based measures. J Mental Health 23(4):197–204CrossRefGoogle Scholar
  53. *53.
    Chen H, Wang Z, Phillips MR (2018) Assessing knowledge and attitudes about mental illness in Ningxia. China. Transcult Psychiatry 55(1):94–119PubMedCrossRefGoogle Scholar
  54. *54.
    Wang J et al (2013) Mental health literacy among residents in Shanghai. Shanghai Arch Psychiatry 25(4):224–235PubMedPubMedCentralGoogle Scholar
  55. *55.
    Peng Y et al (2011) Mental health literacy in Changsha, China. Shanghai Arch Psychiatry 23(6):353–359Google Scholar
  56. *56.
    Gong AT, Furnham A (2014) Mental health literacy: public knowledge and beliefs about mental disorders in mainland China. PsyCh J 3(2):144–158PubMedCrossRefGoogle Scholar
  57. *57.
    Tong H-L et al (2015) Awareness of mental health-related knowledge and attitude towards patients with mental disorders among community residents in Harbin city and the influencing factors. Practi Prev Med 22:1199–1203Google Scholar
  58. *58.
    Lv GQ et al (2004) A questionnaire of awareness of mental disorders and attitudes towards mental health patients. Chin Mental Health J 18:694–695Google Scholar
  59. *59.
    Wang X et al (2017) Investigation of the awareness rate of mental health knowledge and attitude about mental illness in urban and rural general population. Sichuan Mental Health 30:168–174Google Scholar
  60. *60.
    Wang Y-H et al (2010) Investigation of public’s cognition and attitude towards depressive disorder in Tianjin. J Clin Nurs 9:2–4Google Scholar
  61. *61.
    Pan S-M et al (2016) Research on the public attitudes towards mental illness and influencing factors in Guangzhou. Med Philos 37:20–23Google Scholar
  62. *62.
    Zhang H (2011) Investigation on the awareness rate for mental health knowledge, attitude and treat method to psychosis patients. Chin J Health Psychol 19:1307–1309Google Scholar
  63. *63.
    Meng G et al (2005) Investigation of the awareness rate of mental health knowledge among 1783 general population. Shanghai Arch Psychiatry 17:19–20Google Scholar
  64. *64.
    Cai M-Y et al (2012) Survey on knowledge about mental health among community residents in Yuexiu District, Guangzhou City, 2011. Prev Med Tribune 18:757–760Google Scholar
  65. *65.
    Xu Y et al (2014) Investigation and analysis on Shanghai residents’ awareness rate and service demand of mental health in 2012. Jiangsu J Prev Med 25:28–30Google Scholar
  66. *66.
    Gao Y, Wang X, Sun X (2017) Investigation of the awareness rate of mental health knowledge among 3295 residents in Hainan. J Yangtze Univ 14:61–65Google Scholar
  67. *67.
    Wang Y et al (2015) Public knowledge and attitude towards anxiety disorder and depression in Shanghai, Beijing and Changsha. Chin J Psychiatry 48:220–226Google Scholar
  68. *68.
    Meng G et al (2002) Investigation of the awareness rate of mental health knowledge among 2697 residents in Shanghai. Shanghai Arch Psychiatry 14:56–57Google Scholar
  69. *69.
    Jiang Y et al (2007) Investigation of the awareness rate of mental health knowledge among residents in Minhang District, Shanghai. Shanghai J Prev Med 19:281–282Google Scholar
  70. *70.
    Sun X, Li X-Y, Phillips MR (2009) A cross-sectional survey of the awareness of common mental disorders among urban and rural residents in northern China. Chin Mental Health J 23:729–734Google Scholar
  71. *71.
    Yang Q et al (2014) Survey of the awareness of common mental illness among residents from two cities in northern China. Sichuan Mental Health 27:490–494Google Scholar
  72. *72.
    Zhao C et al (2010) Analysis on awareness and demand for mental health services of Jiulongpo area residents. Chin J Health Psychol 18:134–136Google Scholar
  73. *73.
    Xiao Y et al (2015) Knowledge about mental health and attitude to mental disorder in common residents in Yunfu city. China Med Herald 12:75–78Google Scholar
  74. *74.
    Yang X et al (2016) The survey and analysis of awareness rates of mental health knowledge for urban and rural residents in Lanzhou. Foreign Med Sci Sect Medgeogr 37:57–59Google Scholar
  75. *75.
    Song J et al (2013) Mental health knowledge and attitudes of community residents of Chaoyang District in Beijing. Chin J Health Psychol 21:1636–1638Google Scholar
  76. *76.
    Chen Y (2011) Awareness rate for mental health knowledge among 727 general population in Xiamen. Chin J Health Psychol 19:1202–1203Google Scholar
  77. *77.
    Hu H-Y et al (2012) Knowledge about mental health and attitude to mental disorder in urban and rural residents in Guangzhou. Chin Mental Health J 26:30–35Google Scholar
  78. *78.
    Yang C et al (2013) Survey on awareness of residents’ mental health status in Huangpu District of Guangzhou city. Chin J Health Educ 29:377–379Google Scholar
  79. *79.
    Yang L et al (2017) Investigation on awareness of mental health knowledge and service demands of rural and urban residents in Enshi City. Med Soc 30:63–65Google Scholar
  80. *80.
    Sun X et al (2010) Investigation of the awareness rate of mental health knowledge among the general population in Hangzhou. Zhejiang Prev Med 22:88–89Google Scholar
  81. *81.
