Adolescent mental health in China requires more attention
Authors: Chun Wang, Pei Zhang, Ning Zhang
Journal: The Lancet Public Health (2020)

Self-harm during adolescence can be associated with future suicide attempts.1Mars B Heron J Klonsky ED et al.Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study.Lancet Psychiatry. 2019; 6: 327-337Summary Full Text Full Text PDF PubMed Scopus (141) Google Scholar In China, rapid socioeconomic development has been associated with changes in social structure, discrepancies in development between urban and rural areas, a rapid increase in the urban population, increased social pressure and competition, and changes in family structure. For teenagers, high academic requirements and psychological pressure can lead to an increase in negative emotions. Worldwide, the prevalence of non-suicidal self-harm in children and adolescents is about 19·5%;2Lim KS Wong CH McIntyre RS et al.Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: a meta-analysis.Int J Environ Res Public Health. 2019; 16e4581Crossref PubMed Scopus (94) Google Scholar however, in China, estimated prevalence in middle school students (aged 13–18 years) is 27·4%.3Han AZ Xu G Su PY A meta-analysis of characteristics of non-suicidal self-injury among middle school students in mainland China.Chin J Sch Health. 2017; 11 (in Chinese).: 1665-1670Google Scholar Non-suicidal self-harm behaviour is not only an issue for psychiatry, but also a complex societal issue. With 189 million school children and about 28 million undergraduate college students in China,4National Bureau of Statistics of ChinaChina statistical yearbook.http://www.stats.gov.cn/tjsj/ndsj/2019/indexch.htmDate: 2019Date accessed: September 24, 2019Google Scholar the scale of the issue could be enormous. The Healthy China Action (2019–30) plan includes explicit references to initiatives to promote both mental health and school students' health.5National Health Commission of the People's Republic of ChinaHealthy China Action (2019–2030).http://www.nhc.gov.cn/guihuaxxs/s3585u/201907/e9275fb95d5b4295be8308415d4cd1b2.shtmlDate: July 15, 2019Date accessed: July 9, 2019Google Scholar In December 2019, the Chinese Health Commission, Ministry of Education, and ten other government departments launched a joint action plan with a specific focus on child and adolescent mental health. The action plan mandated that by 2022, all levels and types of school should set up psychological service platforms to provide mental health services to students, and 60% of mental health hospitals that at or above the second level (ie, between basic and high level medical services in the Chinese system) should set up outpatient services for children and adolescents. All regions of China are to set up or improve access to psychological assistance hotlines, and promote mental health awareness among children and adolescents, with the aim of reaching 80% of this population.6National Health Commission of the People's Republic of ChinaHealthy China Action—mental health action plan for children and adolescents (2019–2022).http://www.nhc.gov.cn/jkj/dongt/201912/0f680d618ccc45e586e7ae9cf1875891.shtmlDate: Dec 26, 2019Date accessed: December 26, 2019Google Scholar Although the government has introduced important policies that give more attention to mental health, more research and guidance for professionals are needed to establish an interconnected mental health system, which could provide the professional services for schools, communities, and families, and improve the mental health and wellbeing of adolescents in China. We declare no competing interests. Strengthening public health in ChinaSince the emergence of COVID-19 in December, 2019, in Wuhan, China has recorded 92 000 cases and 4749 deaths and seems to have brought its outbreak under control. While the COVID-19 pandemic has shaken Chinese society, the country's long-term future health challenge will be tackling a growing burden of non-communicable diseases. According to the Global Burden of Disease Study (GBD) 2019, the four leading causes of morbidity and mortality in China are ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer, and the leading disease risk factors are tobacco smoking, high systolic blood pressure, and dietary and air pollution risks. Full-Text PDF Open Access