A Review of Mental Health Policies in China

Daohan Liu

School of Philosophy and Sociology, Jilin University, Changchun, Jilin, 130000, China

Keywords: Policy, China, Social Work, Mental Health.

Abstract: With the deepening of the individualization process in China, mental health is-sues have become important

social and livelihood issues. This paper selects the perspective of "policy review" and adopts the method of

literature review to conduct a systematic analysis of the external social environment and research status of

mental health policies in China. The results show that policies in this field have the macro characteristics of

"top-down". While the policy system is improving, there are still problems such as the imbalance of policy

tools and the bias of policy objects. Meanwhile, the existing research mainly focuses on the analysis of texts

at the national level, lacking in-depth discussions on the policy process, implementation effects, and

differences in local policies. In terms of research methods, most quantitative models are limited to relatively

isolated static analysis and fail to fully evaluate the policy synergy and the coordination mechanism among

policy subjects.

1 INTRODUCTION

With the modernization of China, especially the

process of individualization, has entered a new stage,

psychological problems, as one of the important

manifestations of modernity issues, are constantly

attracting the attention of the Chinese government

and society (Yan, 2021). On March 5, 2025, Premier

Li Qiang mentioned "improving the mental health

service system" in the "Report on the Work of the

Government" delivered at the Third Session of the

14th National People's Congress, which is the latest

statement since the first relevant policy document was

issued in 1999 (Li, 2025). However, it is clearly

insufficient to establish a complete system for

"mental health services" from scratch in just 25 years.

In fact, it was not until 2016 that the government

made its first attempt to build a large-scale social

psychological service system, and in 2021, mental

disorders still ranked 11th among the causes of death

for urban and rural residents in some areas of China

(Chen, 2018, National Bureau of Statistics, 2022). It

can be said that mental health and psychological well-

being remain important livelihood and social issues in

Chinese society. Correspondingly, how the

government makes efforts to improve the public

service system used to get the issue solved also has

significant research value.

In 2022, Goldman et al. emphasized the

significance of the connection between evidence and

policy in mental health service research and proposed

the form of "policy review" (Goldman, et al, 2022).

On the basis of this new theoretical perspective, this

article focuses on what efforts China has put into

developing the mental health service system through

policies. Using the method of literature review, the

paper attempts to describe the unique environment

and features of the formation of China's mental health

service system in terms of policies, and summarizes

the current research status in this field from three

aspects: content, object and method, and points out

the deficiencies of the existing research in the policy

process and effect with the aim of pointing out the

direction for subsequent research and the intervention

of social work, and promoting the improvement of the

service system that is related to mental health in

China.

2 METHODS

This study selects core journals and CSSCI to search

for relevant academic research on the websites of

Web of Science and China National Knowledge

Infrastructure (CNKI), taking "psychology", "mental

health" and "policy" as the key words. Inclusion

criteria: (1) The text content is related to mental

276

Liu, D.

A Review of Mental Health Policies in China.

DOI: 10.5220/0014373200004859

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 1st International Conference on Politics, Law, and Social Science (ICPLSS 2025), pages 276-282

ISBN: 978-989-758-785-6

health and related support services; (2) Related to the

policy field; (3) The disciplinary background is

related to sociology or social policies. Through

retrieval, association search, inclusion and exclusion,

a total of 27 literatures were screened out as the

research objects. (See Table 1)

Table 1. General Situation of the literature.

Title Journal Autho

No Health without Mental Health Lancet Prince M., Patel V., Shekhar S.,

etal

Scale up of services for mental health in

low-income and middle-income

countries

Lancet Eaton J., McCay L., Semrau M.,

etal

Equity of access to health care services:

Theor

and evidence from the UK

Social Science &

Medicine

Goddard M., Smith P.

E-therapy: Practical, ethical, and legal

issues

CyberPsychology &

Behavio

Manhal-Baugus M.

Collaborative risk assessment in secure

and forensic mental health settings in the

General Psychiatry Markham S.

Building Bridges Between Evidence and

Policy in Mental Health Services

Research: Introducing the Policy Review

Article T

Psychiatric Services Goldman M.L., Swartz M.S.,

Norquist G.S., etal

Rogers’ Humanistic Educational

Thought and Its Significance

Journal of Sichuan

Normal University

(Social Science

Edition)

Zeng Deqi

The Development of Group Counseling

in China: Review and Prospect

Journal of Tsinghua

University (Philosophy

and Social Sciences)

Pei Fumin

Current Situation of Chinese College

Mental Health Education Faculties and

Polic

of Recommende

Journal of Hubei

University (Philosophy

and Social Science)

