Mental Health-Primary Sources

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1. Deng, Y., Wang, A. L., Frasso, R., Ran, M. S., Zhang, T. M., Kong, D., & Wong,
Y. L. I. (2022). Mental health-related stigma and attitudes toward patient care
among providers of mental health services in a rural Chinese
county. International Journal of Social Psychiatry, 68(3), 610-618.
https://doi.org/10.1177/0020764021992807
Abstract
Background and aims:
The increasing prevalence of mental illness and low treatment rate presents a pressing
public health issue in China. Pervasive stigma is a significant barrier to mental health
recovery and community inclusion. In particular, stigmatizing or supportive attitudes
held by healthcare providers could either perpetuate or mitigate self-stigma of people
with mental illness. Moreover, mental health resources are unevenly distributed in
China, with most of them concentrated in urban centers and provincial capitals. This
study explores healthcare providers’ attitudes toward mental illness and the challenges
they faced at work in a rural Chinese county.
Method:
Four focus groups were conducted with 36 healthcare providers from a three-tier
mental healthcare system in a rural county in southwestern China. Focus group
discussions were recorded and transcribed verbatim. The team employed a
conventional content analysis approach for data analysis. All transcripts were double-
coded by three bilingual team members who are native Chinese speakers. Coding
discrepancies were resolved by consensus.
Results:
Healthcare providers recruited from the county, township, and village levels varied in
educational background, professional qualification, and experience of working with
people with mental illness. Five thematic categories identified across four groups
include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery,
(3) providers’ attitudes toward providing care, (4) providers’ perception toward
patients and family members, and (5) providers’ perception of training needs.
Conclusions:
This is a unique study that included healthcare providers from a three-tier healthcare
system. Findings signal the importance of understanding healthcare practitioners’
experiences and views to inform the design of training initiatives in rural or low-
resource communities.
2. Yu, Y., Liu, Z. W., Hu, M., Liu, H. M., Yang, J. P., Zhou, L., & Xiao, S. Y.
(2015). Mental health help-seeking intentions and preferences of rural Chinese
adults. PloS one, 10(11), e0141889. https://doi.org/10.1371/journal.pone.0141889
Abstract
Purpose
We aimed to investigate mental health help-seeking intentions and preferences of
rural Chinese adults and determine predictors of the intentions.
Methods
A total of 2052 representative rural residents aged 18–60 completed a cross-sectional
survey by face-to-face interviews. The survey included seven questions asking about
respondents’ help-seeking intentions and preferences, and a series of internationally
validated instruments to assess self-perceived health status, depression, anxiety,
alcohol abuse, mental health literacy, and attitudes towards mental illness.
Results
Nearly 80% of respondents were willing to seek psychological help if needed, and
72.4% preferred to get help from medical organizations, yet only 12% knew of any
hospitals or clinics providing such help. A multivariate analysis of help-seeking
intention revealed that being female, having lower education, higher social health,
higher mental health knowledge, and physical causal attribution for depression were
positive predictors of help-seeking intention.
Conclusion
A huge gap exists between the relatively higher intention for help-seeking and
significantly lower knowledge of helpful resources. Predictors of help-seeking
intention for mental problems in the current study are consistent with previous
studies. Interventions to increase help-seeking for mental problems by Chinese rural
adults may be best served by focusing on increasing public awareness of help sources,
as well as improving residents’ mental health literacy and social health, with special
focus on males and those more educated.
3. Yang, Y., Deng, H., Yang, Q., Ding, X., Mao, D., Ma, X., Xiao, B. & Zhong, Z.
(2020). Mental health and related influencing factors among rural elderly in 14
poverty state counties of Chongqing, Southwest China: a cross-sectional
study. Environmental health and preventive medicine, 25, pp.1-10.
Abstract
Background
China has the largest elderly population in the world; little attention has been paid to
the mental health of elderly in areas of extreme poverty. This is the first study to
investigate the mental health of the rural elderly in poverty state counties in
Chongqing and was part of the Chongqing 2018 health literacy promotion project.
Methods
In 2019, a cross-sectional study was conducted to investigate the mental health status
of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of
1400 elderly aged ≥ 65 years were interviewed, where mental health status was
measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic
regression was performed to evaluate the influencing factors related to mental health
of the elderly in these areas.
Results
The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was
labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and
the mental health status of the elderly in the northeastern wing of Chongqing was
better than the one in the southeastern wing of Chongqing. A worse self-rated health
was the risk factor for mental health both in the northeastern and southeastern wings
of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12–
1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR
(95% CI) = 1.33 (1.13–1.56), P = 0.001) was a risk factors in the southeastern wing.
Conclusions
The results showed that mental health of the elderly in poverty state counties was
poor, especially in the southeastern wing of Chongqing. Particular attention needs to
be paid to the males who were less educated, older, and single; female with lower
annual per capital income; and especially the elderly with poor self-rated health.

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