Phillips suggests improving healthcare quality of town-level and county-level hospitals first. Improvements could include bringing in psychiatrists to practice there part-time, with the bigger picture for village doctors to learn from them.

Last year China announced its first mental health law to protect the patients, which is being viewed as a major breakthrough.

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However, many details are still not clear, Phillips says, such as whether the financial support will come from the central government or local governments, how long it will last, how it would be implemented and if the richer provinces will take more responsibility than the poorer provinces.

"Despite all the economic change and urbanization in the country, my own feeling is the ratio of mental illness is fairly stable in China." he says.

More alcohol and drug abuse cases have surfaced recently, but the numbers remain much lower than high-income countries, he says.

"The suicide rate in China dropped by 50 percent over the past 20 years, while in other countries such as South Korea, the rate has gone up threefold," says Phillips, who is also the China representative to the International Association of Suicide Prevention.

Many factors have influenced the drop in suicide rates, including widespread economic improvements that have left fewer people below the poverty line.

Another factor is rapid urbanization which has seen millions of people moving into cities. Data show that one-third of suicides in China are impulsive acts, with many caused by the consumption of pesticide, which is less available in urban settings than it would be rurally.

"I think what China learns will be relevant to other middle income countries, especially large middle-income countries with large rural populations," Phillips adds.

China's investment in mental health has increased substantially. For example, it has launched the "868 program" to identify and monitor severe mental illness in communities and to offer free medicines.

Drug studies are being carried out by Chinese scholars using traditional medicines to deal with mental illness, such as ginkgo biloba herbal supplements to treat early-stage dementia.

Despite all the efforts, a big gap between the budget and the healthcare burden still exists. According to Phillips, mental health issues account for 11 percent of China's total healthcare burden or more, but they only account for 3 to 4 percent of the annual health budget.

The WISH report shows that in high-income countries, spending on mental health accounts for more than 5 percent of the annual healthcare budget, while in low- and middle-income countries, it is about 2 percent.

 

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