Feng Tielei

A Review of Researches on Internet

cholo

ical Counselin

Chinese Journal of

Special Education

Li Chengqi

Research and Practice of System of

Public Ps

cholo

ical Services

Bulletin of Chinese

Academ

of Sciences

Chen Xuefeng

From Mental Health Service to Social

Psychological Service: A Major

Innovation of Social Governance System

in China

The Journal of

Shanghai

Administration

Institute

Lin Ying, Jiang Junjie

Quantitative Analysis of China’s Mental

Health and Mental Hygiene Policy Text

in 1999

—

2023 Based on Polic

Tools

Modern Preventive

Medicine

Chen Xiaomin, Yang Jiamin,

Chen Dandi, etal

The Characteristics, Problems and

Optimization Paths of Mental Health

Service Policies in the New Era: An

Analytical Framework Based on Policy

Concepts, Goals and Tools

Academic Circle Liu Ziyi

The incremental logic of China mental

health policy making: An Interpretion

toward the Road of Mental Health

islation

Chinese Journal of

Health Policy

Zhao Deyu

Exploring the Impact of Online

Dia

nosis and Treatment Service Qualit

Chinese Journal of

Health Polic

Li Zhenlin, Guo Rui

A Review of Mental Health Policies in China

277

on Patients’ Continuance Intention Based

on the Standardized Patient Method:

Taking Online Mental Health Services as

an Example

Exploration on Approaches of Medical

Social Work Involved in Mental Health

Service in China

Medicine and Society Xie Yingying, Fan Minglin

The Coming Age of China’s Mental

Health Social Work and Practical

Research A

endas

Journal of Zhejiang

Gongshang University

Liu Jitong

Research on China's Adolescent Mental

Health Policies - Analysis Based on

PMC Index Model

Frontiers in Public

Health

Yang C.N.

The Public Psychological Service System

with Multiple Integrated Structures:

Policy-making Approach, Construction

Strate

and Core Conten

Advances in

Psychological Science

Wang Junxiu

Research and Prospect of Social

cholo

ical Service S

stem

Henan Social Science Zhang Yanjun

“Live for Yourself” or “Live Your Own

Way”——Rethinking the Localization of

Chinese Individualized Proposition

Exploration and Free

Views

Yan Yunxiang

The evolution of mental health related

policies in China: A bibliometric

anal

sis, 1987-2020

Frontiers in Public

Health

Li H.Y., Zhou Q.Y., Zhu H.,

etal

Mental health policy and implementation

from 2009 to 2020 in China

SSM-Mental Health Chen R.Z., Zhang W.F., Wu X

The Development and Evolution of

Community Mental Health Policies in

China from 1998 to 2013

China CDC Weekly Yan J., Yu X., Zhang X.L.

Mental Health Services in China:

Research on the Relationship between

Demands and Services

Studies of Psychology

and Behavior

Huang Xiting, Zheng Yong

A Study on Mental Health Service Needs

among Older Adults and the Policy

Response in China: Experiences in

Urban Shan

hai

Ageing International Chen H.L., Chen Y.Y., Wang

Y., etal

3 RESULTS

3.1 The Unique Environment and

Features of the Policies in China

The humanistic thought represented by Rogers has

led to the attention of developed states to mental

health issues (Zeng, 2003). In 2007, several authors

including M Prince, on behalf of the WHO, published

a paper reporting global mental health issues in The

LANCET, pointing out that mental health is

inseparable from physical health and that there are

complex interactions between mental health issues

and other health problems, and calling for attention to

mental health issues; subsequently, the follow-up

report released by J Eaton et al. in 2011 conducted a

comprehensive assessment of the expansion of

mental health services around the world through

systematic literature review and global surveys,

providing a practical action guideline for low- and

middle-income nations (Prince, et al, 2007; Eaton, et

al, 2011). However, their research only includes

literature in English, French and Spanish and fails to

fully explore how to adjust the service expansion

strategy according to the specific needs of different

regions; Against this background, Huang Xiting and

Zheng Yong pointed out the limitations of Western

theories in the context of Chinese culture in their

research and proposed the necessity of constructing a

ICPLSS 2025 - International Conference on Politics, Law, and Social Science

278

mental health service system combining traditional

Chinese culture and modern culture (Huang, Zheng,

2015). On this basis, Chen Xuefeng systematically

sorted out for the first time the policy evolution,

practical exploration and international experience of

the construction of China's public psychological

service system, and constructed a relatively complete

theoretical framework, proposing the development

path from psychological counseling to mental health

education and services (Chen, 2018). Chen

mentioned in his article that the core of the public

psychological service system is "to enhance the

mental health of people and foster harmonious and

stable development of society through mental health

services." Although the publication of his research

was later than that of Huang and Zheng's earlier

studies, given Chen's clear demarcation of relevant

definitions and the comprehensiveness and

systematicness of the analytical framework, his

research has become a major symbol of localized

research in China, providing inspiration for

subsequent research on Chinese characteristics.

