Development and limits to development of mental health services in China
Criminal Behaviour and Mental Health (Impact Factor: 1.28). 06/2006; 16(2):69-76. DOI: 10.1002/cbm.626
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ABSTRACT: There are currently around 120 million rural-urban migrants in China. Elsewhere migration has been associated with increased vulnerability to mental health problems. This study was conducted to explore the mental health status and help seeking behaviours of migrant workers in Hangzhou city, Zhejiang Province, and to compare them with permanent urban and rural dwellers. A self-completion questionnaire including items relating to sociodemographics, health and lifestyles and mental health, was completed by 4453 migrant workers and 1957 urban workers in Hangzhou city, and by 1909 rural residents in Western Zhejiang Province. The mean age of the migrants was 27 years, (male 29 years, female 25 years). They worked long hours (28% >12 h per day, 81% 6 or 7 days per week) and their living conditions were very basic. On the SF-36 mental health scale migrants had lower scores (52.4) than rural residents (60.4, P < 0.0001) but scored higher than urban residents (47.2, P = 0.003). The difference between urbanites and migrants disappeared after adjustment for confounders (P = 0.06). Independent predictors of better mental health status among migrants were being unmarried, migrating with a partner, higher salary, good self-reported health and good relationships with co-workers. There were small significant differences in suicide ideation and attempts between the three groups with suicide ideation commonest in migrants and suicide attempts most common in the rural population. Fewer than 1% across all three groups had received any professional help for depression or anxiety. Rural-urban migrant workers in this part of China are not especially vulnerable to poor mental health. This may result from a sense of well being associated with upward economic mobility and improved opportunities, and the relatively high social capital in migrant communities.
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ABSTRACT: To date, there is no systematic analysis of mental health laws and their implementation across the People's Republic of China. This article aims to describe and analyze current legal frameworks for voluntary and involuntary admissions of mentally ill patients in the five cities of China that currently have municipal mental health regulations. Information on the legislation and practice of involuntary admission in the five cities was gathered and assessed using the "WHO Checklist on Mental Health Legislation." The checklist was completed for each city by a group of psychiatrists trained in mental health legislation. Although the mental health regulations in these five cities cover the basic principles needed to meet international standards of mental health legislation, some defects in the legislation remain. In particular, these regulations lack detail in specifying procedures for dealing with admission and treatment and lack oversight and review mechanisms and procedures for appeal of involuntary admission and treatment. A more comprehensive and enforceable national mental health act is needed in order to ensure the rights of persons suffering mental illness in terms of admission and treatment procedures. In addition, more research is needed to understand how the current municipal regulations of mental health services in these cities are implemented in routine practice.
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