The results are in from the first-ever nationwide study of China’s mental health — and they suggest disorders such as depression and anxiety are on the rise.

“The findings of our survey suggest that most mental disorders have become more common across China in the past 30 years,” the authors — led by Huang Yueqin, director of the Division of Social Psychiatry and Behavioral Medicine at Peking University’s Institute of Mental Health — write in the report. The study was funded by China’s National Health Commission and the Ministry of Science and Technology.

The China Mental Health Survey, the first results of which were published in peer-reviewed journal The Lancet Psychiatry this week, is the country’s first nationally representative survey on mental disorders. From 2013 to 2015, researchers interviewed and screened 32,552 people in 31 provincial-level regions for mood disorders, anxiety disorders, alcohol- and drug-use disorders, schizophrenia, eating disorders, and dementia.

In China, there is still significant stigma surrounding mental health issues, with many barriers to receiving treatment or support. According to the World Health Organization, the country has just 1.7 psychiatrists per 100,000 people, compared with 12 psychiatrists per 100,000 people in the United States. China’s first mental health law came into effect in 2013, aimed at safeguarding the interests of people with mental health disorders and improving procedures, admissions, and treatment. In the years since, the State Council — China’s Cabinet — has affirmed that it plans to improve the system.

Based on the results of the survey, the researchers estimated that 16.6 percent of Chinese adults had experienced mental illness at some point in their lives, a much higher rate than in previous surveys, which were limited in scope. Anxiety disorders were the most common. Also on the rise was depression, which had affected 6.9 percent of those surveyed over the course of their lives and 3.6 percent in the previous 12 months.

The report speculates that the rise in the rate of mental disorders may be partly attributed to previous surveys using different diagnostic criteria and methodologies. It also points to a greater willingness among patients to acknowledge symptoms; previously, many were more likely to conceal their symptoms due to social stigmas.

However, the report also notes that “rapid social change is likely to bring about a general increase in psychological pressure and stress.” China’s prevalence of major depressive disorder was similar to the prevalence in high-income countries, though China had a substantially lower prevalence of panic attacks than developed countries.

Among the population aged 65 years or older, the survey estimated that dementia rates across China were 5.6 percent, lower than the 10 percent prevalence of Alzheimer’s disease and other forms of dementia in the United States. As China’s population ages, mental health care for the elderly will come under serious strain: A 2018 study found that people aged over 65 are seven times more likely to take their own lives.

The survey also examined the prevalence of psychotic disorders such as schizophrenia and estimated that such disorders were relatively uncommon at only 0.7 percent of the Chinese population. The report noted that the prevalence of schizophrenia or psychotic disorders may be underestimated due to their diverse symptoms and social stigma, however.

Compared with major developed countries, the percentage of Chinese people who will suffer from mental illness at some point in their lives is still relatively low, but the large population means it will nonetheless impact a huge number of people, the researchers write.

“The Chinese Government should pay more attention to mental health care,” the report says. Zhang Hongxia and Ji Jianlin of the department of psychological medicine at Fudan University agreed, writing “mental problems such as anxiety disorders deserve greater public and governmental attention” in a commentary published alongside the report.

“Current knowledge of the mental health status of almost a fifth of the world’s population is crucial for understanding global mental health concerns,” the report says.

This is an original article written by Ma Danmeng and Ren Qiuyu of Caixin Global and has been republished with permission. The article can be found on Caixin’s website here.

(Header image: People walk down a flight of stairs in Nanjing, Jiangsu province, July 9, 2015. An Xin/VCG)