Due to political and cultural factors, the

individualization process in China shows great

differences compared with that in Europe (Yan,

2021). Correspondingly, "mental health service

system" erected by Chinese government and those in

Europe or the United States have also taken

completely different routes: Different from the form

based on humanistic thought, which is relatively more

detailed and specialized and focuses on the cost of

medical services and patient participation in policies,

it presents a more macroscopic and "top-down"

feature (Goddard, Smith, 2011; Markham, 2020;

Zhang, 2023). That is, under the guidance of the

policies issued by the Party and the state, all sectors

of society carry out mental health services in

accordance with the policy texts and perform their

respective duties. However, due to the continuous

changes in the external environment, the incremental

and cost-saving characteristics of policy-making, the

logic of interpreting the mental health service system

within the Party and the state is inconsistent, the

relevant policies at the national level have undergone

multiple orientation changes (Zhao, 2012; Zhang,

2023). This leads to the fact that on the surface,

mental health policies are constantly introduced, so it

seems like the policy system tends to be improved and

the supporting measures are optimized. In reality,

however, there are still problems such as tension

between the old and new policies, imbalance among

various policy tools, and the main concentration of

policy objects in the health system and the education

system (Liu, 2023; Chen, et al, 2024).

3.2 Classified by Research Content

In terms of research content, scholars in China and

abroad have noticed the importance of online mental

health services at the first time and made a systematic

analysis of it (Li, 2007; Manhal-Baugus, 2001). After

the technical progress and the release of

"Administrative Measures for Internet-based Medical

Diagnosis (Trial)", Li Zhenlin and Guo Rui

mentioned the new situation and problems of online

mental health services in their research, but are

limited to the analysis of the method itself without

discussing existing policy impact of mental health

services online (Li, Guo, 2023). Schools where

teenagers and various ideological trends gather can be

said to be areas where the trend of individualization

is relatively obvious. Regarding mental health

services within the Chinese education system, Yang

Chengning, Fan Fumin and Feng Tielei respectively

made discussions on policy texts, consultation

models and the construction of the teaching staff, but

there is a problem of insufficient sample

persuasiveness (Yang, 2024; Pei, 2005; Feng, 2008).

Unlike individualization under the second modernity

in Europe, the individualization process in China is

led by the state, but the policy system has not yet been

fully established. This requires the foundation of a

social psychological service system to address the

problems that individuals encounter during the

process of embedding into the system. Since the

system's creation, Chen Xuefeng, Wang Junxiu, Lin

Ying and Jiang Junjie have all published pertinent

studies in an effort to pinpoint its precise location and

emphasize the fact that it is not just a mental health

service but also possesses social governance traits

(Chen, 2018; Lin, Jiang, 2019; Wang, 2020).

However, there is a lack of sufficient empirical

support, and the discussions on the cases (such as

Changning District, Shanghai)are relatively not

extensive. As the spokesperson of the government,

social work is directly connected to individuals and

forms an essential part of the social psychological

service system. Regarding the role of social work in

mental health services, Liu Jitong made a systematic

conception for the first time, constructed a practical

research agenda, and clarified the scope of the topics

(Liu, 2017). On this basis, Xie Yingying and Fan

Minglin pointed out the specific intervention paths

and analyzed the existing problems both theoretically

and practically (Xie, Fan, 2019). On this basis, Chen

R Z et al. not only conducted text analysis in the

research on how community mental health policies in

China have developed, but also took the 686 pilot

program as the core case, focusing on discussing the

A Review of Mental Health Policies in China

279

policy adjustments and implementation optimizations

that the project experienced from the pilot practice

(that is, verifying the feasibility of the policy through

local trials) at the beginning of its implementation to

the subsequent gradual promotion to the whole

country (Chen, et al, 2023).

3.3 Classified by the Research Object

The research objects of the literatures can be roughly

divided into policy content, policy process and policy

practice. The research on policy content accounts for

16 out of the existing 23 literatures, basically focusing

on policy objects, policy tools and policy goals.

Among them, a relatively typical one is the

quantitative study by Chen Xiaomin et al. on 144

national policy texts from 1999 to 2023 (Chen, et al,

2024). There are relatively few studies on policy

practice, totaling 4. Among them, the research of

Feng and Yan et al. mainly focuses on the

implementing subjects of mental health policy

practices, pointing out the actual state of policy

practices by describing their evolution (Feng, 2008;

Yan, Yu, Zhang, 2023). The research by Chen R Z et

al. comprehensively demonstrated the effectiveness

of policy practice through the collection of various

types of data and the qualitative analysis of the

transformation of service models (Chen, Zhang, Wu,

2023). Chen H L et al. conducted in-depth interviews

on the demand and supply predicament of services

aiming at improving mental health among the elderly

in Shanghai (Chen, et al, 2023). Starting from the real

situation and personal feelings of the policy objects,

they revealed the deficiencies of policy practice in the

actual effect. It should be pointed out that research on

the policy process is particularly rare. Among all the

research objects in this article, the only one is Zhao

Deyu's study on the process of the mental health

Legislation and the formulation logic of related

policies in 2012 (Zhao, 2012). However, after more

than ten years of development, the reality has

undergone tremendous changes. Many of the

problems and rules pointed out by Zhao in his article

are clearly no longer applicable.