    Zhang P et al (2013) Surveying the awareness rate of knowledge of mental health and attitude towards mental diseases in residents of rural Hebei. Chin Health Serv Manag 10:777–780Google Scholar
  82. *82.
    Zhang J et al (2009) Investigation on awareness rate of mental health related knowledge among ordinary residents in Jining. J Jining Med Univ 32:282–284Google Scholar
  83. *83.
    Gao W et al (2016) Investigation of awareness rate of mental health knowledge among urban and rural residents in Weifang. Med J Chin People’s Health 28:89–92Google Scholar
  84. *84.
    Fang X et al (2010) Investigation of the awareness rate of mental health knowledge among residents in Fujian. Strait J Prev Med 16:30–31Google Scholar
  85. *85.
    Pan H et al (2012) Mental health literacy and its related factors research. Shanxi Med J 41:1195–1197Google Scholar
  86. *86.
    Zhang S et al (2016) Trend analysis of urban and rural residents in Hengshui City mental health knowledge status and behavior. Chin J Health Psychol 24:183–186Google Scholar
  87. *87.
    Liang X et al (2011) Cross-sectional survey on awareness of mental health knowledge among communities in Xi’an. Chin J Health Psychol 19:1200–1202Google Scholar
  88. *88.
    Yao M et al (2013) Awareness rate of mental health knowledge in residents in Zhengzhou City. Chin Mental Health J 27:682–685Google Scholar
  89. *89.
    Wang Q et al (2015) Analysis of mental health knowledge survey of ordinary residents in Yinchuan. Ningxia Med J 37:342–344Google Scholar
  90. *90.
    Ge X, Zhou J (2013) Survey and analysis on mental health knowledge awareness by questionnaires Changsha residents. J Neurosci Mental Health 13:244–247Google Scholar
  91. *91.
    Tao C et al (2014) Status quo of mental health knowledge among community residents in Qingpu District. Health Educ Health Promotion 9:297–298Google Scholar
  92. *92.
    Xiao L, Wu Y, Ji JL (2004) Epidemiological characteristics of awareness for mental health in citizens in Yangpu district of Shanghai city. Chin J Clin Rehabil 8:6596–6597Google Scholar
  93. *93.
    Zhang XX et al (2017) Analysis of cognition and satisfaction with mental health service among residents in Weifang. Chin Med Ethics 30:495–499Google Scholar
  94. *94.
    Tian L et al (2018) Awareness rate for mental health knowledge among general population in Xicheng district of Beijing. Med Innov China 24:62–65Google Scholar
  95. *95.
    He R et al (2014) Difference analysis on mental health knowledge awareness among the residents attending lectures in Beijing. J Neurosci Mental Health 3:293–295Google Scholar
  96. *96.
    Wang NX (2004) An investigation on knowledge about mental health in urban and rural residents of Zhejiang Province. Zhejiang Prev Med 16:8–9Google Scholar
  97. *97.
    Xu Y et al (2005) Levels of common knowledge on common psychiatric disorders and therapeutic means taken in general population: effects of education level and living area. Chin J Prev Med 39:237–240Google Scholar
  98. *98.
    Wang NX, Xu FZ, Shi QC (2005) Investigation of mental health knowledge and attitudes towards mentally ill among residents in Zhejiang Province. Zhejiang Prev Med 17:13–14Google Scholar
  99. *99.
    Yao J, Gao CQ, Zhou L (2008) The investigation of understanding rate on the psychological consultation among Jinxing residents of Kunming. China J Health Psychol 16:1098–1099Google Scholar
  100. *100.
    Xu YE et al (2010) The awareness rate of mental health knowledge and service need: comparison between urban and rural residents in Ningbo Chinese. Prim Health Care 24:35–36Google Scholar
  101. *101.
    Lin YF et al (2015) Investigation the cognition and demand of psychological counseling in community residents in Guangzhou. Soft Sci Health 29:687–690Google Scholar
  102. *102.
    Xia YY et al (2010) Investigation on community residents about mental health knowledge: Data from seven community health centers of Shenzhen traditional Chinese medicine hospital. Chin Med Mod Distance Educ China 8:2–4Google Scholar
  103. *103.
    Chen Q et al (2018) Cognition of mental health and its influencing factors among residents in Yinzhou District. Prev Med 30:374–376Google Scholar
  104. *104.
    Chen GY et al (2009) Comparison study on the healthy literacy of residents between town and countryside. Chin Health Educ 25:163–166Google Scholar
  105. *105.
    Ma Y et al (2012) Survey on Beijing residents’ knowledge of preventing and treating depression. Chin J Soc Med 29:269–271Google Scholar
  106. *106.
    Wang Y, Zhao D (2016) Investigation of the awareness rate of mental health knowledge among residents in a community. Med J Chin People’s Health 28:104–105Google Scholar
  107. *107.
    Li J et al (2018) Evaluation of attitudes and knowledge toward mental disorders in a sample of the Chinese population using a web-based approach. BMC Psychiatry 18(1):367PubMedPubMedCentralCrossRefGoogle Scholar
  108. *108.
    Niu Z, Willoughby JF (2018) Examining cultural identity and media use as predictors of intentions to seek mental health information among Chinese. Asian J Commun 28(4):360–376CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre for Mental Health, Melbourne School of Population and Global HealthThe University of MelbourneCarltonAustralia

Personalised recommendations