3.4 Classified by Research Methods

In terms of research methods, Chen et al. established

a two-dimensional quantitative model of "policy tool-

policy object" by coding the policy text into software

(Chen, et al, 2024). Yang Chengning conducted a

pioneering quantitative assessment of 10 national

adolescent mental health policies through the PMC

index model (Yang, 2024). Li H Y et al. analyzed and

summarized the evolution trend of China's mental

health-related policies from 1987 to 2020 using

bibliometric analysis, and innovatively appropriated

the H-index into the field of policy analysis to

evaluate the influence of policy-issuing institutions

(Li, et al, 2022). The characteristics and problems of

China's mental health service policies in the new era

were analysed qualitatively by Liu Ziyi from three

dimensions: policy concepts, goals and tools, and

constructed an analytical framework based on policy

concepts, goals and tools (Liu, 2023). Zhao Deyu

established the "problem-tool-community" analysis

model and explained the logic of mental health policy

making and law formulation from four aspects:

supply, demand, social impact, formulation authority

and division of functional departments (Zhao, 2012).

Li Zhenlin and Guo Rui employed the "standardized

patient method" to explore the relationship between

the quality of online mental health services and

patients' willingness to continue using them (Li, Guo,

2023). These studies generally constitute the main

paradigms for the current research on domestic

mental health-related policies, providing

methodological guidance for subsequent studies.

4 DISCUSSION

The existing research has made a very detailed and

comprehensive analysis of national policy texts and

their evolution, providing various analysis models

such as "problem - tool - community", PMC index

model, and analysis perspectives such as "demand -

service relationship", "policy concept, goal and tool"

for the quantitative analysis of mental health policy.

It reveals the status quo that the mental health policy

system in China is constantly optimizing and

developing and the legal guarantee system is no

longer missing, as well as problems such as multi-

level imbalances among various policies and the

underdevelopment of community grassroots and

social psychological service institutions.

However, there are significant differences in

social, economic and cultural aspects among various

regions in China, and the two-way influence between

this and local mental health policies is also quite

obvious. For instance, while the development level of

online mental health services in first-tier cities is

relatively high, the number of related institutions

established in some provinces is almost zero. Existing

researches are generally limited to the national policy

level, lacking systematic statistics and differential

analysis of local policies. Moreover, there are few

studies on the policy process and the actual

ICPLSS 2025 - International Conference on Politics, Law, and Social Science

280

implementation effect of policies, especially the lack

of long-term empirical research from the perspective

of policy objects (such as the elderly group, the

student group, etc.). This academic field has remained

almost blank until now.

In addition, models adopted in the current

quantitative research are relatively isolated.

Basically, policy texts are encoded, and then the

patterns are summarized through static classification

and frequency analysis. This method is only able to

assess the completeness of the policy text and the

comprehensiveness of the description, which fails to

take into account the time factor, the synergy of

multiple policies and their common influence, and

cannot directly judge the actual effect or superiority

or inferiority of the policy. The analysis of the issuing

institutions of policies is limited to generating

relationship diagrams or expanding based on the h-

index, that is, the number of citations. This method is

obviously insufficient for in-depth analysis of the

coordination and competition process among various

policy subjects. New parameters need to be

introduced as a common reference for further

explaining the multi-departmental collaboration

mechanism.

5 CONCLUSION

This study focuses on the review and analysis of 27

literatures at home and abroad. Studies show that the

construction of China's mental health service system

relies on the introduction of government policies, and

the orientation of the policies themselves has

currently shifted to "mental health". Existing research

on policy texts has pointed out the imbalance of

policy tools and the bias of policy objects. This

requires all regions to establish a complete social

psychological service system in order to supplement

the deficiencies of government policies. Based on the

consideration of China's socialist ideology and the

policy system characterized mainly by "top-down",

the grassroots governance organization among the

policy objects that has the closest relationship with

the people, namely the "community", should have

been a part that plays an important role in dealing with

the mental problems faced by individuals in the

process of embedding, de-embedding and re-

embedding of drastically changing externalities.

However, existing research indicates that the policies

and measures of the Chinese government in this

regard are still in the initial stage of development and

the construction is not sufficient. Considering that the

national vocational qualification certification for

psychological counselors was abolished in China in

2017 and the relevant industry management has not

been fully established, social work should play a role

with great potential at present. However, there are

problems such as uneven professional levels of social

workers, unclear positioning, and insufficient

professional identity.

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